Lidocaine Oral Thin Film Questionnaire For Dental Hygienists

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Email *

1. Where did you apply the film?

Tongue

Buccal

Palate

Upper Gums (Maxillary Gingiva)

Lower Gums (Mandibular Gingiva)

Sublingual/Floor of mouth

Required

2. Was additional freezing needed?

Yes

3. Was there any residue visible during the appointment?

Yes

4. Did you apply the entire film or alter it in any manner?

Yes

Other:

5. Did the film stay in the intended spot prior to dissolving?

Yes

6. Was opening the packaging easy or difficult?

Easy

Moderate

Difficult

7. Was the size and shape of the film appropriate for the application? *

Yes

8. What procedure was the film applied for?

Dental Hygiene/Cleaning

Deep Scaling

Pain Relief

Required

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