Association‌ of‌ State‌ &‌ Territorial‌ Dental‌ Directors
3858‌ Cashill Blvd.,‌ Reno,‌ NV‌ ‌89509
Phone‌ 775-626-5008‌‌

Data and Oral Health Surveillance

The Association provides technical assistance and support for to state and territorial oral health programs for state and territorial-based oral health surveillance, the National Oral Health Surveillance System (NOHSS), Behavioral Risk Factor Surveillance System (BRFSS), Youth Risk Behavior Surveillance System (YRBSS), Pregnancy Risk Assessment Monitoring System (PRAMS), Synopses of State Dental Public Health Programs (State Synopses), Basic Screening Survey (BSS) training and technical assistance, and any chronic disease or maternal and child health related data requests or technical assistance. Two coordinators and various advisory groups work to accomplish all objectives. The two coordinators also provide technical assistance and training to states on oral health assessment and surveillance.

Oral Health Data, My Water's Fluoride, ASTDD State Synopses of Dental Public Health Programs

State Synopses Questionnaire webcast - Dr. Kathy Phipps, ASTDD Data and Oral Health Surveillance Coordinator, provided an overview of changes to the annual ASTDD State Synopses questionnaire. She provided guidance on completing the survey and answered questions from the audience. (January 2023)
Synopses Webinar PowerPoint

My Water's Fluoride - This CDC Web site allows consumers to find basic information about their water system, including the number of people served by the system and the target fluoridation level. Currently, 26 states provide CDC with this information.

Revision to the National Oral Health Surveillance System (NOHSS) Indicators This position statement, developed and approved by the Council of State and Territorial Epidemiologists (CSTE), describes the process used to update the NOHSS indicators in 2015.

Development and Status of the National Oral Health Surveillance System
This manuscript, published in Preventing Chronic Disease (April 2009), describes the development of the National Oral Health Surveillance System.

State Synopses Summary Report 2022 - This report contains aggregated data for responses to selected items on the 2020-2021 State Synopses of Dental Public Health Programs.

State Synopses 2022 Infographics

State Synopses 2020 Infographics

ASTDD Basic Screening Survey (BSS) Resources

ASTDD BSS Toolkit - This downloadable toolkit contains all of the information you will need to plan and conduct a BSS of children or vulnerable older adults.

ASTDD provides technical assistance with the BSS tool and other aspects of data surveys such as sampling and data analysis. To request assistance, download the Data Technical Assistance Request Form and e-mail to Christine Wood, Executive Director of ASTDD at

States with BSS Oral Health Data - This resource lists all states that have data obtained through a BSS of preschool or3rd grade children or older adults. When available, links to state BSS reports are provided.

Basic Screening Surveys: Monitoring Community Oral Health Presentation by Dr. Kathy Phipps for the UCSF DPH 175 Dental Public Health Lecture Series on March 3, 2020.

National Health and Nutrition Examination Survey Data and BSS Indicators - Many of you have asked for national estimates that coincide with BSS indicators. CDC used data from the 2011-2016 National Health and Nutrition Examination Survey (NHANES) to generate estimates that are similar to what we collect during a BSS. The data collected by NHANES does not match what is collected during a BSS but these estimates are close. For example, NHANES does not ask for a child's current grade – they ask for the highest grade completed. The assumption was made that children with 2nd grade as their highest grade completed are in 3rd grade. NHANES doesn't have information for kindergarten enrollment so the estimates provided are for children aged 5 years. Please contact Kathy Phipps ( if you have any questions.

ASTDD Turning Data into Action Webcast Series

Data Into Action: Using Coalitions and Partners to Spread the Message - Representatives from the Children's Health Alliance of Wisconsin and Washington Dental Service Foundation talked about how to use outsides partners for data dissemination and advocacy. (August 2017)
Turning Data into Action: Oral Health Infographics State Examples - During the sixth webcast in this series representatives from Arizona and New Hampshire discussed how they developed and used oral health specific infographics. (August 2017)

Turning Data into Action: Web-based Oral Health Data Systems - In the fifth of this seven part webcast series, representatives from Colorado and Minnesota discussed how they developed their web-based data systems with special emphasis on the target audience and necessary resources. (July 2017)

Turning Data into Action: Infographics - In the 4th of this seven part series, Carole Stampfel from the Association of Maternal & Child Health Programs provided an introduction to infographics including what they are, how they can be used and how they should be developed. (June 2017)

Turning Data into Action: Using the CDC Oral Health Data Portal to Visually Depict Oral Health Data - In the third in this series of webcasts, CDC Division of Oral Health staffer, Valerie Robison, demonstrated how to use the data portal portion of CDC's Oral Health Data web platform for data analysis, visualization and export. (June, 2017)

