Please complete the questionnaire below to receive an assessment of your dental health.


1. Do you visit a dentist regularly?
Yes, at least twice a year
No
2. If you answered No to question 1, when was the last time that you visited a dentist?
I answered Yes to question 1
1 year ago
Between 1.5 and 2 years ago
More than 2 years ago / I don’t remember the last time I visited a dentist
3. If you go regularly to the dentist, do you request or allow them to remove tartar?
Sí
No
4. Has the dentist ever explained to you how to prevent dental diseases?
Sí
No
5. Do you know how and why cavities form?
Yes, I’ve known for some time
I have learnt recently
No
6. Do you frequently suffer from a dry mouth, probably caused by medication?
Sí
No
7. Do you know what gingivitis and periodontitis are?
Yes, I’ve known for some time
I have learnt recently
No
8. Have you ever been treated for gingivitis and / or periodontitis?
No, it has never been necessary
Yes, I have been treated
No, but maybe it would be sensible to have treatment
9. Have you had any cavities in the last 12 months?
No
Yes, but only one
Yes, two or more
10. Do your gums bleed when brushing or spontaneously?
No
Yes, but only around a few teeth
Yes, all the gums
11. Have you noticed that you often have a bad taste in your mouth and / or your breath smells (halitosis)?
No
Sí
12. Do your gums sometimes swell or redden?
No
Sí
13. Have you noticed an increased tooth sensitivity to cold and / or detected receding gums, which makes your teeth appear longer and separated?
No and / or I have never noticed
Sí
14. Are any of your teeth loose?
No
Sí
15. Have you noticed any changes in how your teeth close when biting, and does it cause you discomfort?
No
Sí
16. Do you have any piercings in or around the mouth region (tongue, lips, cheeks etc)?
No
Yes, but I consulted an odontologist first
Yes, but without consulting a dentist
17. Do you normally clench and grind your teeth during sleep (bruxism)?
No
Yes, but I sleep with a mouth guard
Yes, but it doesn’t bother me
18. Do you bite your nails?
No
Sí
19. Do you frequently suffer from irritations and oral lesions (cold sores, leukoplakia)?
No
Yes, but if they last for a week or more, I consult a dentist
Yes, but I never consult a dentist
20. Do you use dental floss and / or choose a suitable toothbrush for oral hygiene (medium texture, and a small head to clean the zones which are difficult to reach)?
Sí
No
21. How often do you change your toothbrush?
When the bristles become worn and / or every 3 months
When the bristles become worn and / or every 6 months
Once a year
Every 2 years
22. Have you ever been shown how to use a toothbrush correctly?
No
Yes, recently
Yes, I brush for 2 minutes, using short and smooth movements, paying special attention to the gum line, the back teeth with difficult access, and the areas around fillings, crowns and other repairs
23. Do you always brush your tongue?
Sí
No
24. Do you use fluoride toothpaste?
Sí
No
25. Do you use fluoride elixirs?
Sí
No
26. How often do you brush your teeth?
Between two and three times a day
Once a day
I don’t brush daily
27. In the morning, when do you brush your teeth?
Before and after breakfast, or only after breakfast
Never after breakfast
28. How many cigarettes do you smoke a day?
None or a maximum of three
A packet a day and / or I smoke a pipe
More than a packet a day
29. Do you eat regularly, this means not often skipping meals?
Sí
No
30. Does your diet contain foods rich in carbohydrates, sugars and starches?
No
Sí
31. What do you normally eat for breakfast?
Basic sugar free foods (fried or poached eggs, cheese, cereals without sugar)
Almost always sweet foods (jams, honey, sugared cereals)
32. Do you eat sweet breakfasts and later do not brush your teeth?
No
Sí
33. Do you drink coffee, tea or other infusion drinks with sugar?
Sí
No
34. How often do you drink sweet drinks between and / or during your three meals in the day?
Never or once
Two to four times
More than four times a day
35. How often to do you have sweet drinks between your three meals and / or before you go to bed?
0-2 times
3-5 times
More than 5 times a day
36. Do you chew your food thoroughly to avoid collecting food residues between your teeth?
Sí
No
37. Do you use chewing gum?
No
Sí
38. If you eat chewing gum, does it contain xylitol or is it without sugar?
Yes, or I don’t use it
No

See your results