2a) Specific Dental Examination

Consent
A) Chief Concern

If present

B) Oral imaging
C) Oral examination

Need pulp testing details? Use the dedicated template: 2d) Pulp Vitality Testing

D) Diagnosis
E) Prognosis
F) Risks, Benefits, Alternatives
G) Consent for treatment
Foreseeable fees
Free and informed consent of the patient or legal guardian
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2a) Specific Dental Examination Consent Verbal consent received to proceed with data acquisition and the specific exam. Patient understands this is not a full exam; broader issues may require a complete or periodic exam. A) Chief Concern B) Oral imaging C) Oral examination D) Diagnosis E) Prognosis F) Risks, Benefits, Alternatives The following risks, benefits, and alternatives were discussed: The risks of not doing anything were also discussed G) Consent for treatment Foreseeable fees: N/A Free and informed consent of the patient or legal guardian: Verbal
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Templates in this section
Oral Exams
Specific Dental ExaminationCurrent sectionComprehensive Dental ExaminationCaries Risk AssessmentCaries Treatement planningCaries and Other Clinical Findings Report
FPD
New FPD
RPD
Existing RPD
Endo
Pulp Vitality TestingEndo Case Difficulty Assessment
Radiology
General Radiology ReportClinical and Radiological Teeth Exam