Common methods and instruments for essential oral health indicators WP6

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Common methods and instrumentsfor essential oral
health indicators WP6
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DATA COLLECTION

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

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POPULATION SAMPLE, SIZE AND STRUCTURE

• Sample
• Unit for sampling
• Size
• Collection period
• Institutionalized populations
• Non response

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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
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• Interview
• Personal interview
• Telephone interview
• Household
• Individual
• National
• Regional
• Local

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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
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• 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
• Dont 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

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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
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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 Dont
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
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Alternative questions for A3 QA3.4 Do you use
fluoride toothpaste for your child? yes no dont
use toothpaste dont know For test of mothers
knowledge QA3.5 How often should a childs 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?
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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 Dont know what it is
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B1. Daily intake of food and drink
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QB1.1 How often do you eat something in
between your regular meals?
About three times a
day or more1
About twice a day ...2
About once a
day 3
Occasionally, not every day4
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 prunes1.2
Chewing gum containing
sugar 1.2
Candy..1.2

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Fruit Days __ Servings __ Dont
know __ Biscuits, cakes, cream cakes? Days __ S
ervings __ Dont know __ Sweet pies, buns
Days __ Servings __ Dont know __ Lemonade,
Coca cola or other soft drinks Days __ Serving
s __ Dont know __ Jam or honey Days __ Servi
ngs __ Dont know __ Chewing gum containing
sugar Days __ Servings __ Dont
know __ Sweet/candy Days __ Servings __ Dont
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?
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QB1.4 How often do you eat or drink any of the
following foods, even in small
quantities? Fresh fruitseveral 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 ? ? ? ? ? ?
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B2. Tobacco usage prevalence
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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 __ Dont 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) __
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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
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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
? ? ? ? ?
?
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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 Dont
know Would it be possible for you to have an
appointment with a dental professional when
needed? yes No Dont know
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B4 Acess to primary oral care services QB4.1 If
you needed dental care, do you know a dentists
office or clinic you would go to?
Yes
No
Dont 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?
Dentists 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)
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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
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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
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QB5.3 When did you last visit a dental
professional about your teeth, dentures or
gums? __________
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B6 Reasons for last visit to dentist QB6.1 Wha
t 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 Dont
know / dont remember 5
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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
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QB6.3 What was the reason for the last visit to
the dentist?
Check-up ___
Routine treatment ___
Emergency treatment ___
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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 Dont
want to spend money on dental care 2
Afraid or dont 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 Dont know 14
No answer 15
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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
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QB11.2 Do you have any false teeth or dentures
which you can remove? Yes 1 No 2 Dont
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
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• 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 doesnt 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?

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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?
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QD1.3 very often / fairly often /
sometimes / no / dont 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


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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?
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• 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?

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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

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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?

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QD2.4 Yes / No / dont know / No
answer During the past 12 months did your
teeth or mouth ? ? ? ? cause any pain or
discomfort?


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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 / Dont know


How much pain or
discomfort from dental problems did you have ?
? ? ? ? during the last twelve months?




During the past twelve
months, Yes No dont know No answer did
your teeth or gums cause ? ?
? ? you any pain or discomfort?


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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?

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• 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

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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?

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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?


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QD3.4 Very often / fairly often / sometimes
/ no / dont 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 ? ?
? ? ?
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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?

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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?

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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?
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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?


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QD4.3 very often / fairly often / sometimes
/ no / dont 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 ? ? ? ?
?

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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?
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• D5 Social disability due to oral health status
• QD5.1. Have you avoided going out because of
  problems with your teeth, mouth or dentures?
• Have you been less tolerant of your spouse or
  family because of problems with your teeth, mouth
  or dentures?
• Have you had trouble getting on with other people
  because of problems with
• your teeth, mouth or dentures?
• Have you been a bit irritable with other people
  because of problems with your teeth, mouth or
  dentures?
• Have you had difficulty doing your usual jobs
  because of problems with
• your teeth, mouth or dentures?
• Have you felt that your general health has
  worsened because of problems with your
• teeth, mouth or dentures?
• Have you suffered any financial loss because of
  problems with your teeth, mouth or dentures?

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QD5.2 Never / Hardly ever / Occasionally /
Fairly often / Very often Have you been a bit
irritable with other people because of problems
with your teeth, ? ? ? ?
? mouth or dentures? Have you had difficulty
doing your usual jobs because of problems with
your teeth, ? ? ? ?
? mouth or dentures? Have you felt that life in
general was less satisfying ? ? ?
? ? because of problems with your
teeth, mouth or dentures? Have you been totally
unable to function because of problems ? ?
? ? ? with your teeth,
mouth or dentures?

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QD5.3 Never / Seldom / Sometimes / Often /
Always In the past three months how often did
you did you limit ? ? ? ?
? contacts with people because of the
condition of your teeth or denture? In the past
three months how often did you feel
uncomfortable eating in front of people ?
? ? ? ? because of problems
with your teeth or dentures?


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QD5.4 Yes / No / dont know / No
answer During the past twelve months, has the
pain or discomfort of dental problems caused you
? ? ? ? to limit
any of your usual activities? Yes /
No Have you ever avoided meeting people because
of the way ? ? your teeth or gums
looked? Among
the nicest Better than average Average
Below average Among the worst Compared to
your classmates and ? ? ?
? ? friends how do you think your
teeth look?
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QD5.5 very often / fairly often /
sometimes / no / dont know Because of the
state of your teeth, have you experienced any of
the following problems during the ?
? ? ? ?
past 3 months? Less tolerant of spouse or
people who are close to you ?
? ? ? ?
Reduced participation ?
? ? ? ? in
social activities

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QD5.6 Never / Hardly ever / Occasionally /
Fairly often / Very often How often did you
have difficulties carrying out major work /
schoolwork because of problems with mouth or
? ? ? ? ? teeth
in the last 12 months?