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€¦ · Are your teeth sensitive to cold, hot? O No 0 Yes O Yes, Slightly O Yes, Extremely Do your gums bleed when you brush or floss? O No O Yes Do you grind your teeth? O No O

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Page 1: €¦ · Are your teeth sensitive to cold, hot? O No 0 Yes O Yes, Slightly O Yes, Extremely Do your gums bleed when you brush or floss? O No O Yes Do you grind your teeth? O No O
Page 2: €¦ · Are your teeth sensitive to cold, hot? O No 0 Yes O Yes, Slightly O Yes, Extremely Do your gums bleed when you brush or floss? O No O Yes Do you grind your teeth? O No O
Page 3: €¦ · Are your teeth sensitive to cold, hot? O No 0 Yes O Yes, Slightly O Yes, Extremely Do your gums bleed when you brush or floss? O No O Yes Do you grind your teeth? O No O
Page 4: €¦ · Are your teeth sensitive to cold, hot? O No 0 Yes O Yes, Slightly O Yes, Extremely Do your gums bleed when you brush or floss? O No O Yes Do you grind your teeth? O No O
Page 5: €¦ · Are your teeth sensitive to cold, hot? O No 0 Yes O Yes, Slightly O Yes, Extremely Do your gums bleed when you brush or floss? O No O Yes Do you grind your teeth? O No O
Page 6: €¦ · Are your teeth sensitive to cold, hot? O No 0 Yes O Yes, Slightly O Yes, Extremely Do your gums bleed when you brush or floss? O No O Yes Do you grind your teeth? O No O
Page 7: €¦ · Are your teeth sensitive to cold, hot? O No 0 Yes O Yes, Slightly O Yes, Extremely Do your gums bleed when you brush or floss? O No O Yes Do you grind your teeth? O No O
Page 8: €¦ · Are your teeth sensitive to cold, hot? O No 0 Yes O Yes, Slightly O Yes, Extremely Do your gums bleed when you brush or floss? O No O Yes Do you grind your teeth? O No O
Page 9: €¦ · Are your teeth sensitive to cold, hot? O No 0 Yes O Yes, Slightly O Yes, Extremely Do your gums bleed when you brush or floss? O No O Yes Do you grind your teeth? O No O
Page 10: €¦ · Are your teeth sensitive to cold, hot? O No 0 Yes O Yes, Slightly O Yes, Extremely Do your gums bleed when you brush or floss? O No O Yes Do you grind your teeth? O No O
Page 11: €¦ · Are your teeth sensitive to cold, hot? O No 0 Yes O Yes, Slightly O Yes, Extremely Do your gums bleed when you brush or floss? O No O Yes Do you grind your teeth? O No O

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