Dentist Template
Child Check-up (Dental)
A professional Dentist template for healthcare professionals.
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.
Preview template
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
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