By completing this survey, you give Pulpdent Corporation permission to use the information you provide below for quality assurance and compliance purposes.

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* 1) How often do you personally apply fluoride varnish?

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* 2) Which fluoride material do you use regularly?

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* 3) How long have you been using this material? 

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* 4) What do you like most about this product?

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* 5) Please rate the characteristics of the fluoride varnish you chose

  Excellent Good Fair Poor N/a
Color
Texture
Smell
Flowability
Handling
Cost
Ion Release
Patient Acceptance

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* 6) For any answer of fair or poor, please explain:

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* 7) Have your patients experienced any negative issues such as allergic reaction, post-op sensitivity, or infection after use of this material?

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* If yes, please rate the severity of the issue

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* Comments:

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* I give Pulpdent consent to follow up in 6 months

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* Please provide your information, so Pulpdent can contact you for follow up

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