| GOHAI QUESTIONNAIRE | – | – | – |
|---|---|---|---|
| In the past three mouths | Always | Sometimes | Never |
| 1- How often did you limit types or amounts of food you eat because of problems with your teeth or denture? | 4 | 6 | 5 |
| 2- How often did you have trouble biting or chewing any kinds of food, such as firm meats or apples? | 6 | 3 | 6 |
| 3- How often were you able to swallow comfortably? | 9 | 1 | 5 |
| 4- How often have your teeth or dentures prevented you from speaking the way you wanted? | 4 | 4 | 7 |
| 5- How often were you able to eat anything without feeling discomfort? | 3 | 6 | 6 |
| 6- How often did you limit contacts with people because of the condition of your teeth or denture? | 1 | 5 | 9 |
| 7- How often were you pleased or happy with the looks of your teeth, gums or denture? | 6 | 5 | 4 |
| 8- How often did you use medication to relieve mouth pain or discomfort? | 0 | 5 | 10 |
| 9- How often were you worried or concerned about teeth, gums or denture problems? | 2 | 5 | 8 |
| 10- How often did you feel nervous or self-conscious because of problems with your teeth, gums or denture? | 1 | 4 | 10 |
| 11- How often did you feel uncomfortable eating in front of people because teeth or denture problems? | 1 | 4 | 10 |
| 12- How often were your teeth or gums sensitive to hot, cold or sweets? | 3 | 3 | 9 |