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What is your gender?
 
Male
 
Female
 
 
 
What is your age?
 
20-20
 
30-39
 
40-49
 
50-59
 
>60
 
 
 
How many years have you been practicing pediatric dentistry?
 
<10
 
10-19
 
20-29
 
>30
 
 
 
What type of pediatric dentistry training did you receive?
 
Master’s degree (3 or more years)
 
Certificate (2 years)
 
 
 
In what type of institution did you receive your pediatric dentistry training?
 
Hospital-based
 
University- based
 
PhD
 
Combined
 
 
 
Which of the following best describes your current primary activity?
 
Private practice
 
Academic
 
Hospital-based
 
Publicly funded clinic (eg. Dental Public Health/Medicaid clinic/military)
 
Retired from active practice
 
 
 
Where is your practice located?
 
Western Canada- British Columbia, Alberta, Saskatchewan
 
Central Canada- Manitoba, Ontario, Quebec
 
Eastern Canada- New Brunswick, Prince Edward Island, Nova Scotia, Newfoundland and Labrador
 
Northern Canada- Yukon, Northwest Territories, Nunavut
 
New England- Maine, New Hampshire, Vermont, Massachusetts, Rhode Island, Connecticut
 
Mid-Atlantic – New York, Pennsylvania, New Jersey
 
East North Central – Wisconsin, Michigan, Illinois, Indiana, Ohio
 
West North Central – North Dakota, South Dakota, Nebraska, Kansas, Minnesota, Iowa, Missouri
 
South Atlantic – Delaware, Maryland, District of Columbia, Virginia, West Virginia, North Carolina, South Carolina, Georgia, Florida
 
East South Central – Kentucky, Tennessee, Mississippi, Alabama
 
West South Central – Oklahoma, Texas, Arkansas, Louisiana
 
Mountain – Idaho, Montana, Wyoming, Nevada, Utah, Colorado, Arizona, New Mexico
 
Pacific – Alaska, Washington, Oregon, California, Hawaii
 
 
 
How many patients do you see in an average day?
 
0-4
 
5-9
 
10-14
 
15-20
 
20+
 
 
 
How many patients do you perform restorative treatment on in an average day?
 
0-4
 
5-9
 
10-14
 
15+
 
 
What percentage of your practice includes...
0-24% 25-49% 50-74% 75-100%
Developmentally delayed children
Medically compromised children
 
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