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English translation from the Arabic questionnaire Appendix 1.

Oral Health Survey 2002

Male College of Health Sciences,

The Public Authority for Applied Education and Training

Dear participants,

This questionnaire is for collecting information about knowledge and oral health behavior

among students in Kuwait. You do not need to put your name on it and the answers will be

confidential. Please, answer by ticking one alternative for each question and/or by writing

your answer on the line below question. Your participation is highly appreciated!

1) Age

18-20 years

21-25 years

26 years

2) Marital status

Single Married

3) Nationality Kuwaiti Non-Kuwaiti

4) Years in College

One year Two years More than two years

5) Financial status

Very good

Good

Poor

6) Do you think that you have dental diseases? Yes No Dont know

7) What oral/dental diseases do you know?

__________________________________________________________________

__________________________________________________________________

8) How do you describe your current oral health status?

Very poor

Poor

Good

Very good

Excellent

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9) When did you last time visited a dentist?

One year ago

More than one year ago

two years ago

10) What was the purpose of your visit?

Examination, prevention

Need for a filling/extraction

Special treatment i.e. endodontics, prosthodontics, orthodontics

11) If your tooth is very painful do you think that the extraction is the only possible

treatment?

Yes No

12) If a child needs alignment of his/her teeth do you know to what specialist you should

take him/her?

Yes No

If yes, to what specialist? ______________________________________________

13) Do you brush your teeth daily?

Yes No

How many times?

Once a day

Twice a day

Three times a day

Four times a day or more often

14) Do you use toothpaste that contains fluoride? Yes No Dont know

15) How much toothpaste do you apply to a toothbrush?

Less than half

Half

More than half

All the brush

16) Fluoride is added to toothpaste because of

Pleasant taste

Soft feeling Prevents caries

Price

17) Do you know what is the plaque?

Yes No

If yes, explain here: ______________________________________________

_______________________________________________________________

18) Do you know what is the dental calculus?

Yes No

If yes, explain here: _____________________________________________________________________________________________________________

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Next statements are about the dental diseases. Thick one answer to each statement which

you think is correct.

Yes No Dontknow

Sugar is an etiological factor of dental caries.

Bacteria is not the primary reason for dental caries.

Teeth of a baby must be cleaned by toothpaste after bottle-feeding.

Toothpaste, which has fluoride, prevents caries of teeth of a baby.

Soft drinks cause dental caries.

Periodontal diseases occur in men.

The father does not transmit bacteria to his children.

Thank you for answering the questionnaire.

Dr. Jassem Al-Ansari

Health Sciences College