Survey Text

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Ask for each person with "Mouthrinse" in 6b.
d. What brand did -- use most often during the past 2 weeks?
Do not read answer categories. Circle one brand.

1[] ACT, Fluorigard, Kolynos, Listermint, Reach, StanCare
2[] Prescription fluoride rinse
3[] PLAX
4[] Scope, Listerine, Lavoris
8[] Other (Specify) ____
9[] Don't know