Q1. Practice type: a:Solo b:Private group c:HP/PDA d:Public health e:academic f:other
Q2. Same bldg/org other medical care providers: a:Yes/bldg b:Yes/org c:No
Q8. Use computer to manage clinical patient data: a:Yes b:No
Q8a. Brand EDR currently use
Q8b. Likelihood EDR in 2 yrs: a:very likely| b:somewhat| c:not likely| d:not sure
Q10. Willing use data office system data for DPBRN studies: a:Yes b:No c:Dont know
Q11. Willing use electronic vs. paper forms for DPBRN: a:Yes b:No c:Dont know
Q12. Preference for RC contact: a:email me|b:email staffer|c:phone call me|d:phone staffer|e:socialmedia|f:mail
Q13. Preference for new DPBRN results/info: a:email| b:postal mail| c:social media| d:Other
Q14. Personally perform root canals? a:Yes b:No
Q14a. % root canals performed using rubber dam: a:none| b:<25%| c:25-50%| d:51-75%| e:76-99%| f:all
Q14b. Perform root canals-use isolation? a:Yes b:No
Q17. Ever worked w/ EFDH/EFDA normal: a:Yes b:No
Q18. Experience working w/ EFDH/DA: a:much>avg| b:some>avg| c:avg| d:some<avg| e:much<avg
Q19. Think EFDH/EFDA pos/neg on dental care: a:very+| b:+| c:some+| d:someneg| e:neg| f:veryneg| g:DK
Q20. How informed about dental therapist provider: a:not b:little c:somewhat d:moderate e:very
Q22. Think DTs pos/neg impact:a:very+|b:+|c:some+|d:someneg|e:neg|f:veryneg|g:DK
Q23. Practice in MN?: a:Yes b:No
Q24M. MN-Consider hiring DTs: a:VeryUnlikely|b:SomeUnlikely|c:SomeLikely|d:VeryLikely
Q25M. MN-Impact DTs on dental care access: a:Decrease|b:SomeDec|c:None|d:SomeInc|e:Inc|f:DK
Q28M. SES reporting to Board--concern: a:None| b:Little| c:Some| d:Much
Q24. NonMN Consider hiring DTs: a:VeryUnlikely| b:SomeUnlikely| c:SomeLikely| d:VeryLikely
Q25. NonMN Impact DTs on dental care access: a:Decrease| b:SomeDec| c:None| d:SomeInc| e:Inc| f:DK
Q13d. Preference for new DPBRN results/info: Other specified
Q14b. Perform root canals, specific other type of isolation used
Q3. % patients consider you their regular dental care provider
Q4. % patients seek regular/occasional dental care
Q4. % patients seek dental care only for problems
Q5. % patients have regular medical care provider
Q6. % patients diagnosed with diabetes
Q6. % patients diagnosed with CVD/HTN
Q7. Past month, # patients referred to MD for medical problems
Q9. How store clin info: Chief complaint--Paper
Q9. How store clin info: Chief complaint--Computer
Q9. How store clin info: Med hx--Paper
Q9. How store clin info: Med hx--Computer
Q9. How store clin info: Dental hx--Paper
Q9. How store clin info: Dental hx--Computer
Q9. How store clin info: Dental hx--Not at all
Q9. How store clin info: Progress notes--Paper
Q9. How store clin info: Progress notes--Computer
Q9. How store clin info: Prob list/dx--Paper
Q9. How store clin info: Prob list/dx--Computer
Q9. How store clin info: Trtmt plan--Paper
Q9. How store clin info: Trtmt plan--Computer
Q9. How store clin info: Completed trt--Paper
Q9. How store clin info: Completed trt--Computer
Q9. How store clin info: Dental status--Paper
Q9. How store clin info: Dental status--Computer
Q9. How store clin info: Dental status--Not at all
Q9. How store clin info: Periodon charting--Paper
Q9. How store clin info: Periodon charting--Computer
Q9. How store clin info: Radiographs--Paper
Q9. How store clin info: Radiographs--Computer
Q9. How store clin info: Extraoral images/photos--Paper
