Consultation Form

Dental Abscess Antibiotics For Tooth Infection

Are you experiencing any pain around the affected tooth or gum?	Yes No
Please provide more information
Do you have any episodes of sharp pain with exposure to hot or cold food and drink?	Yes No
Please provide more information
Do you have any swelling around the affected tooth or gum?	Yes No
Please provide more information
Do you have any lumps or swelling around your jaw, neck or under your chin?	Yes No
Please provide more information
Do you have any new redness on your face?	Yes No
Please provide more information
Do you have a fever?	Yes No
Please provide more information
Are you experiencing bad breath or an unpleasant taste in the mouth?	Yes No
Please provide more information
Do you have any tooth discolouration?	Yes No
Please provide more information
Which part of the gum/mouth is the suspected infection located? (For example, left upper, right lower , rear or front)
Have you been treated for a dental infection within the last 6 months?	Yes No
Please provide more information