Common methods and instruments for essential oral health indicators WP6

1. Common methods and instrumentsfor essential oral health indicators WP6

2. DATA COLLECTION • Construction of the questionnaire • Data collection method • Face to face • Postal or telephone • Health interview/Health examination survey • Interviewers

3. POPULATION – SAMPLE, SIZE AND STRUCTURE • Sample • Unit for sampling • Size • Collection period • Institutionalized populations • Non response

4. Proposed data collection methods of indicators selected for WP6 (HSE) National survey Oral health survey Household survey Oral health care survey Oral clinical survey (WP7) Individual based survey Interview health surveys (various administrative levels) Household interviews Population based interview survey National studies National screening Simple questionnaires for dental visits Clinical questionnaires

5. Interview Personal interview Telephone interview Household Individual National Regional Local

6. From indicator to instruments Sources: STEPS/WHO Surveillance Manual 2005 (STEPS/WHO Oral health programme 2005 ICSII BIOMED WHO/EURO : Health Interview Surveys 1996 OHIP GOAI Other recommended scientific publications

7. A1. Daily brushing with fluoride toothpaste • QA1.1 How often do you brush your teeth? • Never • A once a week • A few times a week • Once a day • Two or more times a day • QA1.2. Do you use a toothpaste containing fluoride? • Yes • No • Don’t know • QA1.3. Apart from fluoride in toothpaste or in the water supply, • do you use fluoride in any other way, for example in tablets or in a mouth rinse? • Yes • No • Don’t know what it is

8. A2. Preventive care-seeking for pregnant women QA2.1 Do you have children below one year? Yes No Q A2.2 Did you visit a dental clinic during your last pregnancy? QA2.3 For what reason did you visit the dental clinic during your last pregnancy? Check-up/ tooth cleaning, Routine visit Emergency

9. A 3.Mothers’ knowledge of fluoride toothpaste for child caries prevention QA3.1 Do you have children of seven years or less? Yes No Q A3.2 Agree Disagree Don’t know Brushing teeth with fluoride toothpaste O O O will help prevent tooth decay Drinking fluoridated water will help O O O prevent tooth decay Using fluoride is a harmless way O O O of preventing tooth decay

10. Alternative questions for A3: QA3.4 Do you use fluoride toothpaste for your child? yes no don’t use toothpaste don’t know For test of mothers’ knowledge QA3.5 How often should a child’s teeth be brushed? How much toothpaste should be placed on the brush? How much fluoride should the paste contain? How much fluoride toothpaste should be placed on the brush?

11. A 4. Fluoridation exposure rates (WP8) Copy of QA1.1 Apart from fluoride in toothpaste or in the water supply, Do you use fluoride in any other way, for example in tablets or in a mouth rinse? Yes No Don’t know what it is

12. B1. Daily intake of food and drink

13. QB1.1 How often do you eat something in between your regular meals? About three times a day or more…………1 About twice a day………………… ……...2 About once a day…………………… ……3 Occasionally, not every day………………4 Rarely or never eat between meals…......5 QB1.2 Yesterday, did you eat any of the foods listed below? Even if you ate only a very little of the food, you should circle 1 for Yes ´ Yes No Bread……………………………………………..………….1…….2 Sugar-coated cereal…………………………… ………...1…….2 Fresh fruit (apples, oranges)…………………… …….….1…….2 Pastries such as cakes, pies, doughnuts……………..…1…….2 Soft drinks, cola drinks, soda flow (excluding diet cola) 1…….2 Nuts, cheese………………………………………………..1…….2 Jam or honey……………………………………………….1…….2 Dried fruits such as raisins, figs or prunes………………1…….2 Chewing gum containing sugar………………………… 1…….2 Candy……………………………………………………..…1…….2

14. Fruit Days __ Servings __ Don’t know __ Biscuits, cakes, cream cakes? Days __ Servings __ Don’t know __ Sweet pies, buns Days __ Servings __ Don’t know __ Lemonade, Coca cola or other soft drinks Days __ Servings __ Don’t know __ Jam or honey Days __ Servings __ Don’t know __ Chewing gum containing sugar Days __ Servings __ Don’t know __ Sweet/candy Days __ Servings __ Don’t know __ QB1.3 In a typical week, on how Many days do you eat or Drink the following? How many servings do You Eat or drink on one of those days?

