Master's Project Title:

An Oral Health Assessment of High-Risk Third Grade Students: Results from the Minnesota Basic Screening Survey (BSS) 2010 and Public Health Implications

MCH Student:

MaiSee Moua

Date of Defense:

July 11, 2013


Dental caries is the most common childhood chronic disease. Scientific evidence shows  that children are more vulnerable than any other age groups for  oral diseases, which can  jeopardize their physical growth, self-esteem and capacity to socialize. Disparities in  disease, health outcomes, and access to health care across racial, ethnic and  socioeconomic groups exist within this population. This paper aims to identify  oral health  disparities within underserved populations, which can guide public health professionals  to explore and implement strategies to eliminate inequalities and disseminate health  equity to this group.

We conducted a Basic Screening Survey (BSS) to describe the prevalence of caries,  fillings, and sealants, as well as treatment urgency. We used a simple random sample of  40 schools to provide a statewide estimate for students in third grader for  oral health  indicators. With the limited sample size, we could not describe findings on race and  other factors. Therefore, we selected ten sentinel schools using race, proportion of  free/reduced – price lunch, and urban/rural status; these had higher proportions of students  from minority and/or lower socioeconomic communities representing the disparities in  oral health.

Sentinel school third graders had rates of dental sealants comparable to third graders  statewide (62% vs 64%), much higher than that of the US average (32%). The prevalence  of caries experience was almost 50% higher than that of  the state (77% vs 55%) and the  US average (52%). The prevalence of untreated caries was almost double that of the  statewide average (35% vs 18%) and higher than that of the US (29%).

We devised a sentinel approach to gather  oral health data. The most common use of  sentinel sites is by infectious disease specialists to identify trends/changes in a single  indicator. Our approach allows estimates to be generated that are indicative of the health  status of sub – populations at a lower cost than large,  statewide surveys. In sentinel  schools, a high prevalence of untreated caries and caries experience existed despite a high  sealant rate. This may be due to the high proportion of immigrants and lack of prior  fluoridation exposure. Further progress in eliminating disparities and improving better  access to quality  oral health care for those without such services will require efforts and  collaboration from state and local governments and communities.