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Table 1 Questionnaire used in the study

From: Factors influencing patient satisfaction with dental appearance and treatments they desire to improve aesthetics

Survey on patient satisfaction with dental appearance and desired treatment to improve aesthetics

1. Sex â–¡Male â–¡Female

2. Age:___________(years)

3. Education level: â–¡ Primary â–¡ Secondary â–¡ Post secondary â–¡ Tertiary

1.

Are you satisfied with the general appearance of your teeth?

â–¡ Yes

â–¡ No

2.

Are you satisfied with your tooth color?

â–¡ Yes

â–¡ No

3.

Do you feel your teeth are crowded?

â–¡ Yes

â–¡ No

4.

Do you feel your teeth are poorly aligned?

â–¡ Yes

â–¡ No

5.

Do you feel your teeth are protruding?

â–¡Yes

â–¡ No

6.

Do you have dental caries in your front teeth?

â–¡ Yes

â–¡ No

7.

Do you have non-aesthetic fillings in your front teeth?

â–¡ Yes

â–¡ No

8.

Do you have fractures in your front teeth?

â–¡ Yes

â–¡ No

9.

Do you wish to undergo these treatments to improve the appearance of your teeth?

  
 

a. Orthodontic treatment to realign teeth

â–¡ Yes

â–¡ No

 

b. Tooth whitening

â–¡ Yes

â–¡ No

 

c. Dental crowns

â–¡ Yes

â–¡ No

 

d. Tooth coloured fillings

â–¡ Yes

â–¡ No

 

e. Dentures

â–¡ Yes

â–¡ No