Diploma in Dental Hygiene and Therapy

Informed Consent
Study Topic: Relationship between awareness of periodontal disease and good oral health
status of NYP Dental Hygiene and Therapy (DHT) students in 2016
Dear participants,
This research aims to look into the r elationship between awareness of periodontal disease and

good oral health status of NYP Dental Hygiene and Therapy (DHT) students in 2016.
Please note the following:

Participants are only required to come for a one time session at the Teaching Dental Clinic at
Block H, Level 5, which may last for 10 minutes.
For this study, we will need to gather the plaque scores of the participants, with the use of plaque
disclosing tablets. Before administering the plaque disclosing tablet, participants are required to
complete a survey form pertaining to their daily oral hygiene habits. Only gender and age will be
included in the survey. Personal information of the participants will be kept confidential. For
data analysis, we will be using the Statistical Package for the Social Science (SPSS) software,
and participants will be represented in numerical form.
Participants are advised to bring along their toothbrush to remove the dye from the plaque
disclosing tablets.
No incentives will be given to the participants for participating in this study.
Participants are free to withdraw from the study at any point during the research period.
No penalty will be imposed on the participants.
We will not be responsible for any harm caused/received by the participants in this study.

Please tick the box if you agree to participate in this research.

I hereby understand and agree to participate in the research.

______________________________
Full name and NRIC

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Signature & Date