Dental Records List

Images

Photographs

1. Frontal upper anterior teeth image
2. Lateral upper anterior teeth image
3. Upper anterior incisal image with shooting angle inclination to the buccal surfaces
4. Upper anterior incisal image with shooting angle inclination to the palatal surfaces
5. Frontal lower anterior teeth image
6. Lower anterior incisal image with shooting angle more to the labial side
7. Lower anterior incisal image with shooting angle more to the lingual side
8. Upper posterior occlusal surface image right side
9. Upper posterior occlusal surface image left side
10. Upper posterior palatal surface image right side
11. Upper posterior palatal surface image left side
12. Lower posterior occlusal surface image right side
13. Lower posterior occlusal surface image left side
14. Lower posterior lingual surface image right side
15. Lower posterior lingual surface image left side
16. Frontal occlusion image of full arch
17. Posterior teeth occlusion image right side
18. Posterior teeth occlusion image left side
19. Full arch non occlusion image
20. Full arch non occlusion image right side
21. Full arch non occlusion image left side
22. Protrusion image
23. Left side lateral trusion image working side
24. Right side lateral trusion image working side
25. Left side lateral trusion image balancing side
26. Right side lateral trusion image balancing side
27. Incisal edge occlusion image
28. Overbite and overjet image right side
29. Overbite and overjet image left side
30. Upper arch image
31. Lower arch image
32. Perioral tissue image
33. Upper lip mucosa image
34. Lower lip mucosa image
35. Buccal mucosa image right side
36. Buccal mucosa image left side
37. Dorsum of tongue mucosa image
38. Ventrum of tongue mucosa image
39. Left lateral side of tongue mucosa image
40. Right lateral side of tongue mucosa image
41. Mouth floor mucosa image
42. Buccal gingival sulcus mucosa image upper (right and left)
43. Buccal gingival sulcus mucosa image lower (right and left)
44. Hard palate mucosa (using mirror)
45. Soft palate mucosa (using mirror)
46. Soft palate mucosa image (taking directly)

Radiographs

1. Panoramic Radiograph
2. Right Posterior Bitewing
3. Right Anterior Bitewing
4. Left Anterior Bitewing
5. Left Posterior Bitewing
6. Retroalveolar Radiograph of Individual Tooth
7. Occlusal Radiograph of Upper Anterior Teeth
8. Occlusal Radiograph of Lower Anterior Teeth

Notes

Current Complaint

1. How would you describe your current dental problem?
2. Do your gums bleed when you brush or floss?
3. Are your teeth sensitive to cold, hot, sweets or pressure?
4. Is your mouth dry?
5. Do you have earaches or neck pain?
6. Do you have clicking, popping or discomfort in the jaw?
7. Do you brux or grind your teeth?
8. Do you often have sores or ulcers in your mouth?

Examination Notes

1. Do you have any intraoral discomfort or difficulty?
2. Do you have any other extraoral (facial) discomfort or difficulty?
3. Horizontal Percussion
4. Vertical Percussion
5. Cold Test
6. Alveolar Ridge Palpation
7. Buccal/vestibular Sulcus Palpation
8. Plaque Index Score
9. Sextant Periodontal Probing
10. Full Periodontal Probing
11. Tooth Mobility Index

Medical History

1. Are you under care of a physician?
2. Are you in good health?
3. Has there been any change in your general health within the past year? If yes, what condition was/is being treated?
4. Date of last physical exam.
5. Have you had a serious illness, operation or been hospitalised in the past 5 years? If yes, what was the illness or problem?
6. Are you taking or have you recently taken any prescription or over the counter medicine? If yes, please list all.
7. Are you taking, or have you taken, any of these diet drugs?
8. Are you taking or scheduled to begin either of these medications?
9. Since 2001, were you treated or are you presently scheduled to begin treatment with the intravenous bisphosphonates (Aredia or Zometa) for bone pain, hypercalcemia, or skeletal complications resulting from Paget’s disease, multiple myeloma, osteoporosis or metastatic cancer? If yes, when did you begin the treatment?
10. Do you wear contact lenses?
11. Have you had an orthopedic total joint (hip, knee, elbow, finger) replacement? If yes, when was that? Have you had any complications? Please describe complications.
12. Are you allergic or have you had allergic reaction to any of following. Please describe your reaction.
13. Do you use controlled substances (drugs)? Please specify the substances.
14. Do you use tobacco (smoking, snuff, chew, bidis)?
15. Do you drink alcoholic beverages? If yes, how much do you typically drink in a week?
16. Do you drink fizzy drinks or sweetened beverages?
17. Do you eat sweets or sugary foods?
18. Are you pregnant? If yes, number of weeks? Women only
19. Are you taking birth control pills or hormonal replacement? Women only
20. Are you nursing? Women only
21. Have you had any of the following diseases?
22. Do you have any disease, condition, or problem, not listed above? If yes, please specify.

Dental History

1. Have you ever had a serious injury to your head or mouth?
2. Have you ever had orthodontic treatment?
3. Do you wear removable dental appliances?
4. Have you had a difficult problem associated with previous dental treatment? If yes, please explain.
5. When was your last dental exam?
6. What dental procedure was done at that time?
7. When was the last time you took dental x-rays?
8. How do you feel about the appearance of your teeth?