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Oral Health Questionnaire
www.haad.ae/schoolsforhealthName:
School: Age:
Hello. Please answer these
questions by ticking the right box.
Kindly give it to the nurse or
teacher after you have finished.
1. What do you use for cleaning your teeth? (please tick the box)
Brush + toothpaste + dental floss
Dental floss only. Brush + toothpaste only
Don’t know
2. How often do you brush your teeth each day? (please tick the box)
Less than once a day Once a day
Twice a day More than twice a day
Only in the morning Only in the evening
In the morning and evening Don’t know
5. When do you normally brush your teeth? (please tick the box)
6. How often do you floss your teeth each day? (please tick the box)
Don’t knowThree times a day
Never Once a day
Twice a day
3. How much toothpaste do you normally put on your toothbrush? (please tick the box)
Full length of bristles
About the size of a grain of rice About the size of a pea
Half length of bristles
About 30 seconds 4. How long do you normally take to brush your teeth? (please tick the box)
About 2 minutes
About 1 minute
Don’t know
It’s good for your teeth It’s bad for your teeth
It has no effect on your teeth Don’t know
10. What happens if you drink a lot of fizzy drinks? (please tick the box)
7. How often do you visit your dentist? (please tick the box)
Twice a year
Only when I have a toothache
I don’t visitthe dentist
Once a year 9. What happens if you eat a lot of sweets? (please tick the box)
It’s good for your teeth It’s bad for your teeth
It has no effect on your teeth Don’t know
8. Not cleaning your teeth everyday can cause (please tick the box)
Decay Gum disease Bad breath
All of the above Cause nothing Don’t know