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HEALTHY TEETH

HOW HEALTHY ARE MY TEETH?

Complete self-exam and find out!

Your Self Exam is now complete. Congratulations!

You are at low-risk for tooth-related problems. Keep up the good work and do a regular dental check-ups.

Your Self Exam is now complete. Be careful!

You may be at higher risk for tooth-related problems. A dentist is an excellent choice to validate your teeth. Together you will achieve better dental health easier and more quickly.

How old are you?

< 18 years 19-30 31-60 > 60

Have you had any new fillings or crowns in the last 2 years?

Yes No

Are any of your teeth filled or crowned?

Yes No

Have you had any permanent teeth extracted? (except wisdom teeth or teeth removed for orthodontic reasons)

Yes No

Do you have any false teeth?

Yes No

Do you frequently snack on sugary or starchy snacks or drink sugared beverages between meals?

Yes No

Do you have any missing teeth that should be replaced?

Yes No

Have you had any pain from chewing, aching, or sensitivity to hot or cold in your mouth during the past year?

Yes No

Have you had a major health change (like diabetes, a heart attack, stroke, diagnosis of disease such as cancer, Parkinson’s, etc.) during the past 12 months?

Yes No

Does your mouth frequently feel dry?

Yes No

Do you drink fluoridated water, brush your teeth daily with a fluoride toothpaste, or use a nonprescription or prescription fluoride product (mouth rinse, gels…) on a daily basis?

Yes No

Do you have at least 1 dental check-up per year?

Yes No

Do you have developmental or special health care needs that prevent you from brushing or flossing properly?

Yes No

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