dentistry
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- | | **Questions English** | + | | **Questions English** |
- | | Have you ever had surgery? | + | | How often do you go to the dentist? |
- | | Have you ever had kidney surgery? | + | | dentist or oral hygienist / please fill in which of the health providers listed below you have contacted in the past 12 months |
- | | No. | Nee | HEALTH65A | + | | Have you been in contact with a dental hygienist and/or dentist in the past 12 months? | Hebt u in de afgelopen 12 maanden contact gehad met een mondhygiënist en/of tandarts? |
- | | Yes, because of kidney stones. | + | | Do you have supplementary insurance for dental treatments such as check-ups, fill cavities etc. (excluding dental braces) | Bent u aanvullend verzekerd |
- | | Yes, kidney was removed because of a medical problem (year). | + | | In the past 12 months, have you postponed a check-up appointment with the dentist/dental hygienist because of the expected costs? |
- | | Yes, I have donated a kidney for transplantation (year). | + | | In the past 12 months, have you postponed a dental treatment because of the expected costs? |
- | | Yes, I have had a kidney transplant (year). | + | | Dental check / Have you undergone the following treatments once or more in the past 12 months? | Gebitscontrole |
- | | Yes, I have had renal vessel balloon angioplasty (year). | + | | X-ray photo / Have you undergone the following treatments once or more in the past 12 months? |
- | | Have you ever had a tonsillectomy? | + | | Removal of denture calculus |
- | | If you have ever had a tonsillectomy, at what age did you have this surgery? | + | | Fluoride varnish |
- | | If you have ever had a tonsillectomy, how many times have you had this surgery? | aantal keer geopereerd | + | | Plastic dental sealant |
- | | Have you ever had surgery on the appendix? | + | | Filling / Have you undergone the following treatments once or more in the past 12 months? |
- | | If you have ever had surgery on the appendix, at what age did you have this surgery? | + | | Crown / Have you undergone |
- | | If you have ever had surgery on the appendix, how many times have you had this surgery? | Aantal keer geopereerd | + | | Bridge |
- | | Have you ever had surgery for an inguinal hernia? | Liesbreuk/ Kunt u aangeven waarvoor u bent geopereerd? | + | | Implant |
- | | If you have ever had surgery for an inguinal hernia, at what age did you have this surgery? | + | | Root canal treatment |
- | | If you have ever had surgery for an inguinal hernia, how many times have you had this surgery? | + | | Gum treatment / Have you undergone |
- | | Have you ever had knee surgery? | Knieoperatie/ Kunt u aangeven waarvoor u bent geopereerd? | + | | Pulling a wisdom tooth / Have you undergone |
- | | If you have ever had knee surgery, at what age did you have this surgery? | + | | Pulling |
- | | If you have ever had knee surgery, how many times have you had this surgery? | + | | Repairment of (partial) dentures / Have you undergone |
- | | Have you ever had a caesarean section? | + | | New (partial) dentures / Have you undergone |
- | | If you have ever had a caesarean section, at what age did you have this surgery? | + | | Braces / Have you undergone |
- | | If you have ever had a caesarean section, how many times have you had this surgery? | + | | None of the above / Have you undergone |
- | | Have you ever had sterilization surgery? | + | | |
- | | If you have ever had sterilization surgery, at what age did you have this surgery? | + | | |
- | | If you have ever had sterilization surgery, how many times have you had this surgery? | + | | |
- | | Have you ever had surgery for varicose veins? | Spataderen/ Kunt u aangeven waarvoor u bent geopereerd? | + | | |
- | | If you have ever had surgery for varicose veins, at what age did you have this surgery? | + | | |
- | | If you have ever had surgery for varicose veins, how many times have you had this surgery? | + | |
- | | Have you ever had surgery for spinal disc herniation? | Rughernia/ Kunt u aangeven waarvoor u bent geopereerd? | + | |
- | | If you have ever had surgery for spinal disc herniation, at what age did you have this surgery? | + | |
- | | If you have ever had surgery for spinal disc herniation, how many times have you had this surgery? | + | |
- | | Age (xx) / Other surgery 1-6 / How old were you when you had this surgery for the first time? | Leeftijd | + | |
- | | Reason | + | |
- | | If you have ever had surgery, how many times have you had surgery for this specific reason? Surgery 1-6 | Aantal keer geopereerd | + | |
- | | Age (xx) / Other surgery 7-22 / How old were you when you had this surgery for the first time? | + | |
- | | Reason | + | |
