Questionnaire

Questionnaire 1: Knowledge of Green Tea Oral Health Benefits

1. Do you know that:

A. Tea is the most popular drink besides water in the world? Yes NoB. All tea originates from the same plant, Camelia sinensis? Yes NoC. Green tea differs from black tea in the way that it is processed? Yes NoD. Tea contains antioxidants? Yes NoE. Tea contains polyphenols? Yes NoF. EGCG is the major polyphenol in green tea? Yes No

2. For each of the following statements, do you agree or disagree?

A. Green tea can help prevent cavities (dental caries) Agree DisagreeB. Green tea can help prevent bad breath (halitosis) Agree DisagreeC. Green tea can help protect tooth enamel Agree DisagreeD. Green tea is good for your oral health Agree Disagree

3. How often do you drink any kind of tea: Never Rarely Often

4. What type of tea do you drink (choose all that apply):

A. HotB. Cold/IcedC. GreenD. BlackE. WhiteF. HerbalG. OolongH. Other please specify: _______________

5. Why do you drink tea (choose all that apply)

A. TasteB. CaffeineC. For health reasonsD. Other please specify: _________________________________

6. Have you ever taken a green tea and/or EGCG supplement? Yes No

7. Do you use toothpaste and/or mouthwash that have green tea in it? Yes No

8. What is your age?

A. 18 – 25B. 26 – 35C. 36 – 45D. 46 – 55E. Over 56

9. What is your gender?

A. MaleB. Female