DEPARTMENT OF PUBLIC HEALTH DENTISTRY, PACIFIC DENTAL COLLEGE & HOSPITAL

Impact of Oral Health Promotion Materials among the patients visiting Pacific Dental College &
Hospital: A Questionnaire Survey

I, ................................................... have been informed about the purpose of the study and I am willing to furnish
whatever information is being asked without any objection.

Signature

General information

Age (in years):.......... Gender: M/F Level of education: Illiterate / Primary school/ Middle
school/ Graduate / Post graduation

1. How often do you read/listen oral health promotion materials in the waiting area-
● Never ●Rarely ●Occasionally ●Frequent ●Always

If the answer is never, what are the reasons for it –

a) Reading is not my thing
b) I prefer reading a magazine/leaflet
c) If there are many people in the waiting area, it is disturbing to read & listen
d) I think posters are easy to read in the waiting area

2. Are you able to understand the facts in the material – YES / NO

3. Do you find the terms used in the material easy – YES / NO

4. When you read/ listen oral health promotion material, do you discuss its contents with dentist – YES
/NO

5. Have you learned anything from the oral health promotion materials – YES / NO

6. Do you share the information with others – YES / NO

7. Were the oral health promotion materials easily accessible & convenient to read & listen- YES / NO

8. Have you learned something new about improving your oral health- YES / NO

9. Did it help you to improve your oral health related knowledge- YES / NO

10. Do you think oral health promotion materials are readable - YES / NO

11. Do you think the quality of videos are satisfactory – YES / NO

12. Have you noticed the oral health promotion advertisement prepared by the Ministry of Health &
Family Welfare, Government Of India - YES / NO

If yes, what all information have you gathered from that video –
a) Regular visits to your dentist are important.
b) Oral health is the mirror of general health
c) Proper brushing & rinsing your mouth after every meal is important.
d) Maintenance of good oral hygiene is important in pregnant lady, for the good health of her
baby.

13. Which video/ material caught your attention the most

-....................................................................................................................................................................
......................................................................................................................................................................
..
14. Some things that you want to add in the oral health promotion material –
......................................................................................................................................................................
......................................................................................................................................................................