Uplift, Inc. Dental Hygiene Survey
This form will help Uplift collect information from the general public to help with the formation of a new dental hygiene project. Dental health is extremely important and we at Uplift want to help the students we serve protect the health of their teeth as much as we possibly can. Poor dental hygiene is linked to poor health and low academic performance.
Your responses will help inform this effort. We appreciate your time.
Feel free to learn more about Uplift, Inc. at
Please take your time and enjoy sharing your responses to the questions.
Thanks and have a great time!
Tell Us About Yourself!
Highest level of education
PhD, EdD, JD, MD
High School Diploma
What is your family's socioeconomic status?
Use the image below as a guide.
Above the poverty threshold for my family
At the poverty threshold for my family
Below the poverty threshold for my family
Do you have any cavities?
If you could obtain it, would you like a daily record of how you brush?
How often do you drink soda?
Once a day
With every meal
How often do you eat something sweet?
Once a day
Twice a day
Every time I crave something sweet
After every meal (dessert)
How often do you visit the dentist?
Only when I have pain
Once a year
Twice a year
More than twice a year
Do you have children in your household?
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