Gum Disease Risk Assessment Questionnaire
What a gum disease risk assessment questionnaire asks, why each part matters, and how dental practices collect it.
A gum disease risk assessment questionnaire records the symptoms, habits, health conditions, and dental history that raise a person's risk of periodontal disease. The questions here are a typical set based on a periodontal practice's intake form and SDCEP periodontal guidance.
Gum disease risk assessment questionnaire, handled by the AI Doctor avatar
AI Doctor, a real-time AI healthcare assistant avatar, asks the questions on a gum disease risk assessment questionnaire in the patient's own language, strictly following the practice's instructions.
- Intake before the visit. Patients answer online before they arrive, or at a kiosk when they check in.
- Answers ready for the clinician. Clinicians see what the patient said before the visit starts.
- Less workload at the front desk. Staff spend less time handing out forms and entering answers by hand.
- Key details at a glance. The care team sees what matters up front and decides who needs attention first.
The form becomes a natural conversation: patients answer by talking, in their own words. AI Doctor is an information and patient-assistance interface. It collects answers for the care team to review. It doesn't diagnose, triage, or give treatment advice.
Sample gum disease risk assessment questionnaire questions
Typical questions, written out so you can see the level of detail. Every practice words its own form differently.
- Do your gums bleed?Gum symptoms
- Have you noticed loose or shifting teeth?Gum symptoms
- Have you had gum treatment before?Gum history
- Has anyone in your family lost their teeth?Gum history
- Do you smoke or use tobacco products?Tobacco
- Have you smoked in the past?Tobacco
- Do you have diabetes?Health
- What medicines do you take?Health
- How often do you brush each day?Home care
- How often do you floss?Home care
- How often do you visit the dentist?Dental visits
- When was your last professional cleaning?Dental visits
These are examples to read, not a form to fill in.
Gum disease risk assessment questionnaire: FAQ
What does a gum disease risk assessment questionnaire ask?
A typical set covers six areas: gum symptoms, gum and family history, tobacco, health conditions such as diabetes, home care, and dental visits.
Who fills in a gum disease risk assessment questionnaire?
The patient. A periodontal practice may ask these questions on its intake form before a visit.
Why do the questions ask about diabetes and smoking?
Periodontal guidance from SDCEP, a Scottish dental body, lists smoking and diabetes among the factors that affect gum disease risk. A periodontal practice's intake form asks about both.
Is it the same as a periodontal exam?
No. A questionnaire only collects what the patient reports. Risk is confirmed by a clinician who checks for bleeding, pocket depth, and bone loss.
Is there a standard gum disease risk assessment questionnaire?
The sample questions on this page show a typical set, based on a periodontal practice's patient history form.
What happens after the questionnaire?
The dentist or hygienist reviews the answers with the exam findings and decides the next steps. The questionnaire alone is not a diagnosis.
Does AI Doctor give medical advice?
No. It collects information for the care team. It doesn't diagnose, triage, or recommend treatment.
Can patient answers stay on our own servers?
Yes. RAVATAR offers on-prem deployment: the platform can run inside your own perimeter, so patient answers stay there. RAVATAR complies with GDPR and the EU AI Act.
Set up your AI Doctor in Genesis AI Avatar Studio
Genesis AI Avatar Studio is where you set up, test, and publish AI avatars for your website, mobile app, or Holobox. No coding or technical skills needed.
- 01Choose the AI Doctor avatar.
- 02Add your practice's FAQs and visit information.
- 03Talk to it, then publish it.
