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?