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Kindergarten Oral Health Assessment (KOHA)
Information, forms, and reporting templates for schools and parents/caregivers

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KOHA flyer

The Problem

Tooth decay is the most common, chronic childhood disease. According to the California Department of Education, dental problems are the cause of 874,000 school days missed each year, which costs schools over $29 million annually in average daily attendance funding. Dental caries is a preventable disease; yet, more than half of California kindergarteners have experienced tooth decay, and by third grade, this number rises to over 70 percent. Data show that more than a quarter of these children have dental disease that, if left untreated, has deleterious effects on children’s academic performance, social-emotional development, sleep and nutrition, and leads to poor general health outcomes. 

California State Requirements

The Kindergarten Oral Health Assessment (KOHA) requirement was passed into law under the Education Code Section 49452.8 in 2005 by Assembly Bill 1433 (AB 1433). It requires all public school kindergartners and only those first graders enrolling in public school for their first year to have an oral health screening completed by a licensed dental professional. 

The goal is to raise awareness about the importance of oral health and help connect children to a regular source of dental care.  An oral health assessment is a quick, basic screening to identify the overall health of the mouth. It is not a full oral health evaluation, or a substitute for regular, comprehensive appointments with a dentist every 6 months.

It is one way schools can support children’s school readiness and success by identifying children suffering from untreated dental disease and helping parents establish a dental home.  

Some schools in San Mateo County host free oral health screening days on-site, provided by outside dental professionals and organizations. The law was updated with Senate Bill 379 (SB 379) in 2017 to allow schools to use passive consent for these oral health screening school events. Passive consent means every child will receive a screening unless their parent/guardian has signed a form (an “opt-out” letter) indicating they would not like their child to receive the screening.

The Oral Public Health Program collaborates with the San Mateo County Office of Education to ensure all schools and districts are in compliance with this KOHA mandate.

Public school grade levels that must meet this requirement

  • Kindergarten, not including Transitional Kindergarten- All public school children entering Kindergarten grade level must have the KOHA completed. While students in Transitional Kindergarten (TK) can technically complete the assessment during their TK year, the required data for those students (see below) should not be submitted until their kindergarten year.
  • Any student in first grade in public school, only if they did not attend public school Kindergarten the prior year - Some children do not attend public school Kindergarten, and their first year in public school is first grade. For these first grade students only–not all public school first graders–the oral health assessment is required. 

School staff responsibilities around KOHA data collection and entry

By the end of the school year, or by July 1st at the latest, the KOHA legislation requires specific KOHA data to be totaled and entered into a database annually by school staff. 

The database developed for this purpose is called the “System for California Oral Health Reporting,” or “SCOHR.” See step by step instructions on how to use SCOHR below.

School staff often work closely with the County Local Oral Health Program and with the County Office of Education to comply with the KOHA data collection and entry requirements (see more details below).

The Kindergarten Oral Health Assessment is different from the first grade health exam requirement, and both are required 

  • The KOHA is required for public school kindergartners, and only those first graders enrolling in public school for their first year. It must be completed by a licensed dental professional (a dentist or dental hygienist).
  • The first grade health exam is required for first graders, and must be completed by a medical professional. 
  • See our County Health webpage about all school and childcare health requirements here.

How the KOHA requirement is communicated to parents/ guardians

The registration packet for each public school kindergarten student contains the KOHA packet (see below). The KOHA packet consists of:

  • KOHA Notification Letter- describes what the requirement is, what parents need to do, and includes information about how to access dental care in the county, as well as basic oral health information 
  • KOHA Form – the actual screening/assessment form parents need to take to their child’s dental appointment and have the dental provider complete. If the child’s school is hosting a KOHA screening day, the dental providers at the school will complete the required form there.
  • Waiver of the KOHA Requirement- dental providers complete the KOHA assessment during the child’s regular dental appointment. However, if children do not yet have a dentist or dental insurance, cannot easily get to a dentist during their Kindergarten year, or do not attend a school hosting an on-site KOHA screening event, a waiver form may be completed. Parents are encouraged to contact their school health staff, Health Plan of San Mateo Dental, or the Oral Public Health Program if they need help completing the KOHA requirement.