Turning Data into Action: A Developing and Using State Oral Health Data Reports- Representatives from Hawaii and Vermont discussed how they developed their oral health reports and how they have used the reports for program planning, program evaluation and advocacy. (June 2017)

Turning Data into Action: The Importance of Data Dissemination Webcast - ASTDD's Data and Surveillance Coordinator, Dr. Kathy Phipps, provided an overview of why data dissemination is important and why it's a key component of any surveillance system (May 2017)

ASTDD Emergency Department Data Resources

Recommended Guidelines for Surveillance of Non-Traumatic Dental Care in Emergency Departments - The purpose of this document is to provide a standardized framework for how state oral health programs (SOHPs) should evaluate and document the use of emergency departments (EDs) for non-traumatic dental conditions (NTDCs). By following this guidance, SOHPs will be able to compare their ED data to information from other states and have the ability to assess trends in ED use over time. (Updated July 2022)

National Surveillance Data of Non-Traumatic Dental Care in Emergency Departments Available Upon Request - The 2014 National Emergency Department Survey (NEDS) dataset has been acquired by ASTDD from the Healthcare Cost and Utilization Project (HCUP). NEDS is a nationally representative sampling of state data collected through the State Emergency Department Databases (SEDD) system, the system used by most of the states. The NEDS data has been analyzed using the same protocols and diagnosis code sets to provide the ED oral care surveillance indicators that ASTDD recommends for states in the documents, Guidance on Assessing Emergency Department Data for Non-Traumatic Dental Conditions and Recommended Guidelines for Surveillance of Non-Traumatic Dental Care in Emergency Departments. For states conducting such analysis of their state's SEDD data, comparisons of state findings to national estimates may be of interest. These national estimates can be obtained from Mike Manz ( upon request. (December 2017)

Methods in Assessing Non-Traumatic Dental Care in Emergency Departments
This report is a review of studies on the use of emergency departments (EDs) for non traumatic oral health conditions. As with most public health problems, the first steps in addressing the issue are to confirm its existence and quantify its extent. This report explores the extent of variation in the different aspects of research conducted, including target populations, outcomes of interest, predictive factors investigated, data sources used, and specific research methods employed including the diagnostic codes used in defining ED dental care. This report presents the findings of the investigation, summarizes the positive and negative aspects of the findings, and provides recommendations on the conduct of future research. (January 2016)

Methods in Assessing Non-Traumatic Dental Care in Emergency Departments Appendices - The appendices include information taken verbatim from the respective websites. (January 2016)

Methods in Assessing Non-Traumatic Dental Care in Emergency Departments Publications Update (February 2022) - This document provides a listing of additional publications related to the use of emergency departments for non-traumatic oral conditions published since the report, Methods in Assessing Non-Traumatic Dental Care in Emergency Departments was completed. These publications were found using the same search criteria used to complete the literature search for the initial report. This listing of publications may be useful to those interested in information and results from the most recent studies published on this topic. This list is being updated periodically.

Other Data and Surveillance Resources

American Dental Association Health Policy Institute
The Health Policy Institute (HPI) generates, synthesizes, and disseminates innovative research on a variety of topics that are relevant to policy makers, health care advocates, and providers within the U.S. dental care system. Some of the key issues that HPI focuses on include the impact of health reform on the dental care sector, access to dental care for key populations, dental practice economics, dental care service delivery and financing, and dental education.

ASTDD Best Practice Approach Report - State-based Oral Health Surveillance System - A Best Practice Approach is defined as a public health strategy that is supported by evidence for its impact and effectiveness. A Best Practice Approach Report captures key information that describes the public health strategy, determines the strength of evidence, and illustrates implementation with current practice examples. (February 2023)

ASTDD Making Data Count: Slide presentation by Matt Jacob on communicating data effectively to increase awareness of oral health needs and outcomes. (September 2022)

ASTDD's Oral Health Surveillance Plan Template If your state does not have a written oral health surveillance plan or has one that needs to be updated, then you might be interested in the template. It is designed to help states with the cumbersome process of writing, revising or updating an oral health surveillance plan. The template is a complete surveillance plan document that, with a small amount of effort, can be modified to a customized document for your state. The template includes background information on the importance of public health surveillance, the importance of oral health surveillance, and a core set of indicators to include in a state oral health surveillance system (OHSS). (May 2016)

Oral Health Surveillance Plan Template Instructions

ASTDD and the Children's Dental Health Project Making Oral Health Count: Toward a Comprehensive Oral Health Measurement System: The DentaQuest Foundation funded the Association of State and Territorial Dental Directors (ASTDD) and the Children's Dental Health Project (CDHP) to systematically gather input from oral health advocates, provider groups, and federal agency officials responsible for oral health data to develop this issue brief that outlines some of the strategies needed to achieve a comprehensive Oral Health Measurement System. (December 2017)

