Kindergarten Oral Health Assessment

Tips to increase the number of forms returned:  

• Send the KOHA forms to parents/caregivers of incoming transitional kindergartners and kindergartners before the summer break, so they can try to make a dental appointment during the summer.  
• Include KOHA reminders to parents/caregivers in existing reminders about other health paperwork required: immunizations, the first-grade health exam, vision and hearing screenings. 
• Emphasize that forms should be returned as close to the beginning of the school year as possible. Even though parents/caregivers technically have until the end of the school year or May 31st (whichever comes first) to turn in forms, nurses and school staff have given feedback that having the May 31st deadline on all public and parent-facing messaging is not helpful, as it causes procrastination. 
• Make follow-up calls to parents/caregivers of children who have not returned the form. Aim for at least 3 follow-ups to parents/caregivers of children who have not returned the form. 
• Include information about the oral health examination requirement on school and district webpages that have health requirements and/or registration requirements.  

Tips from school staff on tracking KOHA data: 

• Include KOHA data in the existing Student Information Systems (SISs). At a minimum, track which students have returned a completed form, waiver, or on-site screening opt-out letter in the SIS. 
• Run queries from the SIS to get reports showing which students still need to submit the KOHA forms: "All KOHA forms are entered into Infinite Campus. I run an ad hoc to see which children are missing the forms." - School admin assistant  
• If possible, work with IT to include the data fields required in System for California Oral Health Reporting (SCOHR), as of 2022, in the SIS: "The nurse and I enter the data from the oral assessment forms into Infinite Campus. Then run queries to get the data that is required for the report (SCOHR). I also keep a hard copy of the KOHA forms in case I need to refer back to get any other data." - School admin assistant 

What about transitional kindergarteners (TK): should they complete the KOHA? 

• Children in TK can complete the KOHA. Students need to be screened once between TK and K grades (or first grade if that is their first year of public school).  
• In the System for California Oral Health Reporting (SCOHR), TK students will be counted with the kindergarteners and will not be reported as a separate age group. When filling out the KOHA form, enter TK, K, or 1st Grade.  

Can schools still use old forms? 

• No, schools cannot use the old forms (2008). Please use the new form (2022), which has additional information that the old forms do not have. This new information helps ensure children with urgent care needs receive follow-up care. Also, the information on the new form aligns with data entry into SCOHR. There is an effort across the state to share information and use this information to address gaps. 

How is the KOHA requirement different from the first-grade health evaluation requirement?  

• First-grade health evaluation is completed by a licensed medical professional. While it asks briefly about dental care, it is not a full dental screening like the KOHA.  
• The KOHA must be completed by a licensed dental professional (dentist or dental hygienist) and must be completed for kindergarteners (including transitional kindergarteners); it is only completed for first graders if it is their first year of school.
• The KOHA is required for public schools.

On the KOHA form, Section 2, what do the “treatment urgency” levels mean?

• 1 - No obvious problem found: The child has no obvious dental problems and should continue to have routine examinations by their dentist every 6 months.  
• 2 - Early dental care recommended: The child has a tooth or teeth that should be checked by their dentist. They may benefit from sealants. The child’s parent/guardian should contact the child’s dentist who will determine whether treatment is needed. 
• 3 - Urgent care needed: The child has a tooth or teeth that appear to need immediate care, as there is pain, infection, or swelling. The child’s parent/guardian should contact the child’s dentist as soon as possible for a complete evaluation. 

What if a child does not have a dental care provider or his/her family cannot afford an oral health assessment?

• All children should obtain an oral health assessment from a licensed dental professional. If a child does not have a regular source of dental care or if their family cannot afford an oral health assessment, the family should use the find-a-dentist tool, complete the Medi-Cal Dental Care Coordination Form, or contact their Local Oral Health Program or school health staff for assistance in finding dental care. Some schools host free on-site KOHA screening days provided by dental professionals. These professionals may also provide other services like sealants for children. Parents/caregivers can check with their child’s school to see if these services are available. 

What if a parent/guardian is unable to get an oral health assessment for their child?

• The law recognizes that it may not be possible to get the required dental assessment for a child. On rare occasions, a parent/guardian may have their child excused from the requirement by filling out the Oral Health Assessment Waiver Form. To waive the assessment, the parent/guardian must identify on the form what prevented them from getting the dental checkup for the child (e.g., I am unable to find a dental office that will take my child’s dental insurance plan, or I cannot afford a dental checkup, etc.). This information is very important and must be included. The waiver request must be submitted by May 31st or the end of the school year (whichever date occurs first).  

FAQs and answers from COHTAC about KOHA  

KOHA FAQs 

FAQs and answers from COHTAC about SCOHR  

SCOHR information and FAQs