Age (years)
Country of Residence
Marital Status
No. of Siblings
Employment
Monthly Income (SAR)
Educational Level
Residence
Residence (Categories 2)
Systemic Diseases
Systemic Diseases (Categories 2)
Medications in past 6 months?
Medications in past 6 months? (Categories 2)
what is the types of medications?
Age of Puberty (years)?
Regularilty of Period?
Timing of Last Period (days)?
Length of Period Discontinuation (years)?
Smoking
Smoking (Categories 2)
Type of Smoking?
No. of cigarettes (or equivilant) per day?
How long have you been smoking (months)?
Do you brush you teeth?
Do you brush you teeth? (Categories 2)
Do you use other dental cleaning aids (e.g. dental floss, toothpicks, small brushes, siwak)?
Do you use other dental cleaning aids (e.g. dental floss, toothpicks, small brushes, siwak)? (Categories 2)
Do you use mouthwash?
Do you use mouthwash? (Categories 2)
When was the last visit to the dentist?
What was the reason for the last visit to the dentist?
Have you lost any of your teeth?
How many teeth have you lost?
Why did you lose your teeth?
Do you have a tooth replacement?
Do you have a tooth replacement? (Categories 2)
VQ3) Do you find any red or swollen area of your gum more than usual?
Do you bleed gums easily?
Do you feel that your gum is painful?
Do you feel dry mouth?
Have you noticed an unpleasant smell from your mouth?
Do you have any abscess or pus in the mouth?
VQ5) Do you trap foods between your teeth?
VQ4) Do you feel movement in your teeth?
Have you noticed a change in the position of your teeth?
VQ6) Have you noticed that your teeth have become longer?
Do you feel any sensitivity in your teeth?
Do you have any calculus or limestone deposits on your teeth
VQ1) Do you think you have periodontal disease or gum disease, or loss of bone fixation
Has any dentist or hygeinist told you that you have deep gingival pockets?
VQ2) Have you ever been told by a dentist that you have periodontal/gum disease with bone loss?
Have you been informed that you need treatment for the gingiva or periodontal tissue?
Have you received any treatment for the gingival or periodontal tissue?
Have you received surgical treatment for the periodontal tissue?
Self-Reported Periodontal Disease Scale Score - SRPDSS (6 VQs)
Self-Reported Periodontal Disease Scale Score (SRPDSS) (Categories 2)
Self-Reported Periodontal Disease Scale Score (SRPDSS)