• During your pregnancy, did you have any problems with your teeth or gums?
• Did you receive oral health care from a dentist during your pregnancy?
• If your child is bottle fed, how do you test the temperature of the formula in the bottle?
• Do you orally clean a pacifier or a bottle nipple or share utensils (for example, spoons)?

• Does your child have any physical, emotional, or cognitive difficulties?
• Is your child experiencing any developmental delays?

• Does your child currently have a regular primary care health professional (for example, a physician or nurse practitioner)? Is your child receiving care from any medical specialists? If so, which specialties?
• Is your child taking any medication for chronic illnesses or conditions?

• Do you clean your infant’s mouth? How has this been going?
• Do you brush your child’s teeth? Do you use fluoridated toothpaste?
• Has your child been to the dentist before coming here? How did it go?

• Are you breastfeeding or bottle feeding your child, or both? How is feeding going?
• If you bottle feed the child, what do you put in the bottle?
• Does your child fall asleep with a bottle at bedtime?
• Does your child drink from a cup?
• Does your child have any health conditions that limit the foods that your child is able to eat?

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