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YOUR DENTAL CARE -- A Survey by the Caring Families Coalition

A health care system that meets the needs of all families and individuals – this important goal is the mission of the Caring Families Coalition (CFC), a community organization made up of Connecticut residents.

In this survey, we are interested in learning about whether you get dental care – and, if you do, what kind of care -- and about any factors that make it difficult for you to get good dental care.
DENTAL CARE - COST AND COVERAGE
1. 1.  How often do you go to the dentist?
2. 2.  Where do you usually go for dental care?
3. 3.  When was the last time you went to the dentist?
4. 4.  Do you have dental insurance?
ADEQUACY OF CARE
5. 5.  Have you ever had a tooth pulled without a replacement (other than wisdom teeth)?
6. 6.  Have you ever had a tooth pulled because you could not afford to save it?
7. 7.  Do you use over-the-counter dental medications instead of going to the dentist (for example, Oragel, Ambesol)?
8. 8.  Have you ever refused any recommended dental treatment because of the cost?
 
BARRIERS TO GETTING DENTAL CARE
9. 9.  Whether or not you go to the dentist, please check the factors that make it difficult for you to get dental care. (Check all the apply.)
10. 10.  Are you familiar with the Connecticut Dental Health Partnership and what it can do for Husky ( Medicaid) clients?
11. .  .  .  .  .  .  10a.  If you have Huskie (Medicaid) insurance, do you know that you have dental coverage?
12. 11.  Are you familiar with Logisticare?  (Free medical transportation for Husky participants)
And, finally, a few questions that will help us understand your answers about your dental care.
14. 13.  How old are you?
15. 14.  What is your gender?
16. 15.  What is your race/ethnicity?
Thank you very much for helping us learn more about getting dental care in Connecticut. Your participation is important to us!

If you would like to receive the results of this survey-- or learn about the Caring Families Coalition and our work to improve dental health-- please fill in the following information or call us at 860-524-0502.

Enter the following information to be eligible to win one of several gift cards for local stores.
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