Q9. How store clin info: Extraoral images/photos--Computer
Q9. How store clin info: Extraoral images/photos--Not at all
Q9. How store clin info: Intraoral images/photos--Paper
Q9. How store clin info: Intraoral images/photos--Computer
Q9. How store clin info: Intraoral images/photos--Not at all
Q9. How store clin info: Appts--Paper
Q9. How store clin info: Appts--Computer
Q9. How store clin info: Other--Paper
Q9. How store clin info: Other--Computer
Q9. How store clin info: Other--Not at all
Q15a. Employs-Associate Dentist(s): 1:Yes 0:No
Q15b. Employs-Expanded Function Dental Hygienist (EFDH): 1:Yes 0:No
Q15c. Employs-Dental Hygienist(s): 1:Yes 0:No
Q15d. Employs-Expanded Function Dental Assistant(s): 1:Yes 0:No
Q15e. Employs-Dental Assistant(s): 1:Yes 0:No
Q16. Procedure-Oral health ed/prevent: None 1:Yes 0:No
Q16. Procedure-Oral health ed/prevent: Dentist 1:Yes 0:No
Q16. Procedure-Oral health ed/prevent: DentHyg 1:Yes 0:No
Q16. Procedure-Oral health ed/prevent: DentAsst 1:Yes 0:No
Q16. Procedure-Take radiographs: Dentist 1:Yes 0:No
Q16. Procedure-Take radiographs: DentHyg 1:Yes 0:No
Q16. Procedure-Take radiographs: DentAsst 1:Yes 0:No
Q16. Procedure-Take impressions: None 1:Yes 0:No
Q16. Procedure-Take impressions: Dentist 1:Yes 0:No
Q16. Procedure-Take impressions: DentHyg 1:Yes 0:No
Q16. Procedure-Take impressions: DentAsst 1:Yes 0:No
Q16. Procedure-Apply topical meds: None 1:Yes 0:No
Q16. Procedure-Apply topical meds: Dentist 1:Yes 0:No
Q16. Procedure-Apply topical meds: DentHyg 1:Yes 0:No
Q16. Procedure-Apply topical meds: DentAsst 1:Yes 0:No
Q16. Procedure-Etch enamel/apply sealants: None 1:Yes 0:No
Q16. Procedure-Etch enamel/apply sealants: Dentist 1:Yes 0:No
Q16. Procedure-Etch enamel/apply sealants: DentHyg 1:Yes 0:No
Q16. Procedure-Etch enamel/apply sealants: DentAsst 1:Yes 0:No
Q16. Procedure-Place/remove rubber dam: None 1:Yes 0:No
Q16. Procedure-Place/remove rubber dam: Dentist 1:Yes 0:No
Q16. Procedure-Place/remove rubber dam: DentHyg 1:Yes 0:No
Q16. Procedure-Place/remove rubber dam: DentAsst 1:Yes 0:No
Q16. Procedure-Fabricate athletic mouth guard: None 1:Yes 0:No
Q16. Procedure-Fabricate athletic mouth guard: Dentist 1:Yes 0:No
Q16. Procedure-Fabricate athletic mouth guard: DentHyg 1:Yes 0:No
Q16. Procedure-Fabricate athletic mouth guard: DentAsst 1:Yes 0:No
Q16. Procedure-Denture soft relines: None 1:Yes 0:No
Q16. Procedure-Denture soft relines: Dentist 1:Yes 0:No
Q16. Procedure-Denture soft relines: DentHyg 1:Yes 0:No
Q16. Procedure-Denture soft relines: DentAsst 1:Yes 0:No
Q16. Procedure-Remove supra-ging deposits: None 1:Yes 0:No
Q16. Procedure-Remove supra-ging deposits: Dentist 1:Yes 0:No
Q16. Procedure-Remove supra-ging deposits: DentHyg 1:Yes 0:No
Q16. Procedure-Remove supra-ging deposits: DentAsst 1:Yes 0:No
Q16. Procedure-Remove sub-ging deposits: None 1:Yes 0:No
Q16. Procedure-Remove sub-ging deposits: Dentist 1:Yes 0:No
Q16. Procedure-Remove sub-ging deposits: DentHyg 1:Yes 0:No
Q16. Procedure-Remove sub-ging deposits: DentAsst 1:Yes 0:No
Q16. Procedure-Perform root cutterage: None 1:Yes 0:No
Q16. Procedure-Perform root cutterage: Dentist 1:Yes 0:No
Q16. Procedure-Perform root cutterage: DentHyg 1:Yes 0:No
Q16. Procedure-Perform root cutterage: DentAsst 1:Yes 0:No
Q16. Procedure-Remove excess cement: Dentist 1:Yes 0:No
