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10 Dental Health Data

Dental Health Data

Public health dental data in Ontario come from three main sources: Ontario Dental Indices Survey (DIS), Oral Health Screening, and Children In Need Of Treatment (CINOT) program. All of these data are collected by public health units and contain information for children only.

Ontario Dental Indices Survey (DIS)

Original source: Public Health Unit
Distributed by: Public Health Unit
Suggested citation (see Data Citation Notes):
Dental Indices Survey [years], Extracted: [date]

Data Notes

  • The Ontario Dental Indices Survey (DIS) collects data on the dental health of children for use at the public health unit level.

  • The objectives of the DIS are4:

    - To provide a means of measuring dental health status of Ontario school entrants;
    - To identify “at risk” segments of the school aged child population who would most benefit from targeted oral health education and preventive programs;
    - To determine the prevalence of dental disease and to determine needs for prevention and treatments;
    - To help determine the best allocation of provincial resources for oral health programs;
    - To assist with program planning;
    - To provide a means to evaluate the effectiveness of existing programs; and
    - To monitor provincial trends and allow for interprovincial comparisons in the oral health status of school entrants.

  • The DIS was initiated by the Ontario Ministry of Health in 1971, and was conducted biennially until 1990 when a four-year cycle began. The survey was initially designed to include a sample of odd-aged children aged 5 to 13 years who were attending a publicly funded school at the time of the survey. Data were collected by public health units and subsequently sent to the MOH for analyses. Each public health unit received a standard report summarizing the findings of the survey for their health unit area and for the province. Prior to the 1993-94 survey, health units devised their own sampling frames. In 1993, the Ministry determined the sampling frame in order to have more consistent methodology across Ontario.

  • Survey procedures changed in 1997. The Mandatory Health Programs and Services Guidelines now require that Boards of Health conduct the DIS in accordance with the Dental Indices Survey (DIS) Protocol. The Protocol for January 1, 19981

    specifies that the DIS be done for all school entrants (Junior Kindergarten and Senior Kindergarten) in every school annually.

  • Some health units may conduct the DIS for other grades as well.

  • The DIS collects the following information for each child1:

  • Demographic data: health unit number, examiner, recorder, planning area (optional), school code, survey date, school quintile (risk level), child’s name, sex, date of birth, postal code, grade, absent/present/refused, county of origin, water fluoridation;

  • Dental indices: fluorosis index, periodontal indices (GI, DI, CI), malocclusion (optional), deft/DMFT, CINOT eligible (dental), non-urgent treatment required, scaling required, prophylaxis required, sealant required, fluoride required, preventive instruction required.

  • Although public health units are required by Mandatory Health Programs and Services Guidelines to conduct the DIS for all school entrants, many do not have sufficient resources and instead sample only some of the children. Each public health unit uses a different methodology depending upon local resources. As a result, the DIS is not comparable across health units. Comparisons within a health unit over time may be appropriate as long as the sampling methodology has remained consistent.

  • The DIS is conducted primarily by dental hygienists using standard dental indices and equipment (a sterilized Ash #3 pigtail explorer). Training and calibration of the dental hygienists is done by health units with no provincial calibration. Two people conduct the DIS: an examiner and a recorder. The examiner calls out the tooth number and status, and the recorder enters the information on to a laptop computer.

  • Children who are absent from school on the day of the DIS, schooled at home or who refuse are excluded. Children living on native reserves, military bases, in institutions or attending private schools are also excluded.

  • Historical data may not be available from the Ministry of Health for comparison purposes because some of these data were lost. The 1997/98 provincial data does not exist.

  • Rates and proportions based on counts less than 5 must be suppressed.