What parents/ guardians of public school kindergartners need to do

1. It is recommended that you make a dental appointment for your child during the year before they enter kindergarten, so you can turn in the completed oral health assessment form at the beginning of their kindergarten school year. This will give you plenty of time to get a dental appointment if there are longer wait times.

2. Get the Kindergarten Oral Health Assessment form from your child’s registration packet, from the school office staff, or you can download it in English or Spanish directly from our webpage here (see below).

3. Bring the letter and assessment form in English and in your first language (if applicable) to the dental appointment and have the dentist fill them out.

4. Return the completed form to your child’s school office staff.

Step-by-step KOHA instructions for school staff 

 

KOHA Timeline and Checklist for School Staff

Distribute KOHA forms and send reminders

Every year, the required KOHA forms and letters (see below) are included in the Kindergarten registration packet for parents/ caregivers. Make sure the KOHA information is included in the registration information.

The KOHA requirement is for kindergartners, not for Transitional Kindergartners. However, if a TK student returns a completed KOHA screening, it can be entered into the SCOHR database (see below) the next school year for that student, when they are in kindergarten.

1. Let parents/ caregivers know they need to have the KOHA completed by the START of their child’s kindergarten year. While technically parents/ caregivers have until the end of the school year, or May 31st (whichever date comes first), to turn in the oral assessment, the goal is to have all forms returned at the beginning of the child’s kindergarten year. 

2. Include a dental assessment reminder alongside all immunization and health exam requirement reminders to parents/ caregivers at the beginning of the year.

3. At least 3 times a year, have school office staff, wellness staff, or school nurses send a reminder letter to parents/ caregivers of kindergartners about completing the oral health screening. 

​4. Have the staff member assigned to collect and track the returned forms call or email parents/ caregivers who have not yet returned the completed screening form. 

5. Include information about the KOHA requirement and a link to the forms on the school webpage, parent portal, newsletters, with PTA members, etc.

Collect the KOHA forms

As KOHA forms are turned into school staff throughout the year, it is recommended to assign at least one office, wellness, or nursing staff member to: 

  • Make a 2 sided copy of any of the returned forms: 1) the completed screening, 2) the waiver, and/or 3) any on-site screening opt-out forms
  • Place all the original forms in the student’s cumulative file. Place all the copies in a separate, labeled folder. The copies in this folder will be given to the person/s assigned to enter the data from them into the SCOHR database.

Track and total required KOHA aggregate data

As the forms come in throughout the year, set up a system to track the returned forms and to total the aggregate data required in SCOHR for each school. You can use the School-Level KOHA Worksheet and the SCOHR Data Input Form below, or set up your own system to track and total the data. 

The KOHA data from each school should be entered into SCOHR before staff leave for the summer, or by July 1st at the latest.

SMC School-Level KOHA Worksheet-2023- Updated August 2023. This Excel worksheet tracks the KOHA data required for every eligible student at one school. The grand totals from this worksheet go into the SMC SCOHR Data Input form below.

SMC SCOHR Data Input Form and Guide- 2023- Updated August 2023. This form provides KOHA aggregate totals from eligible students at one school, and the format matches the SCOHR “Quick Data Input Form” exactly (see below for more SCOHR information).

Please contact the Oral Public Health Program at: SMCOralHealth@smcgov.org with any questions about KOHA, or to arrange a training on how to collect and enter the data into the database.

Follow-up with students with urgent dental care needs

School nurses and staff have an important role to play in connecting children with urgent and immediate dental care needs to a dental home.

Each student receiving a KOHA screening is marked as having one of three “treatment urgency levels:”

  • No obvious problem found - The child has no obvious dental problems, and should continue to have routine examinations by their dentist every 6 months.  
  • 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. 
  • 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.

For those students returning a completed KOHA screening form with the “treatment urgency” section marked “urgent care needed,” school health and office staff can follow-up with the parent/guardian and help connect them to a dentist if they do not already have one. 

For complete instructions on how to link parents and students to dental care, including emergency dental care, see our “Accessing oral health care” webpage here.

Report KOHA data into the SCOHR database by July 1st

Public elementary school staff need to collect the forms below and enter the data from them into the System for California Oral Health Reporting (SCOHR) database by July 1st at the latest of every school year.

