2009 New Zealand Oral Health Survey

Adult Questionnaire

Published in December 2010 by the
Ministry of Health
PO Box 5013, Wellington 6145, New Zealand

This document is available on the Ministry of Health’s website:

Contents

Initial Demographics

Self-reported Oral Health Status

Module 1: Self-reported number of teeth [all adults]

Module 2: Tooth loss [participants with no natural teeth only]

Module 3: Presence of dentures, bridges, implants [all adults]

Module 4: Assessment of general oral health status [all adults]

Module 5: Orofacial pain/symptoms [all adults]

Module 6: OHIP-14 [all adults]

Module 7: Lost work/school days or activity change due to dental problems [all adults]

Module 8: Appearance [all adults]

Module 9: Self-perceived need for dental care [all adults]

Module 10: ACC – knowledge of cover for dental trauma [all adults]

Risk and Protective Factors

Module 11: Preventative care [adults with natural teeth]

Module 12: Use of fluoridated toothpaste [adults with natural teeth]

Module 13: Use of mouth rinses [adults with natural teeth]

Module 14: Wearing of mouthguards [adults with natural teeth]

Module 15: Current smoking status [all adults]

Utilisation of Oral Health Services, Nature of Barriers to Accessing Services, and the Extent of any Unmet Need

Module 16: Dental visits in last 12 months [all adults]

Module 17: Tooth extraction in last 12 months [all adults]

Module 18: Reasons for no visit in last 12 months [all adults]

Module 19: Last visit (reason) [all adults]

Module 20: Last visit (dental services by type) [all adults]

Module 21: Last visit (where) [all adults]

Module 22: Last visit (choice of dental care provider) [all adults]

Module 23: Last visit (time taken to get there) [all adults]

Module 24: Last visit (time taken to get appointment) [all adults]

Module 25: Cost [all adults]

Module 26: Usual provider of dental care [all adults]

Module 27: Last visit (Health and Disability Code of Rights) [all adults]

Module 28: Regular dental check-ups [all adults]

Module 29: Enrolment of teenager for routine dental care [15–18 year olds]

Module 30: Insurance coverage for dental expenses [all adults]

Module 31: Dental anxiety [all adults]

Orofacial Trauma

Module 32: Orofacial trauma

Opinions and Knowledge of Oral Health and Attitudes Towards Oral Health

Module 33: Perceived importance of oral health [all adults]

Module 34: Opinions about dental care for adults [all adults]

Module 35: Fluoridation of water supplies [all adults]

Sociodemographic Update

Module 36: Age and ethnicity [all adults]

Module 37: Education [all adults]

Module 38: Income support and employment [all adults]

Module 39: Income support and employment [respondents aged 15–59 years; adults who refused to give age or date of birth in NZHS]

Module 40: Income [all adults]

Module 41: Household income [all adults]

Module 42: Household composition [all adults]

Module 43: Recontact information [all adults]

Module 44: Invitation to participate in dental examination component of Oral Health Survey [adults with natural teeth]

2009 New Zealand Oral Health Survey: Adult Questionnaire 1

Initial Demographics

“Before we begin, I just need to enter some information so that I only ask questions applicable to your gender and age group.”

OHSA_Sex. You are male or female?

!INTERVIEWER NOTE: Check aloud with respondent.

1Male

2Female

98Don’t know

99Refused

OHSA_Age. Please tell me your age?

Showcard Q2: Initial demographics

115–19 years

220–24 years

325–34 years

435–44 years

545–54 years

655–64 years

765+ years

98Don’t know

99Refused

Self-reported Oral Health Status

Module 1: Self-reported number of teeth [all adults]

OHSA_Q1. Do you have any of your own natural teeth?

1Yes[Go to OHSA_Q2]

2No[Go to OHSA_Q4]

98Don’t know[Go to OHSA_Q2]

99Refused

OHSA_Q2. How many teeth do you have in your upper jaw?

10

21

32

43

54

65

76

87

98

109

1110

1211

1312

1413

1514

1615

1716

98Don’t know

99Refused

OHSA_Q3. How many teeth do you have in your lower jaw?

