2021 Oral Health Assessment: Pregnant Women Survey

Oral Health Long Beach (OHLB) is a five-year program funded by the state of California to promote oral health as an important component of overall public health. Thank you for completing this survey. The data will help to assess the needs of the community regarding dental care. The survey is anonymous and no identifying information is requested.

1.What is you ZIP Code?

3.Are you insured?

4.If Yes, what kind of insurance?

5.Do you have a dentist?

6.If yes, please name your dentist or dental office

9.Do you have Diabetes?

10.Do you have HIV/AIDS?

11.Is there tobacco use in your home, including vaping, chewing, smoking of any kind?

12.Have you had dental pain that caused you to miss work?

13.Do your gums bleed?

14.Have you seen a dentist during your pregnancy? (It is highly recommended that you do visit a dentist while pregnant. It is safe to do so. Please disclose to your dentist that you are pregnant.)

15.How would you describe your general dental health?

Good

Fair

Poor

Thank you for assisting Oral Health Long Beach

VISION:

Oral health for all

MISSION:

Through collaboration with stakeholders, the Oral Health Long Beach program serves the greater Long Beach community, by connecting people to quality oral health education and dental care.