Overview and quality assurance for the oral health component of the National Health and Nutrition Examination Survey (NHANES), 2009-2010

J Public Health Dent. Summer 2014;74(3):248-56. doi: 10.1111/jphd.12056. Epub 2014 May 22.


Objective: In 2009-2010, the oral health component for the National Health and Nutrition Examination Survey (NHANES) focused on adult periodontal health and included a full mouth periodontal examination as well as a series of questions adminis during the home interview. During this period, intraoral assessments were conducted by dental hygienists.

Methods: This report provides oral health content information and results of dental examiner reliability for data collected during NHANES 2009-2010 on 7,189 persons aged 3-19 years and 30 years and older representing the US civilian, noninstitutionalized population in these age groups.

Results: For caries and dental sealant assessments, Kappa statistics ranged from 0.71 to 1.00. Kappa scores for moderate and severe periodontitis using the Centers for Disease Control and Prevention/American Academy of Periodontology case definition guidelines was 0.70, but were lower for other periodontal status definitions. When defining moderate or severe periodontitis based on the NHANES 2003-2004 study, protocols using data from only three facial periodontal sites, the Kappa scores were 0.64 and 0.55. Interclass correlation coefficients (ICCs) for mean attachment loss were 0.80 or higher for both examiners. Site-specific mean attachment loss ICCs were generally higher for interproximal measurements compared with mid-facial and mid-lingual measurements.

Conclusion: Overall, the data reliability analyses conducted for 2009-2010 indicate an acceptable level of data quality and that examiner (dental hygienist) performance in this data collection cycle is similar to prior survey periods since the NHANES continuous survey began in 1999.

Keywords: NHANES; data reliability; dental public health; epidemiology; oral health; periodontal disease; quality assurance; surveillance.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Humans
  • Nutrition Surveys
  • Oral Health*
  • Quality Assurance, Health Care*
  • United States
  • Young Adult