Dental examination template

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USE OF THIS TEMPLATE FOR EACH AND EVERY PATIENT CARE WILL HELP US IN GIVING OUR PATIENTS THE BEST DENTAL CARE POSSIBLE. THIS IS MADE IN A CONCISE FORMAT AND THEREFORE TOPICS LIKE MEDICAL HISTORY MUST BE ELABORATED.

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Dental examination template

  1. 1. Dental Examination Template and Treatment Planning
  2. 2. Patient Details • Name • Sex • Age • Marital Status • Occupation • Date
  3. 3. HISTORY • PRESENTING COMPLAINT • HISTORY OF PATIENT’S PRESENTING COMPLAINT(S) • MEDICAL HISTORY • DENTAL HISTORY • SOCIAL HISTORY
  4. 4. Oral Hygiene Habit • Toothbrushing • Interdental Aids • Mouthwash • Tongue Cleaning
  5. 5. Personal History • Smoking • Drinking • Contact Sports • Other Habits • PARAFUNCTION
  6. 6. DIET • CHARTS • ANALYSIS
  7. 7. CLINICAL EXAMINATION • EXTRA-ORAL • ASYMMETRY • MOUTH OPENING • INTRA-ORAL • BPE
  8. 8. OCCLUSION • CLASS I / II / III • OVERJET / OVERBITE • ARCH SHAPE • CO:CR • RIGHT LATERAL • LEFT LATERAL • PROTRUSIVE
  9. 9. DENTITION • TEETH PRESENT • CARIES • RESTORATION • HARD TISSUE PATHOLOGY • RESTORATION FAILURES • IMPACTED TEETH
  10. 10. TOOTH SURFACE LOSS • ATTRITION • EROSION • ABRASION • ABFRACTION
  11. 11. SPECIAL TESTS • RADIOGRAPHS • DIAGNOSTIC CASTS • PULP TESTS • PHOTOGRAPHS • CBCT • SALIVA TESTS
  12. 12. DIAGNOSIS • DESCRIPTION ALONG WITH THE PROBABLE CAUSE
  13. 13. TREATMENT OBJECTIVES • AIMS AND OBJECTIVES OF TREATMENT
  14. 14. TREATMENT PLAN • BASED ON ALL THE FINDINGS • CUSTOMIZED INFORMED CONSENT SIGNED
  15. 15. KEY STAGES IN TREATMENT PROGRESS • ALONG WITH DIFFICULTIES AND CHALLENGES ENCOUNTERED
  16. 16. POST-TREATMENT PHOTOGRAPHS: EXTRA-ORAL AND INTRA-ORAL
  17. 17. TREATMENT APPRAISAL • MAY REQUIRE A CHANGE OF PLAN • PLAN FOR FUTURE MANAGEMENT • PROGNOSIS REVISITED
  18. 18. CUSTOMIZED • TREATMENT PLAN BASED ON FINDINGS • INFORMED CONSENT
  19. 19. LONG-TERM TREATMENT PLAN AND FUTURE CONSIDERATIONS • MAINTENANCE AND FURTHER
  20. 20. DISCUSSION AND REFLECTION • REFLECTIVE SUMMARY
  21. 21. REFERENCES • EVIDENCE BASED DENTISTRY

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