10

21

32

43

54

65

76

87

98

109

1110

1211

1312

1413

1514

1615

1716

98Don’t know

99Refused

Module 2: Tooth loss [participants with no natural teeth only]

OHSA_Q4. How old were you when you lost your last natural tooth?

1–97[ENTER AGE]

98Don’t know

99Refused

[If answered Yes or Don’t know to OHSA_Q1, go to OHSA_Q6]

OHSA_Q5. When you lost your last natural tooth, was it because ...

!INTERVIEWER NOTE:Select all that apply.

Showcard Q5: Module 2

1The tooth was decayed and couldn’t be saved – the dentist advised me to have it taken out

2The tooth was decayed and I couldn’t afford to have it fixed

3The gums were bad and the dentist couldn’t save my tooth – the dentist advised me to have the tooth taken out

4The gums were bad, the tooth could have been saved, but I couldn’t afford the treatment

5Of toothache

6Of illness (eg, heart surgery)

7Of an accident

8Of orthodontic reasons

9Of a wisdom tooth problem

10You wanted a full denture

11Or was it for some other reason?

98Don’t know

99Refused

Module 3: Presence of dentures, bridges, implants [all adults]

OHSA_Q6. Do you have a denture or false teeth {removable} for your upper jaw?

1Yes

2No

98Don’t know

99Refused

OHSA_Q7. Do you have a denture or false teeth {removable} for your lower jaw?

1Yes

2No

98Don’t know

99Refused

OHSA_Q8. How long ago did you get your last false teeth/dentures?

1Less than 1 year

2–100[ENTER AGE]

102Don’t know

103Refused

[If answered No to OHSA_Q6 and OHSA_Q7, go to OHSA_Q9]

OHSA_Q9. Do you have one or more bridges?

1Yes

2No

98Don’t know

99Refused

OHSA_Q10. Do you have any dental implants?

!INTERVIEWER NOTE:Dental implant is an artificial tooth root replacement and is used in prostheticdentistry to support restorations that resemble a tooth or group of teeth.

1Yes

2No

98Don’t know

99Refused

OHSA_Q11. Do you think that at sometime you will have full dentures or do you think you will always keep some of your natural teeth?

1Full dentures sometime

2Always keep natural teeth

98Don’t know

99Refused

[If answered No to OHSA_Q1, go to OHSA_Q12]

Module 4: Assessment of general oral health status [all adults]

OHSA_Q12. How would you describe the health of your teeth or mouth?

Showcard Q12: Module 4

1Excellent

2Very good

3Good

4Fair

5Poor

98Don’t know

99Refused

OHSA_Q13. Compared to one year ago, would you say that your dental health has:

Showcard Q13: Module 4

1Stayed the same

2Got worse

3Improved

98Don’t know

99Refused

OHSA_Q14. In general, how satisfied are you with the health of your teeth and mouth?

Showcard Q14: Module 4

1Very satisfied

2Satisfied

3Neither satisfied nor dissatisfied

4Dissatisfied

5Very dissatisfied

98Don’t know

99Refused

Module 5: Orofacial pain/symptoms [all adults]

OHSA_Q15. In the last 4 weeks have you had pain or discomfort in the teeth or mouth?

Showcard Q15: Module 5

1Always

2Often

3Sometimes

4Occasionally

5Never[Go to OHSA_Q19]

98Don’t know[Go to OHSA_Q19]

99Refused

OHSA_Q16. How would you describe the intensity of the pain / discomfort?

Showcard Q16: Module 5

1Mild

2Moderate

3Severe

98Don’t know

99Refused

OHSA_Q17. In the last four weeks have you had toothache?

1Yes

2No

98Don’t know

99Refused

[If answered No to OHSA_Q1, go to OHSA_Q19]

OHSA_Q18. In the last four weeks have you had pain in the teeth with hot/cold food/fluids?

1Yes

2No

98Don’t know

99Refused

OHSA_Q19. In the last four weeks have you had pain in the mouth or face?

1Yes

2No

98Don’t know

99Refused

OHSA_Q20. In the last four weeks have you had pain in or around the jaw joints?

1Yes

2No

98Don’t know

99Refused

OHSA_Q21. In the last four weeks have you had bleeding gums?

