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Persisten t cough great er t han a 3 w eek lu. ati r. Check OK if you Don t Know th e answer to th e question J For the follo wmg questions please mark X your responses to the following questions. Yes No DK Do your gums blee d when you bru sh or fl oss. Are your t eeth sensitive to cold hOl sw eet s 0 pressure. Do you have any c ickl ng popp ng or discomf ort In the jaw Does food or floss cat ch between your teeth Do you brux or grino your teeth. Health History Form E-mail ADA American Dental...
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