It looks like this dentistry practice operates mostly out of Florida with some branch locations in Maryland. Florida being 43rd on the list feels a little strange, I want to imagine a scenario where they sent the survey to existing patients parents and the responses were in the vein of "my kid hasn't had a taste of anything sugary in their life" even though you and I both know that's not how Florida works.
Surveys are generally self-administered, the bigger concern is whether the manner in which the respondents were recruited forms a representative sample or not. Pretty much everything is done online these days, even the big well respected pollsters are mostly online now.
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