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Child dental examination note template
For a child's dental check-up: cooperation and behaviour, examination findings, and prevention tuned for a younger patient. Covers eruption, fissure sealants and fluoride alongside the usual examination findings.
PRESENTING COMPLAINT
Presenting Complaint:
Assisted by:
MEDICAL HISTORY
Medical History:
Allergies:
Medications:
PMS Updated:
DENTAL HISTORY
Toothbrushing:
Interdental Cleaning:
Diet:
Attendance:
BEHAVIOUR & COOPERATION
Cooperation:
Accompanied By:
INTRAORAL: SOFT TISSUE
Mucosa:
Gingivae:
Tongue:
Palate:
Floor of Mouth:
Oropharynx:
HARD TISSUE & DEVELOPMENT
Dentition:
Eruption:
Caries:
BPE (simplified):
Oral Hygiene:
DIAGNOSES
Diagnosis:
Periodontal Diagnosis:
Differential Diagnosis:
RISK ASSESSMENT
Caries Risk:
Periodontal Risk:
Tooth Surface Loss Risk:
Oral Cancer Risk:
PREVENTION & PLAN
Fluoride Varnish:
Fissure Sealants:
Prevention:
Estimate Discussed:
Next Examination:
GDC standard 4.1 expects a patient's clinical record to be made as the appointment happens, and to be accurate and complete.
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Assist fills this in for you.
Assist records the appointment and drafts a note in this structure for the dentist to review and sign off. It writes up what was said in the room, and you check every line before it goes in the record.
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