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CARIES RISK ASSESSMENT FORM CHILDREN AGE 6 AND OVER/ADULTS
Patient Name:___ I.D.#___ Age:___
Date:___ Assessment Date: ___ Is this (please circle) baseline or recall
NOTE: Any one YES in Column 1
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How to fill out caries risk assessment form

How to fill out caries risk assessment form
01
Gather necessary information such as medical history, dental history, dietary habits, and oral hygiene practices.
02
Determine the patient's risk factors such as previous dental caries, presence of dental restorations, and presence of dental plaque.
03
Score the patient based on the identified risk factors using a predetermined scoring system.
04
Interpret the score to determine the patient's level of caries risk (low, moderate, high).
05
Implement appropriate preventive measures and treatment plans based on the assessment results.
Who needs caries risk assessment form?
01
Patients visiting a dentist for routine check-ups
02
Patients with a history of dental caries
03
Patients with poor oral hygiene habits
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What is caries risk assessment form?
The caries risk assessment form is a tool used by healthcare providers to evaluate the risk of an individual developing tooth decay.
Who is required to file caries risk assessment form?
Dentists and other healthcare providers who are treating patients for dental health issues are required to file the caries risk assessment form.
How to fill out caries risk assessment form?
The caries risk assessment form is typically filled out by evaluating the patient's oral health history, diet, hygiene habits, and other risk factors that could contribute to tooth decay.
What is the purpose of caries risk assessment form?
The purpose of the caries risk assessment form is to identify individuals who are at risk for developing tooth decay so that appropriate preventive measures can be taken.
What information must be reported on caries risk assessment form?
Information such as the patient's oral health history, diet, hygiene habits, and other risk factors must be reported on the caries risk assessment form.
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