​To become a new SCOHR database user:

1. Sign up directly on the SCOHR website here. If there is no space to add a new user, email SCOHR support for help at scohr@sjcoe.net, or call (866) 762-9170.

Or, email: SMCOralhealth@smcgov.org. Please include the following information for the new user: First and last name, Title, School, District, Work email, Work phone number, and a preferred Username.

2. When creating a new user account with a username and password in SCOHR, passwords cannot contain any full words, and must contain all the elements required.

You will receive an email from “SCOHR” (noreply@ab1433.org) with the subject: “Ab1433.org new user account created.” It will have your username and a link to create your password. The email link to create a password expires, so plan to create your password the same day you create a new user account.

3. Save your username and password. You’ll need to have them when you enter your KOHA data in at the end of the school year.

Existing SCOHR users:

1. If you forget your password, simply click the “Forgot Password?” button on SCOHR’s main page, and you will receive an email from “SCOHR” (noreply@ab1433.org) with the subject: “Ab1433.org Password Reset Request.” Click the link in the email to reset your password. The email link to create a password expires, so reset your password immediately after receiving the email.

If you click the “forgot password?” button multiple times in a row, make sure when you check your email, you’re looking for the most recent email from SCOHR. The password reset link in any older emails from SCOHR will not work. 

2. If you forget your username, search your email for the subject: ”Ab1433.org new user account created.” This email has your original username in it. If you still cannot find it however, email SMCOralHealth@smcgov.org for assistance. Or, contact SCOHR at: scohr@sjcoe.net or (866) 762-9170. 

Entering data in SCOHR

1. Log into SCOHR with your username and password. 

2. On the top toolbar, click “Data Input.” Then, click the first item in the dropdown menu, titled “Data Input Form.”

3. See the list of your assigned schools in the “Data Input Form” section. Select the appropriate year in the drop down menu titled “Fiscal Year” (this is the same as the school year).

4. Go to the “Actions” column on the far right, and click on the pencil icon.

5. The data input form will appear.

Enter in the school’s KOHA data. Check to make sure:

  • Line 1 equals the sum of Lines 2-9
  • Line 2 equals the sum of Lines 13-15
  • The number in Line 12 for caries experience is greater than or equal to the number in Line 11 for untreated decay. If the number for untreated decay is larger than caries, check the KOHA form Section 2 again or the KOHA worksheets with each student’s data.
    • On the KOHA form (Section 2), if the dental provider checked yes for untreated decay, then caries experience automatically also needs to be checked yes, even if the dental provider checked no. We are working to train dental providers on this, but some still make errors.
    • If using the Excel KOHA data worksheet, any student that has untreated decay marked with an X automatically needs to have an X marked in the column for caries experience.
  • Lines 17-20 apply only to those students who had an urgent dental care need (Line 15). All students who received a KOHA screening on-site at their schools have their parents/guardians notified by letter and/or phone call of the results of their screening.

6. Press submit. If a note pops up, follow the directions in the note to correct your data. After submitting, nothing will change on the  screen. However, when you go back to the menu with your schools listed, if you submitted data correctly, a check mark will appear under “actions” instead of the pencil icon. If the pencil icon still appears after submitting, that means you still have data to correct.

7. You can log back into this section any time to make edits to your data.

All downloadable KOHA forms in English and Spanish

*All forms were newly updated in 2023 

All SMC KOHA forms in English and Spanish 

SMC Packet of KOHA Forms in English and Spanish-2023

English only SMC KOHA Packet of Forms-2023

Spanish only SMC KOHA Packet of Forms-2023

English and Spanish / Español​  versions: Individual SMC KOHA forms- updated 2023

1. SMC Kindergarten Oral Health Assessment Parent/ Guardian Notification Letter (2 pages)

2. SMC Kindergarten Oral Health Assessment Form (2 pages) 

3. SMC Waiver of KOHA Requirement Form 

4. On-Site Dental Screening Opt Out Letter

*In San Mateo County, on-site dental screening organizations usually provide their own letters to parents giving them an option to opt-out of their on-site screenings, so this letter is likely not necessary.