Treatment Notes Testing

PATIENT STATUS:

- New patient
- Continuing treatment course
- Recall patient
- Returning patient, 1-2 years absence
- Returning patient, 2 or more years absence

PATIENT ID NUMBER

PATIENT FIRST NAME:

APPOINTMENT DATE:

ONLINE QUESTIONNAIRE STATUS:

- Click on link below and complete the dental questionnaire
- Click on link below and complete the medical questionnaire
- Dental questionnaire completed
- Medical questionnaire completed
- Patient prefers not to do online questionnaires

SCHEDULED FOR:

Select all that apply.

CONSULTATION FOR:

- 011
- 012
- 013
- 014

CHIEF COMPLAINT:

CONSENT ATTAINED:

- Directly from patient
- From guardian

GUARDIAN CONSENT DETAIL:

- Discussed proposed treatment and quoted fee with benefits and cons explained.
- Quote created and verbal financial consent given
- Signed financial consent obtained, scanned for upload
- Previously signed financial consent for this course of treatment. See documents in communications

TOOTHBRUSHING:

- Reported in dental questionnaire

BRUSHING FREQUENCY:

OTHER BRUSHING FREQUENCY:

FLOSSING:

- Reported in dental questionnaire

FLOSSING FREQUENCY:

- Daily
- Frequently
- Never
- For food impation

EXTRAORAL:

FACIAL ASYMMETRY:

- Not significant
- Mild
- Moderate
- Significant

ASYMMETRY DESCRIPTION:

Short description of the facial asymmetry. Take a photo if asymmetry is significant.

JAW FUNCTION:

OPENING DEVIATION:

- Right
- Left

CLOSING DEVIATION:

- Right
- Left

TMJ CLICKING:

- Right
- Left

TMJ POPPING:

- Right
- Left

TMJ PAIN:

- Right
- Left

ORAL HYGIENE:

- Poor
- Fair
- Good

RADIOGRAPHY:

UPDATE RESTORATIVE CHARTING_CARIES ON BITEWINGS:

Tooth and surface to be noted.

UPDATE DENTAL CHART WITH CARIES ON BITEWINGS:

Tooth and surface to be noted.

OPG FINDINGS:

MISSING TEETH:

Teeth listed above are noted as missing in the dental chart.

MISSING TEETH MANAGEMENT:

- Recommended replacement
- Not requiring replacement

MISSING TEETH REPLACEMENT MANAGEMENT:

- Patient is interested in fixed options
- Patient is interested in removable options
- Patient declined replacement recommendation

PROVIDE QUOTE ON FPD'S:

- Patient is interested in implant tooth replacement
- Patient is interested in tooth supported bridge option

PROVIDE QUOTE ON RPD'S:

- Patient is interested in acrylic denture option
- Patient is interested in Co-Cr denture option

WARNING ABOUT DECLINING TOOTH REPLACEMENT RECOMMENDATION:

- Opposing teeth will over-erupt over time
- Teeth adjacement to the space will drift and tip into the spacePatient is interested in Co-Cr denture option
- Intereference with occlusal function may develop over time
- Teeth replacement option will become more difficult over time
- Food impaction problems may develop over time

ROOT FILLED TEETH_NAD

Teeth listed above are noted as root filled with no abnormality noted.

TMJ NOTABLE RADIOGRAPHIC FINDINGS:

Notable radiographic findings.

IMPACTED WISDOM TEETH:

Teeth listed above are noted as being impacted.

IMPACTED WISDOM TEETH MANAGEMENT:

- Specialist referral needed
- Removal by Dr Maloney
- Schedule removal ASAP
- Monitor for non-immediate removal

SUPERNUMERARY TEETH PRESENT:

Supernumerary teeth listed above are noted on dentition chart.

SUPERNUMERARY TEETH MANAGEMENT:

- Specialist referral needed
- Removal by Dr Maloney
- Monitor over time
- Monitor for non-immediate removal

EAGLES SYNDROME FINDINGS:

- Throat pain experienced
- Neck pain experienced
- Pain radiating into the ear
- Unilateral pain, non-responsive to painkillers
- Specialist referral needed
- Referrence to be email to the patient, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6028820/

UPDATE DENTAL CHARTING_CARIES NOTED IN OPG:

Teeth listed above are noted as having caries on the OPG.

ROOT FILLED TEETH_WITH ABNORMALITIES

Teeth listed above are noted as root filled with abnormality noted.

Dental Charting

DENTITION:

- Dentate
- Edentulous
- Partially dentate

#18:

- Sound & Aligned
- Condition charting
- Missing

#18 REPLACEMENT:

- Not needed
- Needed
- Has been replaced

#18 REPLACEMENT OPTIONS:

#18 REPLACEMENT WITH:

18 OTHER REPLACEMENT OPTION:

18 CONDITION:

18 OTHER:

HARD TISSUE:

MISSING TEETH:

Tooth number separated with comma.

BROKEN TEETH: