NHANES Pilot Studies 2012

Attachment B.

National Health and Nutrition Examination Survey (NHANES)

Dental Fluorosis Imaging Project Feasibility Study (ages 6-19)

OMB no. 0920-0237

Expires: 11/30/2012

Assurance of confidentiality – All information which would permit identification of an

individual, a practice, or an establishment will be held confidential, will be used for

statistical purposes only by NCHS staff, contractors, and agents only when required and with necessary controls, and will not be disclosed or released to other persons without the consent of the individual or establishment in accordance with section 308(d) of the Public Health Service Act (42 USC 242m) and the Confidential Information Protection and Statistical Efficiency Act (PL-107-347).

Public reporting burden of this collection of information is estimated to average 5 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road, MS D-74, Atlanta, GA 30333. ATTN: PRA (0920-0237).

Dental Fluorosis Imaging Project Feasibility Study (ages 6-19):

Eligibility: Sample persons aged 6-19 years or older are eligible for the Dental Fluorosis Imaging Project Feasibility Study. The maximum number of respondents would be 155.

Informed Consent: Written informed consent will be obtained as part of the regular National Health and Nutrition Examination Survey (NHANES) consent process in the Mobile Examination Center (MEC) exam

Exclusion Criteria: Participants will be excluded from the study if they are missing all 6 front upper teeth,

or if they have fixed orthodontic braces or other non-removable orthodontic appliances

Data Collection: A dual imaging camera will be used to capture a standard polarized white light (PWL) image and a Quantitative light fluorescence (QLF) image of the survey participants’ upper six anterior teeth. The MEC dentist will insert a standard orthodontic lip retractor, position the participant into the camera frame, and digitally focus and capture both the QLF and PWL images.

Report of Findings: Findings from this feasibility study will not be reported to participants. Participants do receive a report of findings related to dental fluorosis from the clinical exam administered in the MEC