Fill the Details Below to Calculate Cavities Risk

No. of Cavities

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No. of filled teeth

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No. of sugary snacks per day

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How often do you brush your teeth in a day?

Are you wearing braces or any other appliance?

When was the last time you visited the dentist (months)

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Do your siblings or parents have cavities?

Referring doctor:

Ever had a Pit and Fissure Fillings Done?

Do you use a floride mouthwash?

Do you use a Caries Preventive Toothpaste?

Do you use a Fluoride Varnish?

Is the child a special needs child ?

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