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Orthodontic Health History Former. Nancy Villa, DMD Dr. Tara Savage, DMD Dr. MENA Morgan, DMD2455 Route 516Old Bridge, NJ 088577326792323Date:___ Patients Last Name: ___ First Name: ___ Middle Initial:

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How to fill out adult orthodontic health history

01

Begin by providing your personal information such as name, date of birth, and contact information.

02

Fill out any previous orthodontic treatment history you may have had.

03

Provide information on any existing medical conditions or allergies that may be relevant to your orthodontic treatment.

04

List any current medications you are taking and their dosage.

05

Describe your dental history, including any past surgeries or procedures.

06

Sign and date the form to certify the accuracy of the information provided.

Who needs adult orthodontic health history?

01

Adults seeking orthodontic treatment

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What is adult orthodontic health history?

Adult orthodontic health history is a detailed record of an adult's dental and orthodontic health background, including any previous treatments or conditions.

Who is required to file adult orthodontic health history?

Any adult who is undergoing orthodontic treatment or planning to undergo orthodontic treatment is required to file adult orthodontic health history.

How to fill out adult orthodontic health history?

Adult orthodontic health history can be filled out by providing accurate information about dental and orthodontic treatments, past and present conditions, and any concerns or goals related to orthodontic treatment.

What is the purpose of adult orthodontic health history?

The purpose of adult orthodontic health history is to provide orthodontists with essential information about the patient's oral health background, which can help in determining the best course of treatment.

What information must be reported on adult orthodontic health history?

Information such as previous orthodontic treatments, dental conditions, medications, allergies, and any relevant medical history must be reported on adult orthodontic health history.

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