How many times per year do you visit the dentist?
Visiting the dentist regularly can help prevent and/or treat tooth decay at an earlier stage. It also allows the dentist to diagnose other potential health problems that may have a connection to your oral health.
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0 times
1-2 times
more than 2 times
How many times per day do you brush your teeth?
Regular tooth brushing (at least twice a day) is the most important thing you can do to protect your teeth from cavities.
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0 times
1 time
2 times
more than 2 times
Do your gums bleed when you brush your teeth?
Bleeding gums could be a sign of oral problems, including bacteria build-up in your mouth.
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Yes
No
How many times per day do you floss your teeth?
Flossing at least once every day is an important step to achieving good oral health. Flossing removes debris and bacteria that can get stuck between your teeth.
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0 times
1 time
2 or more times
Do you use toothpaste with fluoride?
Toothpaste that contains fluoride increases your mouth's defenses against decay and cavities.
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Yes
No
Have you had a cavity within the past 3 years?
Patients with a history of dental cavities have a higher risk of getting them in the future.
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Yes
No
How often do you eat sugary snacks between meals?
Sugary snacks increase bacteria in your mouth and can cause tooth decay. Try to limit sugary treats and choose foods that are good for your mouth, including vegetables, nuts and popcorn.
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Never
A few times a week
A few times a day
Do you currently have orthodontic appliances (including braces) or partial dentures?
Orthodontic appliances may make it difficult for you to get all the food and plaque off your teeth, making you more at risk for tooth decay.
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Yes
No
Do you often feel that your mouth is dry (as if you're not producing enough saliva)?
A dry mouth, or a mouth with limited saliva, can contribute to oral disease and cavities.
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Yes
No
Do you have any special needs that may limit your ability to care for your teeth and/or gums?
If you have special health care needs, make sure you talk to your dentist and/or caregiver about how you can make sure you are properly caring for your mouth.
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Yes
No
Do you use any products (e.g., chewing gum, mints, etc.) that contain xylitol?
Xylitol, a natural sugar substitute, can help reduce the risk of cavities when used on a regular basis.
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Yes
No