1Yes

2No

98Don’t know

99Refused

[If answered No to OHSA_Q1, go to OHSA_Q22]

OHSA_Q22. In the last four weeks have you had bad breath?

1Yes

2No

98Don’t know

99Refused

OHSA_Q23. How often does your mouth feel dry?

!INTERVIEWER NOTE:Dry mouth – lack of saliva.

Showcard Q23: Module 5

1Never

2Occasionally

3Frequently

4Always

98Don’t know

99Refused

Module 6: OHIP-14 [all adults]

“The next set of questions is designed to look at how oral health affects a person’s day to day life. These questions ask about your teeth and mouth over the last 12months.”

Q24–Q37. In the last 12 months...

!INTERVIEWER NOTE:Please reiterate throughout that these questions pertain to the ‘last 12 months’.

OHSA_Q24. Have you had any trouble PRONOUNCING ANY WORDS because of problems with your teeth, mouth or dentures?

Showcard question numbers 24–37: Module 6

1Never

2Hardly ever

3Occasionally

4Fairly often

5Very often

98Don’t know

99Refused

OHSA_Q25. Have you felt that your SENSE OF TASTE has worsened because of problems with your teeth, mouth or dentures?

Showcard question numbers 24–37: Module 6

1Never

2Hardly ever

3Occasionally

4Fairly often

5Very often

98Don’t know

99Refused

OHSA_Q26. Have you had PAINFUL ACHING in your mouth?

Showcard question numbers 24–37: Module 6

1Never

2Hardly ever

3Occasionally

4Fairly often

5Very often

98Don’t know

99Refused

OHSA_Q27. Have you found it UNCOMFORTABLE TO EAT ANY FOODS because of problems with your teeth, mouth or dentures?

Showcard question numbers 24–37: Module 6

1Never

2Hardly ever

3Occasionally

4Fairly often

5Very often

98Don’t know

99Refused

OHSA_Q28. Have you been SELF-CONSCIOUS because of problems with your teeth, mouth or dentures?

Showcard question numbers 24–37: Module 6

1Never

2Hardly ever

3Occasionally

4Fairly often

5Very often

98Don’t know

99Refused

OHSA_Q29. Have you FELT TENSE because of problems with your teeth, mouth or dentures?

Showcard question numbers 24–37: Module 6

1Never

2Hardly ever

3Occasionally

4Fairly often

5Very often

98Don’t know

99Refused

OHSA_Q30. Has your DIET BEEN UNSATISFACTORY because of problems with your teeth, mouth or dentures?

Showcard question numbers 24–37: Module 6

1Never

2Hardly ever

3Occasionally

4Fairly often

5Very often

98Don’t know

99Refused

OHSA_Q31. Have you had to INTERRUPT MEALS because of problems with your teeth, mouth or dentures?

Showcard question numbers 24–37: Module 6

1Never

2Hardly ever

3Occasionally

4Fairly often

5Very often

98Don’t know

99Refused

OHSA_Q32. Have you found it DIFFICULT TO RELAX because of problems with your teeth, mouth or dentures?

Showcard question numbers 24–37: Module 6

1Never

2Hardly ever

3Occasionally

4Fairly often

5Very often

98Don’t know

99Refused

OHSA_Q33. Have you been a bit EMBARRASSED because of problems with your teeth, mouth or dentures?

Showcard question numbers 24–37: Module 6

1Never

2Hardly ever

3Occasionally

4Fairly often

5Very often

98Don’t know

99Refused

OHSA_Q34. Have you been a bit IRRITABLE WITH OTHER PEOPLE because of problems with your teeth, mouth or dentures?

Showcard question numbers 24–37: Module 6

1Never

2Hardly ever

3Occasionally

4Fairly often

5Very often

98Don’t know

99Refused

OHSA_Q35. Have you had DIFFICULTY DOING YOUR USUAL JOBS because of problems with your teeth, mouth or dentures?

Showcard question numbers 24–37: Module 6

1Never

2Hardly ever

3Occasionally

4Fairly often

5Very often

98Don’t know

99Refused

OHSA_Q36. Have you felt that life in general was LESS SATISFYING because of problems with your teeth, mouth or dentures?

