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Before we begin, tell us your name.
How old are you?
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When was the last time you went to the dentist?
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How often do you generally brush your teeth per day?
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How often do you generally floss your teeth per day?
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Do your gums bleed when you brush or floss?
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How many fillings do you have?
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Are your teeth sensitive to cold beverages?
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Does your mouth feel dry even after drinking water?
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Have you been diagnosed with diabetes in the past?
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Do you use tobacco products?
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How does your mouth feel today?
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