More than half of California current kindergartners have experienced tooth decay, and by third grade, this number rises to over 70 percent (CDE). Untreated tooth decay is a significant problem for low-income children. According to the Orange County Oral Health Strategic Plan, approximately 11% have untreated tooth decay. Tooth decay is the most chronic yet preventable healthcare need among children.
Untreated cavities can cause infections and pain that can affect a child’s sleep, nutrition, academic performance, and social-emotional development. Children with poor dental health may miss more school days and receive lower grades than children with good dental health (Smile, California).
The Kindergarten Oral Health Assessment (KOHA) Requirement
To ensure a child is ready for school, AB 1433, signed into law in 2006, requires parents or caregivers of children enrolling into kindergarten, or first grade (if not previously enrolled) in a public school, to submit proof of an oral health assessment. The assessment must be performed by a licensed or registered dental health professional. The assessment is turned into the school office by May 31 of a child’s first year in school.
The kindergarten oral health assessment (KOHA) is a dental screening to detect any signs of tooth decay. It helps promote school readiness, identifies children with untreated dental disease, and helps parents find a dental home for their child.
Orange County School Districts Report Lowest KOHA Data in Southern California
In Orange County (OC), there are a total of 27 school districts and charter schools that are required to submit KOHA data into the System for California Oral Health Reporting (SCOHR) online database annually by July 1st.
Reports from the oral health assessment data help prioritize areas for linkage-to-dental care services, oral health education initiatives, and increased dental access initiatives.
During the two reporting periods, 2019-20 and 2020-21, only 10 school districts and two (2) charter schools reported KOHA data into SCOHR. During the 2021-22 school year, OC school districts reported oral health assessment data for 14.2% of all students enrolling in kindergarten. This was the lowest percentage among all counties in Southern California, including Los Angeles (44.8%), Riverside (33.7%), San Bernardino (21.3%), Ventura (39.7%), and San Diego (30.1%).
The Orange County Local Oral Health Program (LOHP) Provides Support to OC School Districts to Help Increase KOHA Reporting
In early 2023, the LOHP team reviewed the 2019-20 and 2020-21 school year KOHA reports from SCOHR and began contacting school district representatives. After identifying barriers in reporting, LOHP staff coordinated with the OC School District Nurses, Health Clerks, and Student Health Services Administration from the Orange County Department of Education to provide resources and support to increase reporting.
Congratulations to All OC School District Staff involved with KOHA Reporting!
For the 2023-24 school year, 25 of 27 school districts submitted oral health assessment 
data into SCOHR. OC school districts also reported oral health assessment data for 48.2% of all students enrolled in kindergarten. This is an increase of 34 % from the 2020-21 school year and 27.3% from the 2022-23 school year.
Sustaining KOHA Reporting, Moving Forward
School office administration, school nurses, and health clerks play an important role with the KOHA. They help ensure families have the KOHA completed, returned to their child’s school, and reported into SCOHR annually.
To help support OC School Districts with KOHA reporting, the LOHP is collaborating with the Buena Park School District and software staff from Aeries, the student information system portal, to develop a data collection dashboard that would help increase reporting. Additional resources are in development and coming soon.
Due to the significant amount of KOHA data collected, LOHP will be working to identify specific areas to prioritize for access to dental care services and/or oral health education initiatives.
Tooth decay is the most chronic yet preventable health care need among California’s children. Missed school days due to dental decay can negatively impact success in school and is costly for school districts. The KOHA is one way schools can help reduce dental disease through connecting children to a source of dental care, reduce chronic absenteeism, and improve school readiness (CDE).
