[p. 167]
N. DENTAL CARE PAGE
Hand calendar. These next questions are about dental care received during the 2 weeks outlined in red on that calendar.
1a. During those 2 weeks, did anyone in the family go to a dentist? Include all types of dentists, such as orthodontists, oral surgeons, and all other dental specialists, as well as dental hygienists.
[] No (3)
b. Who was this? Mark "Dental visit" box in person's column.
c. During those 2 weeks, did anyone else in the family go to a dentist?
[] No
d. Ask for each person with "Dental visit" in 1b: During those 2 weeks, how many times did -- go to a dentist?
N1
Refer to "Dental visit" in 1b.
8[] Other (NP)
Refer to age.
1[] 17 and over, available (2)
2[] 17 and over, callback required (NP)
Complete a separate column for each 2-week dental visit.
2a. (Earlier I was told -- went to the dentist during the 2 week period beginning Monday, (date) and ending Sunday, (date).)
{Now I am going to read a list of dental services.}
When -- went to the dentist ([the last time/the time before that]) did -- have:
A. An x-ray taken?
B. A tooth filled?
C. A tooth pulled?
D. Any other oral surgery?
E. A fluoride treatment?
F. Teeth cleaned?
G. Teeth straightened, that is, orthodontia?
H. Treatment for gums?
I. Work done on a complete denture?
J. Work done on a partial denture?
K. Work done on a bridge?
L. Work done on a crown or cap?
M. Work done on a root canal?
N. An examination?
O. Something else done?
[the brackets represents 1,2,3 visits for each procedure]
B. [] [] [] Filled
C. [] [] [] Pulled
D. [] [] [] Oral surgery
E. [] [] [] Fluoride
F. [] [] [] Cleaned
G. [] [] [] Straightened
H. [] [] [] Gums
I. [] [] [] Complete denture
J. [] [] [] Partial denture
K. [] [] [] Bridge
L. [] [] [] Crown or cap
M. [] [] [] Root canal
N. [] [] [] Examination
O. [] [] [] (Specify, then reask O)
Visit 2 ____
Visit 3 ____
b. During that visit, did -- see a regular dentist or a dental specialist?
[the brackets represents 1,2,3 visits for each procedure]
Dental specialist [] [] []
Ask only if "Dental specialist" in 2b:
c. What kind of specialist did -- see?
Visit ____
Visit ____
d. How long did it take for -- to get to this dentist this time?
Visit 2 ____ Minutes
Visit 3 ____ Minutes
N3
Review 1d for additional visits for this person. If additional visits, reask 2a-d for each visit.
2[] Proxy (Footnote reason if 17 and over)
[p. 168]
N. DENTAL CARE PAGE, Continued
Mark box if "One year old or under 1."
3a. During the past 12 months, (that is, since (12 month date) a year ago) about how many visits did -- make to a dentist? (Include the (number in 1d) visit(s) you already told me about.)
Visits ____
000[] None
Mark "2-week dental visit" box in person's column if visit(s) reported in 1d.
b. About how long has it been since -- last went to a dentist?
2[] 2-week dental visit
3[] Over 2 weeks, less than 6 months
4[] 6 months, less than 1 year
5[] 1 year, less than 2 years
6[] 2 years, less than 5 years
7[] 5 years or more
0[] Never
4a. Does anyone in the family use toothpaste with fluoride?
[] No (5)
[] DK (5)
b. Who is this? Mark "Toothpaste" box in person's column.
c. Anyone else?
[] No
5a. Does anyone in the family use fluoride drops, tablets, or any other fluoride supplements which are swallowed?
[] No (6)
[] DK (6)
b. Who is this? Mark "Fluoride supplements" box in person's column.
c. Anyone else?
[] No
6a. Does anyone in the family use a fluoride mouth rinse which is NOT swallowed?
[] No (7)
[] DK (7)
b. Who is this? Mark "Fluoride mouth rinse" box in person's column.
c. Anyone else?
[] No
7a. Is there anyone in the family who has lost ALL of his or her teeth?
[] No (NEXT PAGE)
b. Who is this? Mark "Lost all teeth" box in person's column.
c. Anyone else?
[] No
Ask 8a-f as appropriate for each person with "Lost all teeth" in 7b.
8a. Does -- have false teeth?
2[] No (NP)
b. Does -- have an upper plate, a lower plate, or both?
2[] Lower
3[] Both
c. Does -- usually wear -- plate(s) while eating?
2[] No
d. Does -- usually wear -- plate(s) when not eating?
2[] No
e. Does -- need new false teeth?
2[] No
f. Do the ones -- had need refitting?
2[] No