15. QB1.4 How often do you eat or drink any of the following foods, even in small quantities? Fresh fruit……………several times every day several times once a several times seldom/ a day a week a week a month never Biscuits, cakes, cream cakes      Sweet pies, buns      Lemonade, Coca Cola or other soft drinks      Jam or honey      Chewing gum containing       sugar Sweets/candy     

16. B2. Tobacco usage prevalence

17. QB2.1 1) Do you smoke any tobacco products? Yes __ No __ 2) If yes: Do you smoke tobacco daily? Yes __ No __ 3) When did you start smoking Age in years __ Don’t remember ____ 4) How many of the following do you smoke each day? Manufactures cigarettes __ Hand rolled cigarettes __ Pipe full of tobacco __ Cigars/cheroots/cigarillos __ Other __ Other (specify) __

18. QB2.2 Do you smoke? - Yes, daily - Yes, occasionally (go to question 3) - No (go to question 4) 2. How many cigarettes do you usually smoke on average each day? - Does not smoke cigarettes - Fewer than 20 - 20 or more (heavy smoker) 3. Compared with two years ago would you say you now have reduced smoking? - Yes (end) - No (end) 4. Have you ever smoked? - Yes, daily - Yes, occasionally - No (end) 5. How long ago did you stop smoking? - Less than two years ago - Two years ago or more

19. BQ2.3 How often do you use any of the following types of tobacco? several times every day several times once a several times seldom/ never a day a week a week a month I smoke cigarettes      I smoke cigars      I smoke pipe      I have chewing tobacco      I have snuff      Other     

20. B 3 Geographic access to oral health care QB3.1 Is it possible for you to reach a dental clinic within 30 minutes? Yes No Don’t know Would it be possible for you to have an appointment with a dental professional when needed? yes No Don’t know

21. B4 Acess to primary oral care services QB4.1 If you needed dental care, do you know a dentist’s office or clinic you would go to? Yes No Don’t know No answer QB4.2 Do you see a particular dentist when you go to the office/clinic? Yes No QB4.3 Which of the following best describes the place you go for dental care? Dentist’s office or private clinic Hospital clinic or a clinic in a university dental school Clinic run by the government Dental clinic in school Other (specify)

22. B5 Dental contact within 12 months QB5.1 How long is it since you have last seen a dentist? Less than 6 months 1 6 – 12 months 2 More than 1 year, but less than 2 years 3 2 years or more, but less than 5 years 4 5 years or more 5 Never received dental care 6

23. QB5.2 How long ago did you receive your last dental care? Less than six month 1 Six months to one year 2 More than 1 year up to 2 years 3 More than 2 years up to 5 years 4 More than 5 years 5 Never received dental care 6

24. QB5.3 When did you last visit a dental professional about your teeth, dentures or gums? __________

25. B6 Reasons for last visit to dentist QB6.1 What was the reason of your last visit to the dentist? Consultation / advise 1 Something was wrong / pain or troubles with teeth or gum 2 It was part of follow-up treatment 3 Routine check-up / treatment 4 Don’t know / don’t remember 5

26. QB6.2 What was the reason you made your most recent visit to a dentist? Something was wrong 1 I thought it was time for an examination or cleaning 2 The dentist reminded me it was time for an examination or cleaning 3 It was part of a series or course of treatment 4

27. QB6.3 What was the reason for the last visit to the dentist? Check-up ___ Routine treatment ___ Emergency treatment ___

28. B7 Reasons for not visiting the dentist the last 2 years QB7.1 What was the main reason you did not visit a dentist in the last two years? Cannot afford cost 1 Don’t want to spend money on dental care 2 Afraid or don’t like dentists or dental hygienists 3 Poor experience with previous dental care 4 Too busy 5 Nothing wrong 6 Dental problem not serious enough 7 Expected dental problems to go away 8 Dental office too far away 9 Have no teeth or have false teeth 10 Physical problems prevent me from going 11 The dentist would not give me an appointment 12 Other 13 Don’t know 14 No answer 15

