Dental treatment needs for Airway Problems Assessment Form

Kigo Dental -Self Assessment form for dental treatment needs for Airway / Breathing Problems.

The following is a self-assessment to help you identify factors that may put you in need of dental or orthodontic treatments for airway/breathing disorders. The assessment is meant to be informative but does not substitute for a comprehensive orthodontic evaluation by your dentist or orthodontist to determine your actual risk and condition.

Airway problems Assessment

Be sure to answer all the questions honestly to obtain an accurate score. Hereafter "you" can be related to you, your child, or any person in need of taking this test.

1. Do you snore loudly, gasp for air, or experience pauses in breathing during sleep?
Yes No

2. Do you feel tired or drowsy during the day, even after a good night's sleep?
Yes No

3. Do you have trouble falling or staying asleep?
Yes No

4. Have you been diagnosed with sleep apnea or other sleep-related breathing disorders?
Yes No

5. Have you ever been told that you grind or clench your teeth while sleeping?
Yes No

6. Do you experience frequent headaches, especially in the morning?
Yes No

7. Have you noticed any changes in your facial structure, such as a receding chin or forward head posture?
Yes No

8. Have you had previous dental work to treat airway problems, such as orthodontic treatment or oral appliances?
Yes No

9. Do you experience difficulty breathing through your nose or have a history of allergies or sinus problems?
Yes No

10. Have you noticed any changes in your voice or speech or experienced difficulty swallowing?
Yes No

11. Do you frequently wake up with a sore or dry throat or experience a choking sensation while sleeping?
Yes No

12. Have you noticed any changes in your weight or appetite or experienced acid reflux or heartburn?
Yes No

Have Doubts? Ask us! Online Consultation

Note: Please note that this self-assessment form does not intend to provide a definitive diagnosis if you / your child has airway/breathing disorders or other health conditions; it is developed to give you approximate knowledge about you / your child’s jaw growth discrepancies so that you / your child can get appropriate consultation. Consulting with a qualified healthcare professional is mandatory to get a definitive diagnosis.

Dental treatment needs for Airway Problems Assessment Form

Kigo Dental -Self Assessment form for dental treatment needs for Airway / Breathing Problems.

LET'S TALK

Book your Appointment

Appointment Timings: Mon-sat: 10:00 am- 8:00 pm | Sun: 10:00 am - 1:00 pm

Appointment Timings:
Mon-sat: 10:00 am- 8:00 pm | Sun: 10:00 am - 1:00 pm

Contact

We would love to be a part of your Smile Reimagining Journey...