ASTDD Webcast: Using the National Oral Health Surveillance System to Set Targets - Mary Davis, DrPH, MSPH, owner of Project Y Evaluation Services, LLC and an ASTDD Evaluation Consultant and John O'Malley, MHI, owner of Positive Sum Health Informatics and developer of the ASTDD National Oral Health Data Portal (NOHDP) presented about the National Oral Health Surveillance System (NOHSS) which monitors the burden of oral disease, use of the oral health care delivery system, and the status of community water fluoridation nationally and by state. States can use NOHSS indicators to monitor these areas and, with partners, create action plans to improve oral health within their communities. Watch the recording to learn about the NOHSS indicators and how states/territories can set targets using data from the system. (August 2022)

BRFSS (Behavioral Risk Factor Surveillance System)
Searchable database by year and category of the Behavioral Risk Factor Surveillance System. Most states participate in this survey and provide oral health data. Search on "oral health" to view data on the oral health questions.

BRFSS/PRAMS/YRBS State Added Questions - This list of optional state added BRFSS, PRAMS and YRBS questions from 2016 - 2022 was compiled based on responses to a query to state dental directors.

Compendium of ASTDD Oral Health Data and Surveillance Resources - This compendium provides a brief description of data and surveillance resources available from ASTDD and other organizations. (March 2022)

Compendium of ASTDD Emergency Department Data Collection Resources - This compendium provides a brief description of emergency department data collection resources available from ASTDD (March 2022)

Fedstats - This website is the gateway to statistics from over 100 US Federal Agencies.

HDPulse: An Ecosystem of Health Disparities and Minority Health Resources from NIMHD. HDPulse consists of two easy-to-use portals: a Data Portal and an Intervention Portal (forthcoming in Fall 2018). The Data portal will help public health professionals and researchers identify, track, and study issues related to health disparities, and the Intervention portal will offer evidence-based interventions to improve minority health and health disparities. The Data Portal houses data collected from public health surveillance systems, published reports, and public use files.

HP 2020 Midcourse Review. Chapter 32. Oral Health

Letter from CDC regarding changes to the BRFSS (October 2012)

National Center for Health Statistics
NCHS is the Nation's principal health statistics agency, compiling statistical information to guide actions and policies to improve health. The website displays information on major national surveys such NHANES, the National Health Interview Survey, the National Health Care Survey and the National Vital Statistics System.

Partners in Information Access for Public Health Workforce
This website contains many links to health statistics, data sets, and resources to support data collection.

PRAMS (Pregnancy Risk Assessment Monitoring System)
PRAMS is a surveillance project of the CDC and state health departments. Developed in 1987, PRAMS collects state-specific, population-based data on maternal attitudes and experiences before, during, and shortly after pregnancy.

State-Based Oral Health Surveillance Systems: Conceptual Framework and Operational Definition - The Council of State and Territorial Epidemiologists (CSTE), in collaboration with ASTDD, published this document that provides (1) an overview of oral and craniofacial health surveillance at national and state levels, including components of a state oral health surveillance system (SOHSS), (2) an overview of the development and revision of the National Oral Health Surveillance System (NOHSS) and of other national public health surveillance initiatives, (3) a new operational definition for HP2020 Objective OH-16 (Increase the number of states and DC that have an oral and craniofacial health surveillance system), and (4) a discussion of future potential changes and directions for oral health surveillance systems. (October 2013)

State Oral Health Surveillance System Report - This example from the Oregon State Oral Health Program, shows how information about state oral health data can be shared with stakeholders in an easy to read, easy to update format.

State Surveillance Data Reference Guide The purpose of this reference guide is to provide information on sources of oral health data that are available at the state level and can be used for a state-based oral health surveillance system. It lists available oral health indicators, identifies if the indicator is a NOHSS or Healthy People indicator, and provides information on the primary data source. The guide includes three tables: Table 1: Quick Reference Guide for the National Oral Health Surveillance System Indicators by Topic Area, Table 2: Quick Reference Guide for the National Oral Health Surveillance System Indicators by Population Group and Table 3: Detailed State Surveillance Data Reference Guide by Population Group All Oral Health Data.

Title V Information System
This website contains all types of information relating to the Title V MCH Block Grants, including state needs assessments and profiles, data reports, and national and state performance measures. It is a searchable database.

Using Oral Health Data to Inform Decisions and Policy Development
Have you collected oral health data and are wondering how to best use and present the data? If yes, then this helpful document is for you. It provides tips for the use and presentation of complex oral health data so that the information is understandable and meaningful for a non-dental audience. It also provides a list of resources ranging from a communications toolkit to developing a "plain English" document.

YRBS (Youth Risk Behavior Surveillance System)
The Youth Risk Behavior Surveillance System monitors six types of health-risk behaviors that contribute to the leading causes of death and disability among youth and adults.

State Examples