- | | If you have ever had surgery, how many times have you had surgery for this specific reason? Surgery 7-22 | Aantal keer geopereerd | + | |
- | | Have you had surgery since the last time you filled out this questionnaire? | Bent u geopereerd sinds de vorige keer dat u deze vragenlijst invulde? | + | |
- | | Have you had a tonsillectomy since the last time you filled out this questionnaire? | Verwijderen van amandelen/ Kunt u aangeven waarvoor | + | |
- | | If you have had a tonsillectomy, | + | |
- | | Have you had surgery on the appendix since the last time you filled out this questionnaire? | Blinde darmontsteking | + | |
- | | If you have had surgery on the appendix, how many times have you had this surgery since the last time you filled out this questionnaire? | + | |
- | | Have you had surgery for an inguinal hernia since the last time you filled out this questionnaire? | + | |
- | | If you have had surgery for an inguinal hernia, how many times have you had this surgery since the last time you filled out this questionnaire? | + | |
- | | Have you had knee surgery since the last time you filled out this questionnaire? | + | |
- | | If you have had knee surgery, how many times have you had this surgery since the last time you filled out this questionnaire? | + | |
- | | Have you had a caesarean section since the last time you filled out this questionnaire? | + | |
- | | If you have had a caesarean section, how many times have you had this surgery since the last time you filled out this questionnaire? | + | |
- | | Have you had sterilization surgery since the last time you filled out this questionnaire? | + | |
- | | If you have had sterilization surgery, how many times have you had this surgery since the last time you filled out this questionnaire? | + | |
- | | Have you had surgery for varicose veins since the last time you filled out this questionnaire? | + | |
- | | If you have had surgery for varicose veins, how many times have you had this surgery since the last time you filled out this questionnaire? | + | |
- | | Have you had surgery for spinal disc herniation since the last time you filled out this questionnaire? | + | |
- | | If you have had surgery for spinal disc herniation, how many times have you had this surgery since the last time you filled out this questionnaire? | + | |
- | | Have you had a balloon angioplasty for heart problems and/or bypass surgery since the last time you filled out this questionnaire? | + | |
- | | If you have had a balloon angioplasty for heart problems and/or bypass surgery, how many times have you had this surgery since the last time you filled out this questionnaire? | + | |
- | | Have you had surgery for a hip fracture since the last time you filled out this questionnaire? | + | |
- | | If you have had surgery for a hip fracture, how many times have you had this surgery since the last time you filled out this questionnaire? | + | |
- | | Have you had another type of surgery since the last time you filled out this questionnaire, | + | |
- | | If you have had another type of surgery, how many times have you had this surgery since the last time you filled out this questionnaire? | + | |
- | | Have you had another type of surgery since the last time you filled out this questionnaire, | + | |
- | | If you have had another type of surgery, how many times have you had this surgery since the last time you filled out this questionnaire? | + | |
- | | | Hebt u ooit een kijkonderzoek van de slokdarm/ | + | |
- | | Did your child receive any surgery between the age of 6 months and the present? | + | |
- | | Tonsillectomy (removal of the tonsils) / Surgery from age 6 months until the present | + | |
- | | Tonsillectomy / Age | Amandelen verwijderen / Leeftijd | + | |
- | | Tonsillectomy / Number of times operated on | Amandelen verwijderen / Aantal keer geopereerd | + | |
- | | Appendicitis (removal of the appendix) / Surgery from age 6 months until the present | + | |
- | | Appendicitis / Age | blindedarmontsteking (appendicitis) / | + | |
- | | Appendicitis / Number of times operated on | blindedarmontsteking (appendicitis) / Aantal keer geopereerd | + | |
- | | Placement of ear tubes / Surgery from age 6 months until the present | + | |
- | | Placement of ear tubes / Age | Buisjes in de oren plaatsen / Leeftijd | + | |
- | | Placement of ear tubes / Number of times operated on | Buisjes in de oren plaatsen / Aantal keer geopereerd | + | |
- | | Other surgery (1-5) / Reason | + | |
- | | Other surgery (1-5) / Age | Overige operatie (1-5) / Leeftijd | + | |
- | | Other surgery (1-5) / Number of times operated on | Overige operatie (1-5) / Aantal keer geopereerd | + |
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