Dental History Form

Oral Health Works Hand in Hand with Your Body

Dental care is just one part of total health care. Because of that, we need to keep current with your entire health history, the good and the bad. Be sure to tell us if you…

  • experienced any new allergies or sensitivities
  • quit smoking (or started)
  • are taking any new medications, even over-the-counter drugs
  • have had any accidents or injuries
  • are diagnosed with any illness or other medical condition
  • had a baby, are pregnant, or expecting to become pregnant

Depending on what you tell us, we may need to use an alternative local anesthetic, or administer antibiotics before treatment.

Then, we’ll alert you to possible problems for you to discuss with your physician. Oral examinations can detect over 40 serious diseases in the mouth—including bulimia, tumors and diabetes. The texture, color and condition of your tongue and gums can also give us clues to high blood pressure or osteoporosis.

That’s why we encourage you to make at least two dental appointments every year, especially if you don’t get annual physical exams. We’re here to make sure your teeth stay in great shape, along with the rest of your body!