Q16. Procedure-Remove excess cement: DentHyg 1:Yes 0:No
Q16. Procedure-Remove excess cement: DentAsst 1:Yes 0:No
Q16. Procedure-Place temp fillings: None 1:Yes 0:No
Q16. Procedure-Place temp fillings: Dentist 1:Yes 0:No
Q16. Procedure-Place temp fillings: DentHyg 1:Yes 0:No
Q16. Procedure-Place temp fillings: DentAsst 1:Yes 0:No
Q16. Procedure-Cement/adjust temp restorations: None 1:Yes 0:No
Q16. Procedure-Cement/adjust temp restorations: Dentist 1:Yes 0:No
Q16. Procedure-Cement/adjust temp restorations: DentHyg 1:Yes 0:No
Q16. Procedure-Cement/adjust temp restorations: DentAsst 1:Yes 0:No
Q16. Procedure-Re-cement perm crowns: None 1:Yes 0:No
Q16. Procedure-Re-cement perm crowns: Dentist 1:Yes 0:No
Q16. Procedure-Re-cement perm crowns: DentHyg 1:Yes 0:No
Q16. Procedure-Re-cement perm crowns: DentAsst 1:Yes 0:No
Q16. Procedure-Cavity excavation/prep: None 1:Yes 0:No
Q16. Procedure-Cavity excavation/prep: Dentist 1:Yes 0:No
Q16. Procedure-Cavity excavation/prep: DentHyg 1:Yes 0:No
Q16. Procedure-Place/carve/adjust restorations: None 1:Yes 0:No
Q16. Procedure-Place/carve/adjust restorations: Dentist 1:Yes 0:No
Q16. Procedure-Place/carve/adjust restorations: DentHyg 1:Yes 0:No
Q16. Procedure-Place/carve/adjust restorations: DentAsst 1:Yes 0:No
Q16. Procedure-Suture removal: None 1:Yes 0:No
Q16. Procedure-Suture removal: Dentist 1:Yes 0:No
Q16. Procedure-Suture removal: DentHyg 1:Yes 0:No
Q16. Procedure-Suture removal: DentAsst 1:Yes 0:No
Q16. Procedure-Extract primary teeth: None 1:Yes 0:No
Q16. Procedure-Extract primary teeth: Dentist 1:Yes 0:No
Q16. Procedure-Extract primary teeth: DentHyg 1:Yes 0:No
Q16. Procedure-Admin local anesthetic: Dentist 1:Yes 0:No
Q16. Procedure-Admin local anesthetic: DentHyg 1:Yes 0:No
Q16. Procedure-Admin N2O inhalation: None 1:Yes 0:No
Q16. Procedure-Admin N2O inhalation: Dentist 1:Yes 0:No
Q16. Procedure-Admin N2O inhalation: DentHyg 1:Yes 0:No
Q16. Procedure-Admin N2O inhalation: DentAsst 1:Yes 0:No
Q21a. DT-Disrupt relationship w/patients: 1:strong agree-->4:strong disagree, 5:DK
Q21b. DT-Free time for more complex dental: 1:strong agree-->4:strong disagree, 5:DK
Q21c. DT-Admin burden not worth it: 1:strong agree-->4:strong disagree, 5:DK
Q21d. DT-Trust quality in all trained areas: 1:strong agree-->4:strong disagree, 5:DK
Practitioner type 1-4
Practitioner Gender 1=M 2=F
Practitioner race
Practitioner ethnicity: 1=Hispanic 2=Not
Graduation year category
AL/MS, FL/GA, Other SE, PDA/West, HP/Midwest, SK
Q26Ma. DTs issues w/ liability ins: 1:NotImportant| 2:A little| 3:SomeImport| 4:VeryImport
Q26Mb. Contract agreemt b/n dentist/DT:1:NotImportant| 2:A little| 3:SomeImport| 4:VeryImport
Q26Mc. Whether DT has experience as DA:1:NotImportant| 2:A little| 3:SomeImport| 4:VeryImport
Q26Md. Whether DT has experience as RDH:1:NotImportant| 2:A little| 3:SomeImport| 4:VeryImport
Q27Ma. Barriers hiring DT-Space: 1:Big| 2:Mod| 3:Small| 4:None| 5:DK
Q27Mb. Barriers hiring DT-Overhead: 1:Big| 2:Mod| 3:Small| 4:None| 5:DK
Q27Mc. Barriers hiring DT-Patient Accept: 1:Big| 2:Mod| 3:Small| 4:None| 5:DK
Q27Md. Barriers hiring DT-Demand: 1:Big| 2:Mod| 3:Small| 4:None| 5:DK
Q27Me. Barriers hiring DT-Supervision: 1:Big| 2:Mod| 3:Small| 4:None| 5:DK
Q27Mf. Barriers hiring DT-Risk Leaving: 1:Big| 2:Mod| 3:Small| 4:None| 5:DK
Practitioner Specialty
Month survey completed
Year survey completed