Dentist Template

Child Check-up (Dental)

A professional Dentist template for healthcare professionals.

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Specialty

Dentist

Used

185 times

Type

Note

Last edited

2026/07/27

Created by

Faathima Karim

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About this template

This Child Check-up (Dental) template is designed for dentists conducting routine dental examinations for children. It includes sections for recording the dentist and nurse's names, appointment details, and the child's medical and dental history. The template guides the dentist through the examination process, including oral hygiene assessment, risk assessment for caries, periodontal disease, and tooth surface loss. It also covers treatment discussions, consent, and orthodontic assessments. This template is ideal for paediatric dentists and general dentists focusing on child dental care, ensuring comprehensive documentation of each visit.

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Dentist: Faathima Karim Nurse: Sarah Johnson Pt attended at: 10:00 AM / with: Mother EXAM C/O: nil/checkup MH: Checked, no changes, signed by Mrs. Lisa Brown DH: - Brushing: 2 Adv always brush x2 a day - morning before breakfast & evening - Diet: MOD Sugar & LOW Acid E/O: nad I/O: nad Teeth charted OH: GOOD Compliance: good Risk Assessment: - Caries risk: LOW - Perio risk: LOW - TSL risk: LOW DISCUSSED: Discussed importance of maintaining good oral hygiene and regular dental check-ups. Advised on reducing sugar intake. TX PLAN: 1. OHI, diet advice, fluoride toothpaste 2. Topical Fluoride application 3. None Treatment and options explained, parent understands. Parent consented to tx plan Band 1 Verbal consent gained FP17DC signed by mum ORTHO ASSESSMENT: Pt too young for ortho assessment Radiographs (Consent Gained from) - Taken By: Faathima Karim LEFT BITEWING: Justification: assess caries and bone levels REPORT: No decay, bone levels normal RIGHT BITEWING: Justification: assess caries and bone levels REPORT: No decay, bone levels normal Treatment: 1. OHI - advised brushing x2/day for 2 mins with F- toothpaste spit don't rinse 2. Diet advice - Low sugar advised & low acid - Advised sugary snacks/drinks with meals, not between meals. Cut down fizzy drinks, use straw if needed. 3. Topical fluoride application NV: 6-month recall for routine check-up Dr. Faathima Karim Dentist