Showcard question numbers 24–37: Module 6

1Never

2Hardly ever

3Occasionally

4Fairly often

5Very often

98Don’t know

99Refused

OHSA_Q37. Have you been TOTALLY UNABLE TO FUNCTION because of problems with your teeth, mouth or dentures?

Showcard question numbers 24–37: Module 6

1Never

2Hardly ever

3Occasionally

4Fairly often

5Very often

98Don’t know

99Refused

Module 7: Lost work/school days or activity change due to dental problems [all adults]

OHSA_Q38. In the last 12 months, have you taken time off work or school because of problems with your teeth or mouth?

1Yes

2No[Go to OHSA_Q42]

98Don’t know[Go to OHSA_Q42]

99Refused[Go to OHSA_Q42]

OHSA_Q39. How much time did you take off?

[ENTER DAYS] or [ENTER HOURS]

98Don’t know

99Refused

OHSA_Q40. In the last 12 months, have you taken time off work or school to have treatment for these problems?

1Yes

2No[Go to OHSA_Q42]

98Don’t know

99Refused

OHSA_Q41. How much time did you take off?

[ENTER DAYS] or [ENTER HOURS]

98Don’t know

99Refused

OHSA_Q42. Have you had difficulty getting time off work for a dental appointment?

1Yes

2No

3I haven’t needed to ask for time off work for a dental appointment

98Don’t know

99Refused

Module 8: Appearance [all adults]

OHSA_Q43. In general, how satisfied are you with the appearance of your teeth, mouth or dentures?

Showcard Q43: Module 8

1Very satisfied

2Satisfied

3Neither satisfied nor dissatisfied

4Dissatisfied

5Very dissatisfied

98Don’t know

99Refused

OHSA_Q44. In general, compared to other persons, do you think the appearance of your teeth is

Showcard Q44: Module 8

1Among the nicest

2Better than average

3Average

4Below average

5Among the worst

98Don’t know

99Refused

OHSA_Q45. Do you have any marks on your teeth which won’t brush off?

1Yes

2No[Go to OHSA_Q47]

98Don’t know[Go to OHSA_Q47]

99Refused[Go to OHSA_Q47]

[If answered No to OHSA_Q1, go to OHSA_Q47]

OHSA_Q46. Do these marks bother you?

1Yes

2No

98Don’t know

99Refused

OHSA_Q47. Are you planning, in the future, to have dental treatment to improve the appearance of your teeth and/or gums?

1Yes

2No[Go to OHSA_Q49]

98Don’t know[Go to OHSA_Q49]

99Refused[Go to OHSA_Q49]

OHSA_Q48A. If yes, what would you like to have done? I would like to

!INTERVIEWER NOTE: Select all mentioned.

Showcard Q48: Module 8

1Have my teeth cleaned

2Have my gums looking better

3Have my broken or chipped teeth repaired

4Have my decayed teeth fixed

5Have my teeth straightened

6Have my teeth whitened

7Have gaps closed

8Have the shape of my teeth changed

9Have white fillings in back teeth

10Have new dentures or existing dentures replaced

11Other, please specify

98Don’t know

99Refused

[If answered No to OHSA_Q1, go to OHSA_Q48B]

OHSA_Q48B. If yes, what would you like to have done? I would like to

!INTERVIEWER NOTE:Select all mentioned.

Showcard Q48: Module 8

10Have new dentures or existing dentures replaced

11Other, please specify

98Don’t know

99Refused

[If answered Yes to OHSA_Q1, go to OHSA_Q50]

OHSA_Q49. If no, why not?

Showcard Q49: Module 8

1My teeth are OK as they are

2I would like to but I couldn’t afford it

3I don’t want fancy treatment

98Don’t know

99Refused

Module 9: Self-perceived need for dental care [all adults]

OHSA_Q50. Do you feel that you currently need dental treatment?

1Yes

2No[Go to OHSA_Q52]

98Don’t know[Go to OHSA_Q52]

99Refused[Go to OHSA_Q52]

OHSA_Q51A. What type of dental care do you think you need now?

!INTERVIEWER NOTE: Select all mentioned.