29. B11 Removable denture prevalence QB11.1 Do you have removable dentures? Yes No A partial denture? 1 2 A full upper denture? 1 2 A full lower denture? 1 2

30. QB11.2 Do you have any false teeth or dentures which you can remove? Yes 1 No 2 Don’t know 3 No answer 4 A partial denture? Yes 1 No 2 A full upper denture? Yes 1 No 2 A full lower denture? Yes 1 No 2 How many years ago did you get your last false teeth / dentures? _____Years ago

31. D1 Oral Disadvantage due to Functional Limitation • QD1.1 • Have you had difficulty chewing any foods because of problems with your teeth, mouth or dentures? • Have you had trouble pronouncing any words because of problems with your • teeth, mouth or dentures? • Have you noticed a tooth which doesn’t look right? • Have you felt that your appearance has been affected because of problems with your teeth, mouth or dentures? • Have you felt that your breath has been stale because of problems with your teeth, mouth or dentures? • Have you felt that your sense of taste has worsened because of problems with your teeth, mouth or dentures? • Have you had food catching in your teeth or dentures? • Have you felt that your digestion has worsened because of problems with your teeth, mouth or dentures? • 9. Have you felt that your dentures have not been fitting properly?

32. QD1.2 Never Hardly ever Occasionally Fairly often Very often Have you had trouble pronouncing any words because of problems   with your teeth mouth or dentures? Have you felt that your sense oftaste has worsened because of   problems with your teeth, mouth or dentures?

33. QD1.3 very often / fairly often / sometimes / no / don’t know Because of the state of your teeth, have you experienced any of the   following problems during the past 3 months? Difficulty in chewing/biting foods   Difficulty with speech/ trouble   pronouncing words

34. QD1.4 Are you able to chew hard things, such as hard bread or apples? Yes / No ______________________________________________________________________ QD1.5 Never / Hardly ever / Occasionally / Fairly often / Very often How often during the past 12 months      have you experienced difficulties with eating and chewing food due to mouth and teeth problems?

35. D2 Physical Pain due to Oral Health Status • QD2.1 • Have you had painful aching in your mouth? • Have you had a sore jaw? • 12. Have you had headaches because of problems with your teeth, mouth or dentures? • 13. Have you had sensitive teeth, for example, due to hot or cold foods or drinks? • Have you had toothache? • Have you had painful gums? • 16. Have you found it uncomfortable to eat any foods because of problems with your teeth, mouth or dentures? • Have you had sore spots in your mouth? • 18. Have you had uncomfortable dentures?

36. QD2.2 Never Hardly ever Occasionally Fairly often Very often Have you had painful aching in your   mouth? Have you found it uncomfortable to eat   any foods because of problems with your teeth, mouth or dentures

37. QD2.3 Never Seldom Some / Often / Always times In the past three months how often did you use medication to relieve      pain or discomfort from around your mouth? In the past three months how often were your teeth or      gums sensitive to hot, cold or sweets?

38. QD2.4 Yes / No / don’t know / No answer During the past 12 months did your teeth or mouth     cause any pain or discomfort?

39. QD2.5 In the past twelve months, have you had any of the following problems? A broken or chipped tooth Yes / No Gums that hurt or bleed Yes / No Gums that frequently bled when you brushed or flossed Yes / No Teeth that hurt when you ate or drank hot or cold liquids or foods Yes / No Sores on your tongue or on the inside of your mouth or cheeks Yes / No Teeth that ached or throbbed Yes / No A bad taste in your mouth or bad breath Yes / No Teeth that hurt when you ate or drank sweet things Yes / No Has the pain or discomfort caused you to miss Yes / No classes or school days during the past year? A lot / Some / Not much / None / Don’t know How much pain or discomfort from dental problems did you have     during the last twelve months? During the past twelve months, Yes No don’t know No answer did your teeth or gums cause     you any pain or discomfort?

40. QD2.6 Never / Hardly ever / Occasionally / Fairly often / Very often How often have you Experienced toothache/      painful gums/sore spots in the past 12 months?

