Get the free RefeRRal foR PeRiodontal evaluation

Harold Snyder III, DDS, MS Deborah S. Jones, DDS Gala I. Torres, DMD, MS Harold Snyder III., DDS, MS I Gala Torres, DMD, MS I'm Sharing Seth, DDS 130 Thomas Johnson Drive, Suite 6 Frederick, Maryland

How to fill out referral for periodontal evaluation

How to fill out a referral for periodontal evaluation:

1. Fill out the patient information section: Provide the patient's full name, contact information, date of birth, and any relevant medical history, including current medications and allergies. Also, include the referring dentist's information, including their name, address, and contact details.
2. Specify the reason for the referral: Clearly state the reason why the patient is being referred for a periodontal evaluation. This could include symptoms of gum disease, underlying medical conditions that may affect oral health, or the need for a specialized treatment that the referring dentist cannot provide.
3. Include relevant dental and medical history: Provide a brief overview of the patient's dental history, including any previous periodontal treatment received, oral hygiene habits, and any known risk factors for gum disease. Additionally, mention any pertinent medical conditions that may impact their periodontal health.
4. Provide radiographs and diagnostic records: Attach any recent dental radiographs, such as bitewing or panoramic X-rays, that can assist the periodontist in evaluating the patient's oral health. If the patient has undergone previous treatments like scaling and root planing, include relevant post-treatment records to provide an overview of their progress.
5. Note specific concerns or questions: If there are any specific concerns or questions the referring dentist has regarding the patient's periodontal health, clearly state them in the referral. This information will help the periodontist focus on addressing these concerns during the evaluation.

Who needs a referral for periodontal evaluation:

1. Patients with symptoms of gum disease: Individuals experiencing symptoms such as bleeding gums, persistent bad breath, receding gumline, loose teeth, or changes in bite should seek a referral for a periodontal evaluation. These symptoms may be indicative of underlying gum disease.
2. Patients with a history of advanced gum disease: Those who have previously been diagnosed with periodontitis or have undergone periodontal treatment could benefit from regular periodontal evaluations. This helps monitor the progression of the disease and ensures timely intervention if necessary.
3. Individuals with certain medical conditions: Patients with medical conditions like diabetes, cardiovascular disease, or immunocompromised individuals may be more susceptible to gum disease. Therefore, a referral for a periodontal evaluation can help manage their oral health and prevent further complications.
4. Patients requiring specialized periodontal treatment: In cases where advanced periodontal treatment, such as gum grafting or dental implants, is needed, a referral to a periodontist becomes essential. These specialists are trained in providing specialized care for complex periodontal conditions.
5. Individuals seeking a second opinion: Some patients may wish to seek a second opinion regarding their periodontal health or proposed treatment plan. In such cases, a referral for a periodontal evaluation can provide a fresh perspective and help the patient make an informed decision.

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What is referral for periodontal evaluation?

Referral for periodontal evaluation is a request made by a dentist for a patient to see a periodontist for evaluation and treatment of gum diseases.

Who is required to file referral for periodontal evaluation?

Dentists are required to file referral for periodontal evaluation when they suspect a patient has gum disease that requires specialized treatment.

How to fill out referral for periodontal evaluation?

Referral for periodontal evaluation should include patient's information, reason for referral, and any relevant dental history.

What is the purpose of referral for periodontal evaluation?

The purpose of referral for periodontal evaluation is to ensure that patients receive proper evaluation and treatment for gum diseases by a periodontist.

What information must be reported on referral for periodontal evaluation?

Referral for periodontal evaluation should include patient's name, contact information, reason for referral, and any relevant dental history.