Have you any concerns about your mouth or teeth? |
Please consider: |
• Painful teeth or gum |
• Bleeding gums |
• Ulcers, lumps or bumps |
• Difficulty speaking |
• Dry mouth |
What affects your ability to eat and drink? |
Please consider: |
• Illness |
• Quality/amount |
• Stress/worry |
• Painful mouth/gums |
• Dentures |
• Appetite |
• Likes/dislikes/choice |
• Availability of Food |
• Other |