Oral Health Questionnaire

www.haad.ae/schoolsforhealthName:

School: Age:

Hello. Please answer these

questions by ticking the right box.

Kindly give it to the nurse or

teacher after you have finished.

1. What do you use for cleaning your teeth? (please tick the box)

Brush + toothpaste + dental floss

Dental floss only. Brush + toothpaste only

Don’t know

2. How often do you brush your teeth each day? (please tick the box)

Less than once a day Once a day

Twice a day More than twice a day

Only in the morning Only in the evening

In the morning and evening Don’t know

5. When do you normally brush your teeth? (please tick the box)

6. How often do you floss your teeth each day? (please tick the box)

Don’t knowThree times a day

Never Once a day

Twice a day

3. How much toothpaste do you normally put on your toothbrush? (please tick the box)

Full length of bristles

About the size of a grain of rice About the size of a pea

Half length of bristles

About 30 seconds 4. How long do you normally take to brush your teeth? (please tick the box)

About 2 minutes

About 1 minute

Don’t know

It’s good for your teeth It’s bad for your teeth

It has no effect on your teeth Don’t know

10. What happens if you drink a lot of fizzy drinks? (please tick the box)

7. How often do you visit your dentist? (please tick the box)

Twice a year

Only when I have a toothache

I don’t visitthe dentist

Once a year 9. What happens if you eat a lot of sweets? (please tick the box)

It’s good for your teeth It’s bad for your teeth

It has no effect on your teeth Don’t know

8. Not cleaning your teeth everyday can cause (please tick the box)

Decay Gum disease Bad breath

All of the above Cause nothing Don’t know