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Nose hill Dental Center Family Dentistry #101, 1829 Ranch lands Blvd N.W. Calgary, AB T3G 2A7 pH: 4032411900 Fax: 4032418895 TOOTH EXTRACTION INFORMATION SHEET I understand that there are potential
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How to fill out tooth extraction information sheet

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How to fill out a tooth extraction information sheet:

01
Start by filling out your personal information. This includes your full name, date of birth, contact information, and any relevant medical history.
02
Next, provide details about the tooth that requires extraction. Specify the location and the reason for the extraction, such as decay, infection, or orthodontic treatment.
03
Indicate any allergies or sensitivities to medications or anesthesia. This is crucial information for the dental professional to ensure your safety during the procedure.
04
Mention any current medications you are taking, including over-the-counter drugs and supplements. Some medications can interact with dental treatments or affect the healing process, so it's important to provide accurate information.
05
If applicable, disclose any previous dental or medical history related to extractions or oral surgery. This may include complications or adverse reactions experienced in the past.
06
Sign and date the information sheet to confirm that the provided details are accurate and complete. By signing, you give your consent for the dental procedure and affirm that you understand the potential risks and benefits.

Who needs a tooth extraction information sheet:

01
Individuals scheduled for a tooth extraction procedure generally need to fill out an information sheet. This can include patients with impacted wisdom teeth, severe tooth decay, periodontal disease, or any other dental condition that necessitates tooth removal.
02
It is also recommended for patients undergoing more complex treatments like oral surgery, where dental extractions may be part of the overall treatment plan.
03
Patients with certain medical conditions, such as heart disease, diabetes, or a compromised immune system, may need to provide detailed information to ensure proper care and minimize potential complications from the tooth extraction procedure.
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A tooth extraction information sheet is a document that details the removal of a tooth, including reasons for extraction, procedure performed, and post-operative care instructions.
Dentists or oral surgeons who perform the tooth extraction are required to file the information sheet.
The tooth extraction information sheet should be filled out with details of the patient, tooth extracted, reason for extraction, procedure performed, and post-operative care instructions.
The purpose of the tooth extraction information sheet is to document the tooth extraction procedure for patient records and follow-up care.
Information such as patient's name, date of birth, tooth extracted, reason for extraction, procedure performed, and post-operative care instructions must be reported on the tooth extraction information sheet.
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