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Worksheets

Let's Get to Know You!

Total questions: 12

Worksheet time: 11mins

Name
Class
Date
1.

What does your daily oral hygiene routine look like? (Check all that apply)

a)

Toothbrushing

b)

Flossing

c)

Mouthwash

d)

Tongue Scraper

e)

Nothing

2.

Do you have bleeding when you brush or floss?

a)

Always

b)

Sometimes

c)

Never

3.

How many times have you been to the dentist in the last 12 months?

a)

1

b)

2

c)

3+

d)

Not at all

4.

Do you have any orthodontic appliances?

a)

Braces

b)

Retainer

c)

Expander

d)

Nothing

e)

Other

5.

What sports do you play?

4 lines
6.

What do you usually eat in a day?

a)

Mostly healthy foods (ex: fruit/veggies, beans, nuts, meat, milk, whole grain bread)

b)

Mostly junk food (ex: chips, candy, fast food, ice cream)

c)

A mixture of healthy and junk foods

7.

Do you usually eat sweet snacks and drinks between meals?

a)

Always/Everyday

b)

Sometimes

c)

Never

8.

In your own words, explain what a cavity is.

4 lines
9.

What causes cavities? Choose all that apply.

a)

Bacteria

b)

Drinking lots of water

c)

Not regularly brushing your teeth

d)

Sugar

e)

Not sure

10.

Have you ever had a cavity?

a)

Yes

b)

No

11.

Do you know what Fluoride is?

a)

Yes

b)

No

12.

What topics did you want to learn more about?

4 lines