This paper describes the cognitive testing of eight self-report questions as part of a broader effort to evaluate and validate the use of these questions in estimating the prevalence of periodontitis in the United States population. This study examined how United States respondents understood and processed the proposed questions in English and Spanish, as well as identifying and correcting for possible response errors. The set of eight questions was selected by the Centers for Disease Control and Prevention Periodontal Disease Surveillance Workgroup for further testing after analytical assessments and field testing of an array of potential questions. Evaluation of these eight oral health questions was based on 40 in-depth, semi-structured cognitive interviews in English and Spanish. Results of this cognitive test study are presented. The recommendations from this cognitive testing evaluation served as the basis to improve the original questions in English and Spanish to be more inclusive and consistent and improve the estimation of periodontal disease in the United States population.