What is the OSST?
The Oral Status Survey Tool (OSST) is a novel nine item tool that was developed with adults with intellectual disabilities (ID) to be quick, acceptable, robust and administered by well-trained dentists / non-dentists without scribe. The OSST was developed over five years via Trinity College Dublin and Dublin Dental University Hospital. The development team promote the sharing of the OSST under Creative Commons Licensing.
The version shared here is version 1 of the Health Evaluation Survey format of the OSST (OSST(v1)-HES), which distinguishes it from the self-reported Health Information Survey under development (OSST(v1)-HIS).
What does the OSST measure?
The OSST can record a range of clinical oral features that are important for policy makers and service providers. These features, including tooth count; denture wear; occluding pairs of teeth and functional dentition; oral cleanliness; gum condition; carious cavitation and oral pain, will be useful within health surveys of this and similarly neglected populations. These variables can be transformed directly by researchers themselves or automatically using the OSST google forms template to generate important OSST indicators (See below).
Outcome |
Measure |
n (denominator) |
Count (numerator) |
% |
Indicators of oral function
|
Edentulism in both arches |
0 |
0 |
#DIV/0! |
Edentulous in either arch |
0 |
0 |
#DIV/0! |
|
Unrestored edentulism in both arches |
0 |
0 |
#DIV/0! |
|
Unrestored edentulism in either arch |
0 |
0 |
#DIV/0! |
|
10 or more teeth |
0 |
0 |
#DIV/0! |
|
20 or more teeth |
0 |
0 |
#DIV/0! |
|
Functional dentition |
0 |
0 |
#DIV/0! |
|
Average number of teeth |
#DIV/0! |
SD (n-1) |
#DIV/0! |
|
Have 3 or 4 occluding pairs of premolars |
0 |
0 |
#DIV/0! |
|
Have front 12 teeth |
0 |
0 |
#DIV/0! |
|
|
|
|
|
|
Indicators of oral disease and treatment need
|
Clean mouth |
0 |
0 |
#DIV/0! |
Healthy gums |
0 |
0 |
#DIV/0! |
|
Caries free |
0 |
0 |
#DIV/0! |
|
Pain free |
0 |
0 |
#DIV/0! |
Is the OSST a robust tool?
The tool was developed robustly, demonstrating construct validity for all items, concurrent validity was demonstrated for tooth count, carious teeth and gum condition, fair to very good inter-rater reliability and moderate to very good intra-rater reliability. The tool was acceptable to people with ID and non-dental data collectors (Mac Giolla Phadraig et al., 2021). The tool will continue development and validation across multiple uses. A self-report version (Health-Information-Survey) is being tested for favourable attributes.
Who is a suitable population?
The OSST is designed for adults with disabilities, who are traditionally excluded from oral health research and may be useful for other, similar populations. The OSST has been used successfully to record surveys among broad samples of people with ID in Ireland including those with severe and profound ID. The tool has been initially validated for people over 40 years of age with mild to moderate disability and further development and validation is required for use in children and in adults with severe profound disability. The OSST can also be used to inform local and national service planning and policy.
What are the weaknesses of the OSST?
Health measurement is a complex phenomenon and, like any measure, particularly a new measure the OSST is not perfect. The OSST is designed to generate information that is useful at a policy and service level, rather than at an individual tooth or person level. The OSST does not attempt to replace traditional epidemiological measurement. Rather, the OSST is shared in an attempt to overcome barriers to inclusion in research that leads to health disparities for potentially vulnerable populations. The process of development is ongoing and further study is needed.
What do I need, to use the OSST?
The OSST can be scored by well-trained dental professionals or non-dental professionals. The OSST can be applied once data collectors have completed training in its use. The recommended time to complete training is two days. Training should be supported with calibration to ensure valid and reliable recording, as per WHO guidelines (WHO, 2013). Repeat training and calibration is recommended across examiners and over time, depending on the project to ensure reliability. Developer generated training tools are available. Developer generated data collection forms with built in dashboards are available for data management purposes.
WORLD HEALTH ORGANISATION. 2013. Oral health surveys: basic methods - 5th edition [Online]. Available: https://www.who.int/oral_health/publications/9789241548649/en/ [Accessed 29/04/2020].
Downloads and Resources
You can download all you need to use the OSST on this page. These resources are designed to support use of the tool as published in 2021 (OSST-HES.v1). We do not have an online training module developed yet but you can peruse our training manual and protocol. You can download a range of options for data collection and direct data entry with built-in functionality too. You can download a word file or use a specifically designed Spreadsheets template that you can copy for your own uses. This template is designed to automatically output OSST Indicators and can be used following simple permission from the development team
Training manual and protocol
You can download our Training Manual here.
You can download our Protocol here.
Data Collection OSST(v1) files.
Excel
Access the Data Collection / Data Entry Excel file here.
See Instructions for Excel here
Google Forms
Access the Data Collection / Data Entry Google Forms and Sheets here.
See Instructions for Google Sheets and Forms here
Printable
Download the printable PDF version of OSST(v1) data collection form here.
Evidence base for OSST
Research reporting use of OSST
Byrne,K., MacGiolla Phadraig, C. Daly, B., McCarron, M. & McCallion, P., The Oral Health Status of Older People with Intellectual Disabilities in Ireland. Initial Findings., International association of disability and oral health (IADH), Paris, France, 24th-26th August, 2022, poster presentation
Byrne,K., MacGiolla Phadraig, C. Daly, B., McCarron, M. & McCallion, P., The Oral Health Status of Older People with Intellectual Disabilities in Ireland. Initial Findings., Irish Society of disability and oral health (ISDH), Kilkenny, Ireland, 23rd of June 2022, oral presentation
Published articles
Mac Giolla Phadraig C, Ishak NS, van Harten M, et al. The Oral Status Survey Tool: construction, validity, reliability and feasibility among people with mild and moderate intellectual disabilities. Journal of Intellectual Disability Research : JIDR. 2021 Mar. DOI: 10.1111/jir.12820. You can read this article here:
Scientific presentations
Mac Giolla Phadraig C, McCarron, M, McCallion P. Oral health data collection among people with intellectual disabilities: valid, simple, feasible. Oral Presentation, IASSID, 2021.
Mac Giolla Phadraig C, van Harten M. Tackling inequalities using a novel Oral Status Survey Tool (OSST). Poster presentation 2021 IADR General Session. Abstract ID#: 3572677
Future developments
We will update this site as we develop the OSST further and learn more about its functions, utility and attributes. We hope that researchers who use this tool will inform us of how this can be improved in the future. Please contact the development team if you plan to use this tool.
Where can I find out more about this tool?
You can find out more about this tool by contacting macgiolla@dental.tcd.ie