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Table 1 Questionnaire including the various components of oral health

From: Self-reported oral health in the Dutch 100-plus Study of cognitively healthy centenarians: an observational cohort study

Do you have:
☐ natural teeth
☐ natural teeth in combination with a removable partial denture
☐ removable complete dentures
☐ no natural teeth, no removable dentures
What is the time period since your last visit to an oral health care provider?
☐ Less than one year
☐ 1–5 year(s)
☐ 5–10 years
☐ 10–20 years
Do you experience pain or discomfort in your mouth?
☐ Yes
☐ No
☐ Sometimes
Are you able to chew adequately?
☐ Yes
☐ Rather good
☐ Poor
☐ No
Which option does apply to your situation?*
☐ My mouth feels dry when eating
☐ My mouth feels dry
☐ I have difficulty eating dry foods
☐ I have difficulties swallowing certain foods
☐ My lips feel dry
  1. *Xerostomia questionnaire. Reply on this questionnaire can be: “never” = 1, “sometimes” = 2, “always” = 3. A total sumscore < 8 indicates no xerostomia, a total sumscore ≥8 indicates xerostomia