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    Dental Health

    Uploaded by

    ARMANDO CORTEZ

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    Dental Health

    Uploaded by

    ARMANDO CORTEZ
    5 views2 pages

    Original Title

    DENTAL HEALTH

    Copyright

    © © All Rights Reserved

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    5 views2 pages

    Dental Health

    Uploaded by

    ARMANDO CORTEZ

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 2

    Revised as of February 2024

    Republic of the Philippines


    DEPARTMENT OF EDUCATION
    REGION III - CENTRAL LUZON Latest 1.8 inches x 1.4
    BALBALOTO ELEMENTARY SCHOOL inches picture

    DENTAL HEALTH RECORD


    Name:
    Birth
    Age: Sex: Date: --
    Event:
    Parent/Guardian:

    CONDITION AND TREATMENT NEEDS


    CONDITION
    RIGHT LEFT
    TEMPORARY TEETH
    5 5 5 5 5 6
    5 4 3 2 1 1 62 63 64 65

    1 1 1 1 1 1 1 1 2 PERMANENT TEETH

    8 7 6 5 4 3 2 1 1 22 23 24 25 26 27 28
    CONDITION

    4 4 4 4 4 4 4 4 3
    8 7 6 5 4 3 2 1 1 32 33 34 35 36 37 38

    TREATMENT NEEDS
    TREATMENT NEEDS
    TEMPORARY TEETH
    RIGHT
    LEFT

    8 8 8 8 7 7 7 7 7
    5 4 3 82 1 1 2 3 4 5
    CONDITION
    ]

    YEAR LEVEL REMARKS


    DATE
    EXAMINATION
    SEALANT (GI)
    PERMANENT FILLING
    AR
    T
    EXTRACTION
    ORAL PROPHYLAXIS
    REFERRAL
    OTHER ORAL
    TREATMENT

    SYMBOLS FOR MOUTH EXAMINATION SYMBOLS FOR ACCOMPLISHMENT


    X - TOOTH INDICATED DU - DECUBITAL ULCER XT - EXTRACTED PERMANENT TOOTH
    MA
    FOR EXTRACTION L - MALOCLUSSION xt - EXTRACTED TEMPORARY TOOTH
    FL
    F - TOOTH INDICATED U - FLUOROSIS Am - AMALGAM FILLING
    FOR FILLING Gn - NORMAL Com - COMPOSITE FILLING
    HEA - TOOTH WITH TEMPORARY Gm - MODERATE GINGIVITIS
    VY
    SHA
    DE FILLING (1-2 QUADRANTS) ARTIFICIAL RESTORATION
    RC - RECURRENT CARIES Gs - SEVERE GINGIVITIS JC - JACKET CROWN
    RF - ROOT FRAGMENT (3-4 QUADRANTS) I - INLAY
    CM
    M - MISSING TOOTH R - COMPLETE MOUTH REHAB OP - ORAL PROPHYLAXIS
    (√) - SOUND ERUPTED PERMANENT ZOE - ZINC OXIDE UEGENOL FILLING
    TOOTH TF - TEMPORARY FILLING

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