References and Resources

  1. Ministry of Health, Dental Indices Survey (DIS) Protocol, Child Health Program. January 1, 1998.

  2. Farrell, V. Ontario Dental Health Indices Health Unit Procedures. March 1983.

  3. Central East Health Information Partnership, Health Data: Ontario Dental Health Indices Survey Database.
    URL:

  4. Ontario Ministry of Health. Dental Indices Software Program Manual. December 9, 1997.

  5. Ontario Ministry of Health, Ontario Dental Health Indices Survey Field Guide. September 1993.

  6. Bennett S. Results from the 1993-94 Ontario Dental Health Indices Survey. PHERO 1996;355-358.

Oral Health Screening

Original source: Public Health Unit
Distributed by: Public Health Unit
Suggested citation (see Data Citation Notes):
Oral Health Screening [years], [Public Health Unit], Extracted: [date]

Data Notes

  • Oral health screening is conducted by public health units to identify children with gross dental health problems and those eligible for the Children In Need Of Treatment (CINOT) program or for preventive oral health services (topical fluoride or pit and fissure sealants).

  • Screening is conducted primarily by dental assistants and consists of a 30-second look in the child’s mouth, using a light and hand mirrors.

  • The screening population is determined by the current year’s DIS results. The Dental Indices Survey (DIS) Protocol specifies that oral health screening be done for:
    - All children in Grades 2, 4, 6 and 8 in schools in which the school-entry DIS found that 14% or more of the school entrants had a “d+D” of the deft/DMFT Index of two or more (see deft/DMFT Index). These are defined as high risk schools;
    -Children in Grades 2 and 8 in schools where 9.5% or more of the school entrants had a “d+D” of the deft+DMFT Index of two or more. These are defined as medium risk schools.

  • Screening is not required in low risk schools whereby less than 9.5% of the school entrants had a “d+D” of the deft+DMFT Index of two or more.

  • Similar to the DIS, some public health units may not complete the required screening due to insufficient resources. As a result, screening methodologies vary across health units.

  • Children who are absent from school on the day of dental screening, schooled at home or who refuse are excluded.

  • Information that is collected as part of oral health screening include:
    - Demographic data: health unit number, examiner, recorder, planning area (optional), school code, survey date, school quintile (risk level), child’s name, sex, date of birth, postal code, grade, absent/present/refused, county of origin, water fluoridation;
    - Dental indices: CINOT eligible (dental), non-urgent treatment required, scaling required, prophylaxis required, sealant required, fluoride required, preventive instruction required.

References and Resources

  1. Ministry of Health, Dental Indices Survey (DIS) Protocol, Child Health Program. January 1, 1998.

Children In Need Of Treatment (CINOT)

Original source: Public Health Unit
Distributed by: Public Health Unit
Suggested citation (see Data Citation Notes):
Children In Need Of Treatment (CINOT) Database [years], Extracted: [date]

Data Notes

  • The Children In Need Of Treatment (CINOT) Program provides treatment to children from birth to Grade 8 (or their 14th

    birthday, whichever is later) who have urgent dental health needs and whose parents declare financial hardship.

  • The program is funded by the Ontario Ministry of Health and Long-Term Care (MOHLTC) and is administered by public health units. Demographic and treatment data for each claim are entered into the MOHLTC’s CINOT Database.

  • Urgent needs include large lesions, infection, trauma, pathology, or irreversible periodontal disease. The public health unit determines eligibility for the program, although dentists can refer children to the public health unit for screening.

  • Children who are declared eligible for the CINOT Program receive a "one-time" course of treatment with a follow-up of prevention and education. This one-time course of treatment or claim covers all procedures approved by the public health unit and may include more care than just the urgent problem. Any urgent problems that appear following a child’s admission to the program receive care under a new claim.

  • The CINOT Database does not contain a unique person identifier such as health number. Thus, the true number of children treated is unknown but can be estimated using of a combination of personal identifiers such as postal code and date of birth.

  • Rates and proportions based on counts less than 5 must be suppressed.

References and Resources

  1. Main P. Dental Public Health Programs in Canada 1995: Cross Canada Dental Check-up. Canadian Journal of Community Dentistry 1995;10(1):12-15.

  2. Woodward, GL & Knight A. Central East Health Information Partnership. Re-collection and analysis of data from the Ontario Dental Health Indices Survey. July 1999.

  3. Bennett S. Recent changes and evolution in care patterns in the Children in Need of Treatment (CINOT) dental program: 1990-1999. PHERO 2001;12(3):105-112.
Date of Last Revision: May 17, 2006
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