Dental treatment needs Post Pregnancy Assessment Form

Kigo Dental - Self Assessment form for dental treatment needs after pregnancy.

The following is a self-assessment to help you assess dental health and determine if you need to seek professional dental advice post-pregnancy. The assessment is meant to be informative but does not substitute for a comprehensive dental evaluation by your dentist or orthodontist to determine your actual risk and condition.

Assessment Form

Be sure to answer all the questions honestly to obtain an accurate score.

1. Do you have any dental concerns or issues at present?
Yes No

2. Have you experienced any oral health changes during your pregnancy till now? For example, bleeding gums, swelling, increased sensitivity, dry mouth, pain or discomfort in your teeth, gums, or jaw?
Yes No

3. Have you experienced any morning sickness or vomiting during your pregnancy? If yes, have you noticed any changes to your teeth or oral health?
Yes No

4.Have you had a dental check-up in the past three months?
Yes No

5. Do you have any history of dental issues or concerns? For example, cavities, gum disease, oral cancer or dental injury?
Yes No / Not Applicable

6. Are you currently experiencing any dental-related anxiety or concerns due to your pregnancy?
Yes No

7. Have you had any dental procedures done in the past that may require follow-up care?
Yes No

8. Have you experienced or presently experiencing tooth sensitivity, decay, loose teeth, or any unusual taste or smell in your mouth during or after pregnancy?
Yes No

9. During pregnancy or after pregnancy, have you experienced or presently experiencing jaw pain, stiffness, or difficulty opening your mouth?
Yes No

10. Do you have any concerns about dental treatment post-pregnancy that you want to discuss with your dentist or healthcare provider?
Yes No

11. Do you have any dental restorations, such as fillings or crowns, that may need to be replaced?
Yes No

12. Have you had any complications during pregnancy, such as gestational diabetes or high blood pressure?
Yes No

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Note: Regular dental check-ups and cleanings must be crucial after pregnancy to prevent and address any dental issues that may arise. After Pregnancy, women should also maintain good oral hygiene practices at home, including brushing twice daily with fluoride toothpaste and flossing as their dentist or healthcare provider recommends.

Dental treatment needs Post Pregnancy Assessment Form

Kigo Dental - Self Assessment form for dental treatment needs after pregnancy.

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