Dental Implant Usage Survey
Help us understand your experience and satisfaction with dental implants. Your feedback will support better patient care and implant outcomes.
Your Full Name
*
First Name
Last Name
Your Age
*
Gender
*
Male
Female
Non-binary
Prefer not to say
How long ago did you receive your dental implant(s)?
*
Please Select
Less than 1 year ago
1-3 years ago
4-6 years ago
7-10 years ago
More than 10 years ago
How many dental implants do you have?
*
What type of dental implant(s) do you have?
*
Single tooth implant
Multiple teeth implants
Full arch implant
Other (please specify)
Please rate your overall satisfaction with your dental implant(s).
*
1
2
3
4
5
Since receiving your dental implant(s), have you experienced any of the following? (Select all that apply)
*
Pain or discomfort
Infection
Gum issues
Implant loosening
No complications
Other (please specify)
How often do you visit your dentist for check-ups after receiving your implant(s)?
*
Every 3 months
Every 6 months
Once a year
Only when I have a problem
Please indicate your agreement with the following statements about your dental implant(s):
*
Rows
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
My dental implant(s) feel natural in my mouth.
1
2
3
4
5
I can eat and chew comfortably with my implant(s).
6
7
8
9
10
I am confident in my smile since receiving my implant(s).
11
12
13
14
15
The maintenance of my implant(s) is easy for me.
16
17
18
19
20
Please describe your daily oral care routine for your dental implant(s).
Do you have any suggestions or feedback to improve dental implant care or the patient experience?
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