Table 1.
Child Oral Health Impact Profile original and Short Form (++ indicates items retained in short form)
| Oral Symptoms |
| ++Had pain in your teeth/toothache. |
| Been breathing through your mouth or snoring. |
| ++Had discolored teeth or spots on your teeth. |
| ++Had crooked teeth or spaces between your teeth. |
| Had sores or sore spots in or around your mouth. |
| ++Had bad breath. |
| ++Had bleeding gums. |
| Had food sticking in or between your teeth. |
| Had pain or sensitivity in teeth with hot or cold things. |
| Had dry mouth or lips. |
| Functional Well-being |
| Had trouble biting off or chewing foods such as apple, carrot or firm meat. |
| ++Had difficulty eating foods you would like to eat |
| ++Had trouble sleeping1 |
| ++Had difficultly saying certain words |
| Had people have difficulty understanding what you were saying. |
| ++Had difficulty keeping your teeth clean |
| Social-Emotional Well-being1 |
| ++Been unhappy or sad |
| ++Felt worried or anxious |
| ++Avoided smiling or laughing with other children |
| ++Felt that you look different |
| ++Been worried about what other people think about your... |
| Felt shy or withdrawn |
| ++Been teased, bullied or called names by other children |
| Been upset or uncomfortable with being asked questions about your... |
| School/Environment1 |
| ++Missed School for any reason |
| Had difficulty paying attention in school |
| ++Not wanted to speak/read out loud in class |
| Not wanted to go to school |
| Self-Esteem1 |
| ++Been confident |
| ++Felt that you were attractive (good looking) |
| I have good teeth. |
| I feel good about myself. |
| When I am older, I believe (think) that I will have good teeth. |
| When I am older, I believe (think) that I will have good health. |
1
Questions finish with “because of your teeth, mouth, or face”.