Showcard Q51: Module 9

1Teeth filled or replaced (for example, fillings, crowns and /or bridges)

2Teeth pulled / extracted

3Gum treatment

4Denture work

5Relief of pain

6Work to improve appearance (for example, braces or bonding)

7Cleaning

8Other, please specify

9Nothing

98Don’t know

99Refused

[If answered No to OHSA_Q1, go to OHSA_Q51B]

OHSA_Q51B. What type of dental care do you think you need now?

!INTERVIEWER NOTE: Select all mentioned.

Showcard Q51: Module 9

4Denture work

8Other, please specify

9Nothing

99Refused

[If answered Yes to OHSA_Q1, go to OHSA_Q52]

Module 10: ACC – knowledge of cover for dental trauma [all adults]

OHSA_Q52. Do you know whether ACC can help pay for treatment when you have an injury to your mouth and teeth?

Showcard Q52: Module 10

1Yes, they can help

2No, they can’t or won’t

3Not sure if ACC can help

98Don’t know

99Refused

Risk and Protective Factors

Module 11: Preventative care [adults with natural teeth]

[If answered No to OHSA_Q1, go to OHSA_Q65 as modules 11, 12, 13 and 14 are only for adults with natural teeth]

OHSA_Q53. How often do you brush your teeth?

Showcard Q53: Module 11

1Never

2Less than once a week

3Once or twice a week

4More than twice a week but not once a day

5Once a day

6Twice a day

7More than twice a day

98Don’t know

99Refused

OHSA_Q54. How often do you clean between your teeth (using dental floss, dental tape, an interdental brush or a toothpick)?

Showcard Q54: Module 11

1Never

2Once a month

3A few (2–3) times a month

4Once a week

5A few (2–6) times a week

6Once a day

7Two or more times a day

98Don’t know

99Refused

OHSA_Q55. Do you have any physical problems that make it difficult for you to clean your teeth such as opening your mouth or moving your hand?

1Yes

2No

98Don’t know

99Refused

OHSA_Q56. Have you ever had your teeth cleaned by a dentist or dental hygienist?

1Yes

2No[Go to OHSA_Q58]

98Don’t know[Go to OHSA_Q58]

99Refused[Go to OHSA_Q58]

OHSA_Q57. When was the last time they were cleaned by a dentist or dental hygienist?

Showcard Q57: Module 11

16 months ago or less

2Over 6 months to 12 months

3Over 12 months to 2 years

4Over 2 years to 5 years

5More than 5 years

98Don’t know

99Refused

Module 12: Use of fluoridated toothpaste [adults with natural teeth]

OHSA_Q58. Do you use toothpaste when you clean your teeth?

Showcard Q58: Module 12

1Always

2Often

3Sometimes

4Occasionally

5Never[Go to OHSA_Q60]

98Don’t know[Go to OHSA_Q60]

99Refused[Go to OHSA_Q60]

OHSA_Q59. Which toothpaste do you usually use?

!INTERVIEWER NOTE:Use 3 show cards here with photographs of brands of toothpaste that contain:

Showcard Q59: Module 12

11000ppm fluoride ‘Colgate’, McLean’s’ and ‘Aim’ (all fluoridated)

2400–500ppm fluoride children’s brands of toothpaste (low fluoride)

3Non-fluoridated brands

98Don’t know

99Refused

Module 13: Use of mouthrinses [adults with natural teeth]

OHSA_Q60. In the last week, did you use a mouth rinse or mouth wash?

1Yes

2No[Go to OHSA_Q62]

98Don’t know[Go to OHSA_Q62]

99Refused[Go to OHSA_Q62]

OHSA_Q61. How many times did you use a mouth rinse or mouth wash in the last week?

1–97[ENTER HOW MANY TIMES]

98Don’t know

99Refused

Module 14: Wearing of mouthguards [adults with natural teeth]

OHSA_Q62. Do you play contact sport?

1Yes

2No[Go to OHSA_Q65]

98Don’t know[Go to OHSA_Q65]

99Refused[Go to OHSA_Q65]

OHSA_Q63. When you are playing contact sports do you wear a mouth guard to protect your teeth from injury?

