Thanks for sharing your valuable feedback to improve the lives of our patients!

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* 1. Have you ever suffered from TMJ disorders and/or Bruxism (teeth grinding or clenching)?

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* 2. Have you ever suffered with a sleep-breathing disorder such as sleep apnea?

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* 3. Have you ever suffered with acid reflux or heartburn?

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* 4. How would you personally rate the condition of your oral health 5 years ago? (i.e. how healthy your gums and teeth were back then)

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* 5. How would you personally rate the condition of your oral health TODAY? (i.e. how healthy your gums, teeth and smile are.)

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* 6. How would you personally rate the quality of your care at Pinecrest Dental?

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* 7. How much do you feel your oral health links to your medical health on a scale of 1-10? (i.e. gum health and heart health, prevention of infection, sickness, etc.)

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* 8. What do you feel would help the general public better understand the link between oral health and overall health?

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* 9. Any comments?

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* 10. Your name (optional - will not be shared with any 3rd parties)

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