Oral Health
Respondent sequence number
When did you last visit a dentist
Main reason for last dental visit
Past yr need dental but couldn't get it
Could not afford the cost
Did not want to spend the money
Insurance did not cover procedures
Dental office is too far away
Office not open at convenient time
Another dentist recommended not doing it
Afraid or do not like dentists
Unable to take time off from work
Too busy
Expected dental problems to go away
Other reason could not get dental care
Age started brushing teeth
Age started using toothpaste
Received Rx fluoride drops or tablets?
Age started taking prescription fluoride
Age stopped taking prescription fluoride
Told benefits of giving up cigarettes
Told benefits of checking blood sugar
How often last yr had aching in mouth?
Last yr had diff w/ job because of mouth
Do you think you might have gum disease?
Rate the health of your teeth and gums
# times you brush your teeth in 1 day?
How much toothpaste do you use?
Ever had treatment for gum disease?
Ever been told of bone loss around teeth
How many days use dental floss/device