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MetLife - Dental Survey 01 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=0C367FF0-9A1C-3FCD-E044-0003BA3F9857

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https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=0C367FF0-9A1C-3FCD-E044-0003BA3F9857
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  1. 12/18/14 12/18/14 - Martin Dugas
  2. 9/20/21 9/20/21 -
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September 20, 2021

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Creative Commons BY-NC 3.0 Legacy
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Demographic - MetLife - Dental Survey 01 - 2448788v1.0

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  1. StudyEvent: MetLife - Dental Survey 01
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Contact Information
A. Post Operative Hypersensitivity With Composite Resin Restorations
Is the frequency of composite resin hypersensitivity a concern in your practice
What is your estimate of the percentage of Class I restorations with this problem
How frequently have you noticed hypersensitivity in two or more restorations for a number of patients
Do you routinely use a self-etching dentin bonding system for composite restorations
Do you routinely use a resin modified glass ionomer liner for composite restorations
B. Dental Care For Pregnant Women
Do you provide comprehensive dental care for pregnant women in your practice
Do you limit treatment of pregnant women to emergency care
About how many individual pregnant women present for care in your dental practice
Does your state have guidelines for treatment of pregnant women
C. Porcelain Repair
How often is porcelain repair employed in your practice on a per month basis
How often do these repairs fail
Do you use hydrofluoric acid etching of porcelain during the repair
Do you use "micro etching" (sandblasting) during a porcelain repair
Do you use both "micro etching" and hyrofluorid acid etching
C. Porcelain Repair
In mildly symptomatic teeth do you selectively leave caries in deep preparations to avoid pulpal exposure
If yes to the above, what method of indirect pulp capping procedure do you follow
If no to the above, do you usually
If you must perform a direct pulp cap which procedure do you follow after stopping the bleeding
E. Smoking Cessation
Do you have a smoking cessation program in your practice
If yes, what percentage of the patients approached concerning this program participates
If no, would you consider incorporation of a program if it were reimbursed for each patient enrolled
Is a course on smoking cessation required for a dental license in your state
F. Visual Classification Of Caries
Are you aware of visual classification systems for the progress of caries
Do you routinely employ a caries risk assessment of patients in your practice that is part of the patient chart
Do you place any of your patients on a caries management program with the intent of promoting remineralization of early lesions
G. Cracked Tooth
How often in a month do you diagnose and treat a patient for one or more cracked posterior teeth
Do you feel the diagnosis of a cracked tooth is a routine procedure
What method besides visualization and radiographs do you primarily use to assist with diagnosis
H. Leaking Sealant Detection
Do you routinely apply sealants to children's teeth in your practice
Do you routinely apply sealants to young adults (16-30 years of age) teeth in your practice
Would a dye with good sensitivity for detection of a leaking sealant be useful in your practice
If detection of leaking sealant was possible would this change and/or increase your use of sealants in your practice
Ii. Professional Information
General Practice or Specialist
If Specialist, which
Gender
Ethnicity
If Hispanic or Latino, specify
Race
Iii. Description Of Your Practice
How would you characterize your practice

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