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1590 West Street Road, War minster, PA 18974 pH: (215)9570700 Fax: (215)9570703www.bucksdental.com Patient Information Patient Name:Date: Nastiest Male Female Married Single Child OtherSocial Security
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How to fill out patient dental history

01
Start by gathering all the necessary information about the patient, including their personal details such as name, date of birth, and contact information.
02
Ask the patient about their dental and medical history, including any previous dental treatments, surgeries, or medications they have taken.
03
Inquire about the patient's oral hygiene habits, such as how often they brush and floss their teeth, and whether they use any special dental products.
04
Record any known allergies that the patient may have, especially to dental materials or anesthesia.
05
Ask about the patient's current dental concerns or problems, such as toothaches, sensitivity, or gum issues.
06
Take note of any systemic health conditions or medications that may impact the patient's dental treatment.
07
Include a section for the patient to provide insurance information, if applicable.
08
Make sure to explain the importance of providing accurate and complete information for their dental history.
09
Review the filled-out dental history form with the patient to ensure its accuracy and address any additional questions.
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Keep the patient dental history form securely stored and easily accessible for future reference.

Who needs patient dental history?

01
Dentists
02
Dental hygienists
03
Orthodontists
04
Oral surgeons
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Periodontists
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Prosthodontists
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Any dental healthcare professional responsible for providing patient care
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Patient dental history is a record of a patient's past and current dental health issues, treatments, and medications.
Dentists, dental hygienists, or any other healthcare provider who is treating the patient is required to file patient dental history.
Patient dental history can be filled out by gathering information from the patient through a questionnaire or interview, and updating the record with each visit.
The purpose of patient dental history is to provide healthcare providers with a comprehensive understanding of the patient's dental health, which helps in making informed treatment decisions.
Patient dental history should include details about past dental procedures, medications, allergies, chronic conditions, and any issues or symptoms the patient is experiencing.
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