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eligible beneficiaries from the local village tribal authorities. In three of the sites where we had local project staff assisting us, we obtained from school administrative staff lists of children who were currently enrolled in the respective local school. These lists were used to draw a systematic sample of 66 school children per site. In these three sites, the adults who volunteered to participate had heard of the study by word of mouth. In the other two sites, both adults and children learned of the study by word of mouth. In these last two sites, the villages were small and self-contained, so we assume that virtually everyone in the community had heard that we were conducting the study. Overall, across all five sites, there were between 61 and 106 individuals examined, including three 5-year-old children. Adults comprised 21% of examined subjects overall, ranging from 5% to 54% across sites. The examinations were conducted by two examiners for Site A and by one of these examiners for Sites B–E. Examiners participated in a 3.5-day training session for all data collection procedures, of which approximately 2 days were devoted to the oral health survey. Following calibration with an experienced examiner, inter-examiner reliability across 10 subjects for cavitated caries vs. non-caries calls was 94%. Intra-examiner reliability was not assessed. The reported outcome measures calculated from these surveys include (1) the percentage of subjects with untreated decay, (2) coronal DMF (decayed/missing/filled) score and components, (3) root DF (decayed/filled) score and components, and (4) for children ages 6 to 10, df score and components. These measures are reported for subjects in three age groups: dentate adults (20 year or older), adolescents (ages 11 to 19), and children (ages 6 to 10). These age groups were used for analysis to reflect the customary ages in assessing comparability with other studies of oral health, particularly those involving younger persons who may have a mix of primary and permanent teeth. In addition, the percentage of children ages 9 and 10 (estimated to be in third grade) with any caries experience (DMF/df > 0), untreated caries (D/d + DF/df > 0), or with any sealed teeth is compared to similar data for Alaska’s American Indian/Alaska Native population (Alaska Department of Health and Social Services Oral Health Program, 2007). Finally, from the CPI data, the distribution of highest (worst) CPI score from among the six sextant scores, was calculated for adults. 3.4

Clinical Technical Performance

Examiners recorded evaluations reflecting clinical technical performance during the oral health surveys and during periods of observation at the site’s dental clinic. Some of these evaluations are considered by many to measure the “quality of care” that has been provided, 3-3