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. 2019 Apr 23;14:881–892. doi: 10.2147/COPD.S194991

Table S1.

Oral health questionnaire

Global oral health assessment
Overall, how would you rate the health of your teeth and gums? Excellent Very good Good Fair Poor
OHIP-5
In the last month: Never Hardly ever Occasionally Fairly often Very often
Have you had difficulty chewing any foods because of problems with your teeth, mouth, dentures, or jaw?
Have you had painful aching in your mouth?
Have you felt uncomfortable about the appearance of your teeth, mouth, dentures, and jaws?
Have you felt that there has been less flavor in your food because of problems with your teeth, mouth, dentures, or jaws?
Have you had difficulty doing your usual jobs because of problems with your teeth, mouth, dentures, or jaws?
Dental symptoms
Yes No
Do you think you might have gum disease? (symptoms of gum disease include bad breath that won’t go away, red or swollen gums, tender or bleeding gums, painful chewing, loose teeth, sensitive teeth, and receding gums or longer appearing teeth).
Have you ever had any teeth become loose on their own, without an injury?
Do your gums bleed after you brush your teeth?
Do you have dry mouth?
Dental habits
Do you have removable dentures? Yes No
If yes, are your dentures: Partial denture Full denture
How often do you brush or clean your teeth or dentures? Never <1x per day 1x per day 2x per day >2x per day
How long has it been since you last saw a dental specialist (dentist or orthodontist)? <6 months ago 6–12 months ago 1–2 years ago >2 years ago Never
Do you use any of the following to clean your teeth or dentures? (check all that apply) Tooth-brush Dental floss Mouth-wash Denture cleanser