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Orthodontic Referral Oral Health and Hygiene Assessments form must be completed by the referring dentist and forwarded to the evaluating orthodontist. RECIPIENT INFORMATION Recipient NameRecipient

How to fill out orthodontic referral

How to fill out orthodontic referral

1. Begin by gathering all necessary patient information, such as their name, age, contact details, and any relevant medical history.
2. Clearly state the reason for the orthodontic referral, including any specific concerns or issues that need to be addressed.
3. Provide a detailed description of the patient's current dental condition, including the alignment of their teeth, bite relationship, any crowding or spacing issues, and any existing dental work.
4. Mention any previous orthodontic treatment the patient may have received, including the type of appliances used and the duration of treatment.
5. Include any relevant radiographs or dental images to support the referral, highlighting any abnormalities or specific areas of concern.
6. Specify the desired outcome or treatment goals for the patient, such as correcting misalignment, improving function, or enhancing aesthetics.
7. Provide any additional information or special instructions that may be helpful for the receiving orthodontist, such as specific treatment preferences or limitations.
8. Sign and date the referral form, ensuring it is legible and easily understandable by the receiving orthodontist.
9. Send the completed referral form, along with any supporting documents, to the designated orthodontic office through preferred communication methods, such as fax, email, or secure online portals.
10. Keep a copy of the referral form and any related records for your own reference and future follow-up.

Who needs orthodontic referral?

1. Orthodontic referral is typically needed for individuals who require specialized orthodontic treatment to address dental abnormalities, malocclusions, or other oral problems.
2. Common candidates for orthodontic referral include:
3. - Children and adolescents with malocclusions or jaw growth discrepancies.
4. - Adults with misaligned teeth or bite problems.
5. - Patients with severe crowding, spacing, or irregularities in tooth alignment.
6. - Individuals with temporomandibular joint (TMJ) disorders or functional jaw issues.
7. - Those seeking cosmetic improvements or smile makeovers.
8. It is important to consult with a dentist or orthodontist to determine if an orthodontic referral is necessary for a particular individual.

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What is orthodontic referral?

Orthodontic referral is a process where a dentist sends a patient to an orthodontist for specialized treatment.

Who is required to file orthodontic referral?

Dentists are required to file orthodontic referral when they believe the patient needs specialized orthodontic treatment.

How to fill out orthodontic referral?

To fill out an orthodontic referral, dentists need to provide the patient's information, reason for referral, and any relevant medical history.

What is the purpose of orthodontic referral?

The purpose of orthodontic referral is to ensure that the patient receives appropriate orthodontic treatment from a specialist.

What information must be reported on orthodontic referral?

Information such as patient's name, contact information, reason for referral, and any relevant medical history must be reported on orthodontic referral.