Oral health status and academic performance among Ohio third-graders, 2009-2010.

OBJECTIVE: Although recent literature indicated an association between dental caries and poor academic performance, previous work relied on self-reported measures. This analysis sought to determine the association between academic performance and untreated dental caries (tooth decay) using objective measures, controlling for school-level characteristics. METHODS: School-level untreated caries prevalence was estimated from a 2009-2010 oral health survey of Ohio third-graders. Prevalence estimates were combined with school-level academic performance and other school characteristics obtained from the Ohio Department of Education. Linear regression models were developed as a result of bivariate testing, and final models were stratified based upon the presence of a school-based dental sealant program (SBSP). RESULTS: Preliminary bivariate analysis indicated a significant relationship between untreated caries and academic performance, which was more pronounced at schools with an SBSP. After controlling for other school characteristics, the prevalence of untreated caries was found to be a significant predictor of academic performance at schools without an SBSP (P=0.001) but not at schools with an SBSP (P=0.833). CONCLUSIONS: The results suggest the association between untreated caries and academic performance may be affected by the presence of a school-based oral health program. Further research focused on oral health and academic performance should consider the presence and/or availability of these programs.

School-based survey participation: oral health and BMI survey of Ohio third graders.

During the 2009-2010 school year, the Ohio Department of Health conducted a statewide oral health and body mass index (BMI) screening survey among 3rd grade children. This marked the fifth school-based survey regarding the oral health of Ohio children since 1987. At 50 %, the participation rate of the 2009-2010 oral health and BMI survey was at the lowest level ever experienced. This study aimed to identify the factors associated with participation rates in a school-based survey. A stratified, random sample of 377 schools was drawn from the list of 1,742 Ohio public elementary schools with third grade students. All third grade children in the sampled schools with parent or guardian consent received an oral health screening and height/weight measurement by trained health professionals. Participation rates at the school level were then combined with data on school characteristics and survey implementation. Predictors of school form return, participation, and refusal rates were assessed by generalized linear modeling (GLM). High student mobility and larger school size were associated with lower form return (p = 0.000 and p = 0.001, respectively) and lower participation rates (p = 0.000 and p = 0.005, respectively). Surveying in the fall or spring (as opposed to winter) significantly decreased form return (p = 0.001 and p = 0.016, respectively) and participation rates (p = 0.008 and p = 0.002, respectively), while being surveyed by internal staff (versus external screeners) significantly increased form return (p = 0.003) and participation rates (p = 0.001). Efforts to increase participation should focus more on schools with higher student mobility and larger size. Additionally, participation could be improved by using internal staff and surveying during winter.

Targeting school-based dental sealant programs: who is at "higher risk"?

OBJECTIVES: To assess the effect of various school-level Free and Reduced Price Meal Program (FRPMP) enrollment-based risk thresholds on the ability of school-based sealant programs (S-BSPs) to reach higher risk children. METHODS: We used data from a statewide third grade oral health survey to compare: a) prevalence of dental caries for higher-risk children, using three different sets of child risk criteria based on social determinants; and b) dental caries and other access-related indicators for children at higher-risk schools based on four FRPMP-based thresholds (> or = 60 percent of children FRPMP-enrolled, > or = 50 percent, > or = 40 percent, > or = 30 percent). In addition, we used school enrollment and FRPMP enrollment data to compare the percentages of eligible schools and of higher-risk children resulting from the various thresholds. RESULTS: The prevalence of caries experiences and untreated caries were not significantly different for higher risk children categorized by the respective child caries risk criteria. Regardless of school-level risk threshold, children at higher risk schools were more likely to have caries experience, untreated caries, and no recent dental visit and less likely to have private dental insurance than children at lower risk schools. For these measures, children at higher risk schools were similar to each other regardless of risk threshold and were similar to higher risk children at all schools. The number of additional higher risk children per additional higher risk school showed a large decline between the 40-49 percent and 30-39 percent FRPMP enrollment tiers. CONCLUSIONS: Targeting higher risk schools to reach higher risk children is a practical and effective approach for increasing sealant prevalence through S-BSPs.