Master, College of Conscious Sedation            

​​Omaha Sedation Dental Center         

The Advanced Sedation Dentistry Practice
  1. Are you in any pain or discomfort at this time?
  2. Does it come and go?
  3. On a scale of 0-10 where 0 is no pain and 10 is the worst pain you ever had what is it when it is at its worse?
  4. Are you having to take pain meds or antibiotics for your teeth?
  5. Does it hurt to bite on your teeth?
  6. Do you grind or clench your teeth?
  7. Does your bite feel off?
  8. Are you missing teeth? Do you have trouble swallowing or chewing food?
  9. How often do you brush
  10. How often do you floss?
  11. How often do you have your teeth cleaned and polished?
  12. Have you ever been told you have gum disease?
  13. Have you been treated for gum disease?
  14. Did the dentist explain to your satisfaction why you have gum disease?
  15. Do you have bad breath?
  16. Do you snore?
  17. Are you diabetic? If so are you in control?
  18. Have you had a bad experience at the dentist? What happened?
  19. Are you a perfectionist?
  20. Have you had braces?
  21. Have you had your wisdom teeth removed?
  22. Have you ever had dental sedation?
  23. Do you have any jaw joint problems? Have you been treated for this problem and how successful was it?
  24. Do you suffer from sleep apnea?
  25. Do you suffer from dry mouth problems?
  26. If so do you know the cause of your dry mouth; what is it?
  27. Do any of your teeth feel loose
  28. Do your gum bleed when you brush or floss them?
  29. Are your teeth sensitive to hot or cold
  30. Are you a mouth breather?
  31. Do you wear a denture or removable partial?
  32. How satisfied are you with your removable teeth?
  33. How long have you worn partials? Dentures?
  34. Have you noticed any bone loss?
  35. Do you smoke or use tobacco? If so for how long and how frequently?
  36. What do you like to drink? Soda? If so how much soda do you drink per day? What is the name of your favorite?
  37. Do you have an adult beverage? How often?
  38. How much exercise would you estimate you get per week?
  39. How would you describe your diet? Healthy? Do you like sweets?

Here are some questions to consider.

If you like you can print them off and bring the answers with you to the office

Email izuteam@stardds.com New Patient Direct Phone Line 402.391.1931 Scheduling and all other 402.926.4848
Call Now to arrange a free Private telephone Consultation with Dr. Starkey about sedation dentistry, dental implants, or any other concerns you may have 402.391.1931
Email mike@stardds.com Phone 402.926.4848 Text 402.740.9235

Advanced Sedation Dentistry

for a healthier and happier life

Michael A. Starkey, DDS, PC

And The Sedation Dental Surgery Team

7618 Dodge Street Omaha, Ne 68114



When you were at the dentist last what did you have done?

What did your previous dentist say about your teeth?

What did you like about your favorite dentist?

On a scale of 1-10 with one being dreadful and 10 being you love it, how  you feel about going to the dentist?

What are your concerns regarding going to the dentist?

Do you have an over active gag reflex?

Do you experience dental anxieties?

Do you have dental implants?

Are you satisfied with them?

What other issues or concerns do you have?

More about cosmetic appearance

  1. How do you like the appearance of your teeth on a scale of 1-10 where one means totally unacceptable to 10 they are perfect?
  2. What is it about your smile that you do not like?
  3. How do you like the color of your teeth?
  4. Are you missing teeth?
  5. Do your teeth look worn to you or have you been told they are worn
  6. Have you had braces?
  7. have you bleached or whitened your teeth? Were you happy with the results?
  8. What if anything would you like to change about your teeth and smile?

Dental Questions to Consider