41. D3 Psychological Discomfort due to Oral Health Status • QD3.1 • 19. Have you been worried by dental problems? • 20. Have you been self conscious about your teeth, mouth or dentures? • 21. Have dental problems made you miserable? • 22. Have you felt uncomfortable about the appearance of your teeth, mouth or dentures? • 23. Have you felt tense because of problems with your teeth, mouth or dentures? • 24. Has your speech been unclear because of problems with your teeth, mouth or dentures? • Have people misunderstood

42. QD3.2 Never / Hardly ever / Occasionally / Fairly often / Very often Have you been self-conscious because of your teeth, mouth      or dentures? Have you felt tense because of problems with your teeth      mouth or dentures?

43. QD3.3 GOHAI Never / Seldom / Sometimes / Often / Always I In the past three months how often were you able to eat anything without feeling discomfort?      In the past three months how often were you pleased or happy with the looks of your      teeth, gums or dentures? In the past three months how often were you worried or concerned      about the problems with your teeth, gums or dentures? In the past three months how often did you feel Nervous or self-conscious      because of problems with your teeth, gums or dentures?

44. QD3.4 Very often / fairly often / sometimes / no / don’t know Because of the state of your teeth, have you experienced any of      the following problems during the past 3 months?      Embarrassed about appearance of teeth      Felt tense because of problems      with teeth or mouth Avoid smiling because of teeth      Sleep is often interrupted     

45. QD3.5 Very much / Quite a bit / They look OK / Not much / Not at all How often do you have trouble sleeping because of pain      or discomfort from dental problems? How often do you avoid laughing or smiling because      of unattractive teeth or gums? How often do you avoid conversation because of      unattractive teeth or gums or bad breath? How much do you like      the way your teeth look?

46. QD3.6 Never / Hardly ever / Occasionally / Fairly often / Very often How often have you felt tense because of teeth, mouth      or denture problems in the past 12 months?

47. D4 Psychological Disability due to Appearance of Teeth or Dentures QD4.1 24. Has your speech been unclear because of problems with your teeth, mouth or dentures? 25. Have people misunderstood some of your words because of problems with your teeth, mouth or dentures? 26. Have you felt that there has been less flavour in your food because of problems with your teeth, mouth or dentures? 27. Have you been unable to brush your teeth properly because of problems with your teeth, mouth or dentures? 28. Have you had to avoid eating some foods because of problems with your teeth, mouth or dentures? 29. Has your diet been unsatisfactory because of problems with your teeth, mouth or dentures? 30. Have you been unable to eat with your dentures because of problems with them? 31. Have you avoided smiling because of problems with your teeth, mouth or dentures? 32. Have you had to interrupt meals because of problems with your teeth, mouth or dentures? 33. Has your sleep been interrupted because of problems with your teeth, mouth or dentures? 34. Have you been upset because of problems with your teeth, mouth or dentures? 35. Have you found it difficult to relax because of problems with your teeth, mouth or dentures? 36. Have you felt depressed because of problems with your teeth, mouth or dentures? 37. Has your concentration been affected because of problems with your teeth, mouth or dentures? 38. Have you been a bit embarrassed because of problems with your teeth, mouth or dentures?

48. QD4.2 Never / Hardly ever / Occasionally / Fairly often / Very often Has your diet been unsatisfactory because of problems with your teeth, mouth or dentures?      Have you had to interrupt meals because of problems with your      teeth, mouth or dentures? Have you found it difficult to relax because of problems with      your teeth, mouth or dentures? Have you been a bit      embarrassed because of problems with your teeth, mouth or dentures?

49. QD4.3 very often / fairly often / sometimes / no / don’t know Because of the state of your teeth, have you experienced any of      the following problems during the past 3 months?      Days taken off work      Difficulty doing usual activities     

50. QD4.4 Do other students make jokes about the way your teeth look? Yes / No _________________________________________________________________ QD4.5 Never / Hardly ever / Occasionally / Fairly often / Very often How often have you felt embarrassed because of the appearance of your teeth or      dentures in the past 12 months?