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What is the MOSST?

The MOSST is a health evaluation survey that collects important oral data. There are seven questions (items) in the MOSST tool. The MOSST covers four items that indicate oral function and three items that indicate oral health or disease. Content coverage is balanced with feasibility by ensuring that the tool produces a range of useful oral health data, is feasible for use across many contexts, and is not too onerous on participants or data collectors.

The Tool was developed to be quick, acceptable, robust and administered by well-trained dentists / non-dentists without scribe. The MOSST was developed that was developed with adults with intellectual disabilities over ten years in Trinity College Dublin, Trinity Centre for Ageing and Intellectual Disabilities and Dublin Dental University Hospital. The development team promote the sharing of the MOSST under Creative Commons Licensing.

The MOSST also consists of a Self-Report Supplement (MOSST-SRS) described further below.

Aim of MOSST?

The aim of the MOSST is to record a range of oral features that are important for policy makers and service providers. This includes the following concepts: Functional tooth units, Aesthetics, vis a vis presence of the Front twelve teeth, Denture wear, Tooth count, Cavitated teeth, Gum condition, and, Oral cleanliness.

What does the MOSST measure?

The MOSST can record a range of clinical oral features that are important for policy makers and service providers. These parameters are important to measure within health surveys of this and similarly neglected populations. Outputs can be reported as measured or can be transformed simply to generate important MOSST indicators (See below).

Excel diagram here:

Is the MOSST a robust tool?

The MOSST is a revised version of the original OSST tool, which was developed robustly, demonstrating content validity for all items, concurrent validity for tooth count, carious teeth and gum condition, fair to very good inter-rater reliability and moderate to very good intra-rater reliability across items. The tool was acceptable to people with disabilities and non-dental data collectors (Mac Giolla Phadraig et al., 2021). The further development of the MOSST tool aims to improve on these attributes. Our understanding of the MOSST will grow with further testing of attributes in validation and field.

Which population is the MOSST useful for?

The MOSST is designed for adults with disabilities, who are traditionally excluded from oral health research and may be useful for other, similar populations. The MOSST has been used successfully to record surveys among broad samples of people with ID in Ireland in the IDS TILDA wave 5 health fair (Byrne et al 2023). The MOSST has been used successfully to record surveys among broad samples of people with disabilities in Ireland including those with severe and profound disabilities. The tool has been developed and validated with people over 40 years of age with mild to profound disability. Further development has been achieved with people with profound and severe disability also. The tool is not designed for children. Further validation is required for use among other populations such as people of older age, people in low resource economies, etc.

Why use the MOSST?

The MOSST can be used for research or to inform local and national service planning and policy. The MOSST is not designed for use as an individual oral health assessment tool, a tool for diagnosis or clinical screening. The MOSST does not facilitate the practice of dentistry, or replace the need for regular dental assessment by a registered dental professional.

Who can score the MOSST?

The MOSST can be scored by well-trained dental professionals or non-dental professionals. The MOSST should be applied once data collectors have completed training in its use. Training is online and in person. 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. The MOSST is designed to be scored directly onto a tablet without a scribe.

Training

All data collectors should be trained in its use prior to administration. Calibration is also recommended as part of training to ensure valid data collection. This should be completed prior to using the MOSST data collection. Data collectors may also need further training, such as in person centred communication, inclusive research methods, data management, infection control, and related fields as per local policy, and their project needs.

Disclaimer

Data collectors should ideally come from clinical professions, and have training and experience in research ethics, person-centred communication, clinical data collection and have high standards of infection control. Data collection must align with local policies regarding infection control, waste management, risk assessment and other relevant policies. The developers have made every effort to support data collection in traditionally excluded populations and do not take responsibility for use of the tool by others. It is important to distinguish data collection using the MOSST from the practice of Dentistry. The MOSST will not be used for individual risk assessment, triage or clinical assessment for the purposes of dental examination, treatment planning or further practice of Dentistry. Users of the MOSST must comply with local and national laws and standards that limit the practice of dentistry to specifically qualified and registered dental professionals.

What are the weaknesses of the MOSST?

Health measurement is a complex phenomenon and, like any measure, particularly a new measure the MOSST is not perfect. The MOSST is designed to generate information that is useful at a policy and service level, rather than at an individual tooth or person level. The MOSST does not attempt to replace traditional epidemiological measurement. Rather, the MOSST 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 MOSST?

The MOSST can be scored by well-trained dental professionals or non-dental professionals. The MOSST can be applied once data collectors have completed training in its use. The recommended time to complete training is virtual training using a training app approx. 4hours and 1 day in-person training. 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/  

The virtual element of the MOSST v1.0 can be viewed on the link below. To be calibrated to use the MOSST a second day of training would be required. This would need to be done with a gold standard on the MOSST. Please see contact details below.

What is the MOSST-SRS?

The MOSST-SRS is a thirteen-item health information survey (HIS) that aims to collect data on selected aspects of oral healthcare utilization, oral health behaviours, and oral health related-quality of life. There are thirteen items in total. Items were generated through a combination of researcher content selection and input from a PPI panel from the IDS-TILDA study. All PPI panellists had intellectual disabilities and conveyed what they felt was most important to capture in data collection. Content was then scraped from computer assisted personal interview and national oral data collection surveys in UK and Ireland, with modification as indicated by PPI panel and content development team. The attributes of the MOSST (SRS) self-report supplement (Health-Information-Survey) have not been tested. The MOSST SRS is designed for adults, who are traditionally excluded from oral health data collection, such as people with disabilities. To support participant inclusion, easy-read resources are available.

Downloads and Resources

You can download all you need to use the MOSST on this page.

Training App

MOSST data Collection forms.

Qualtrics

Download a Qualtrics package here

Printable

Download the printable documents here

Evidence base for OSST and MOSST

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

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

Peer reviewed 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:

Published reports

https://www.tcd.ie/tcaid/assets/pdf/idstildawave5report.pdf

Future developments and feedback

We will update this site as we develop the MOSST 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.

Please give us feedback here.

https://tcdhealthsciences.qualtrics.com/jfe/form/SV_6J3gaBdWn5oQGA6 

If you want to complete a MOSST survey as a test please do so by clicking this link here.

Please note any responses are not used for research and will not be published.

This is simply a test version for information purposes.

Link here: https://tcdhealthsciences.qualtrics.com/jfe/form/SV_ePP3vDbBhChVrjo

Where can I find out more about this tool?

You can find out more about this tool by contacting macgiolla@dental.tcd.ie or kbyrne1@tcd.ie