Showcard Q63: Module 14

1Always

2Often

3Sometimes

4Occasionally

5Never[Go to OHSA_Q65]

98Don’t know[Go to OHSA_Q65]

99Refused[Go to OHSA_Q65]

OHSA_Q64. Where do you get your mouthguard from?

Showcard Q64: Module 14

1Chemist/pharmacy

2Sports shop

3The internet

4Large retailer, eg, the Warehouse

5Dental professional

6Sports team supplies the mouthguard

98Don’t know

99Refused

Module 15: Current smoking status [all adults]

OHSA_Q65. Have you ever smoked cigarettes or tobacco at all,even just a few puffs? Please include pipes and cigars.

!INTERVIEWER NOTE: If asked, this does not include marijuana.

1Yes

2No[Go to OHSA_Q68]

98Don’t know[Go to OHSA_Q68]

99Refused[Go to OHSA_Q68]

OHSA_Q66. Have you ever smoked a total of more than 100cigarettes in your whole life?

1Yes

2No

98Don’t know

99Refused

OHSA_Q67. How often do you now smoke?

!INTERVIEWER NOTE:Read answer options. If more than one frequency, code the highest one.

Showcard Q67: Module 15

1You don’t smoke now

2At least once a day

3At least once a week

4At least once a month

5Less often than once a month

98Don’t know

99Refused

Utilisation of Oral Health Services, Nature of Barriers to Accessing Services, and the Extent of any Unmet Need

Module 16:Dental visits in last 12 months [all adults]

OHSA_Q68. Have you been to a dental professional in the last 12 months?

1Yes

2No[Go to OHSA_Q70]

98Don’t know[Go to OHSA_Q70]

99Refused[Go to OHSA_Q70]

Module 17: Tooth extraction in last 12 months [all adults]

OHSA_Q69. Have you had a tooth taken out by a dental professional during the last 12 months?

!INTERVIEWER NOTE:Not for orthodontic reasons [orthodontic] – treatment of improper bites, tooth irregularity, requiring braces.

1Yes[Go to OHSA_Q71]

2No[Go to OHSA_Q71]

98Don’t know[Go to OHSA_Q71]

99Refused

Module 18:Reasons for no visit in last 12 months [all adults]

OHSA_Q70. What are the reasons you have not visited a dental professional in the last 12 months?

!INTERVIEWER NOTE: Select all that apply.

Showcard Q70: Module 18

1Afraid of dental professionals / don’t like the thought of going to a dental professional

2Nervous

3Needles

4Cost

5Don’t know dentist

6Dentist too far/ difficult to make the journey

7Can’t get there

8No problems

9No teeth

10Not important

11Didn’t think of it

12Other, please specify

98Don’t know

99Refused

Module 19: Last visit (reason) [all adults]

OHSA_Q71. What was the main reason that you last visited a dental professional?

Showcard Q71: Module 19

1Went in on own for check-up, examination or cleaning

2Was called in by the dental professional for check-up, examination or cleaning

3Something was wrong, bothering or hurting

4Went for treatment of a condition that dental professional discovered at earlier check-up or examination

5To get treatment for teeth damaged in an accident

98Don’t know

99Refused

Module 20: Last visit (dental services by type) [all adults]

OHSA_Q72A. What did you have done during this last visit?

!INTERVIEWER NOTE: Select all mentioned.

Showcard Q72: Module 20

1General exam, check-up or consultation

2Cleaning or polishing

3X-rays, radiographs or bite-wings

4Fluoride treatment

5Sealant (plastic coatings on back teeth)

6Fillings

7Inlays

8Crowns or caps

9Root canal

10Periodontal scaling, root planing, or gum surgery

11Periodontal recall visit (periodic or recall)

12Extraction, tooth pulled

13Implants

14Abscess or infection treatment

15Other oral surgery (eg, third molar surgery)

16Fixed bridges

17Dentures or removable partial dentures

18Relining or repair of bridges or dentures

19Orthodontics, braces or retainers

20Whiten or bleach

21Treatment for TMD or TMJ

22Other, please specify

98Don’t know

99Refused

[If answered No to OHSA_Q1, go to OHSA_Q72B]

OHSA_Q72B. What did you have done during this last visit?