Oral Health

Questionnaire

Name:
www.haad.ae/schoolsforhealth School: Age:
Hello. Please answer these
questions by ticking the right box.
Kindly give it to the nurse or
teacher after you have finished. Dental floss only. Brush + toothpaste only

1. What do you use

for cleaning your teeth?
(please tick the box)

Brush + toothpaste + dental floss Dont know

Less than once a day Once a day

2. How often do you brush

your teeth each day?
(please tick the box)

Twice a day More than twice a day

 Full length of bristles Half length of bristles
3. How much toothpaste 5. When do you Only in the morning Only in the evening
do you normally normally brush
put on your toothbrush? your teeth?
(please tick the box) (please tick the box)

About the size of a

About the size of a pea
grain of rice In the morning and evening Dont know

6. How often do
you floss your
teeth each day?
About 30 seconds About 1 minute Never
4. How long do you Once a day (please tick the box)
normally take to
brush your teeth?
(please tick the box)

Twice a day Three times a day Dont know

About 2 minutes Dont know
 Once a year Twice a year
Its good for your teeth Its bad for your teeth 9. What happens
7. How often do you
if you eat a lot
visit your dentist?
(please tick the box)
of sweets?
(please tick the box)

Only when I I dont visit

It has no effect on your teeth Dont know
have a toothache the dentist

8. Not cleaning
Decay Gum disease Bad breath Its good for your teeth Its bad for your teeth
your teeth 10. What happens if you
everyday drink a lot of fizzy drinks?
can cause (please tick the box)
(please tick the box)

All of the above Cause nothing Dont know

It has no effect on your teeth Dont know