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7320 Ent4 Presentchecklist Alt (Page 1) 4.0 PRESENTATION CHECKLIST PATIENT NAME: ________________________________________________ r/Staff r/Staff ed ed or/Staff ed ct tient tient tient Initials Date View Pa Initials Docto Initials Date View Pa Initials Do Date View Pa Initials Docto Initials BRIDGES ESTHETIC DENTISTRY HYGIENE Diagnosis: All-Porcelain: Bridges Diagnosis: Bridges All-Porcelain: Crowns Bad Breath Procedure: Bonding Bruxism 3-Unit Anterior The Goal Infective Endocarditis Cantilever Home Whitening Oral Piercing General Care Ind. Resin: Advantages Smokeless Tobacco Maryland Bridge Ind. Resin: Amalgam Problems Snoring Posterior Gold Ind. Resin: Procedure Toothbrush Abrasion Posterior Porcelain Veneers Prevention: Post-Op Instructions: White Fillings Brushing Permanent Bridge Post-Op Instructions Disclosing Tablets Temporary Bridge Electric Toothbrush Alternatives ESTHETIC SOLUTIONS GALLERY Flossing Gallery All-Porcelain Crowns Fluoride Closing Spaces: Bonding The Hygienist CROWNS Closing Spaces:Veneers Importance of Reg. Exams Diagnosis: Complete Makeovers Nutrition & Health After Root Canal Instant Ortho Oral Irrigator All-Porcelain Crown Intrinsic Problems Periodontal Involvement Cracked Tooth Lengthening Teeth Sealants Cracked Tooth Syndrome Lightening Teeth: Bonding Soft Drinks & Health Failing Crown Lightening Teeth:Veneers Superfloss Large Cavity Subtle Changes Ultrasonic Scaling PFM Crowns White Fillings Worn Fillings A Younger Smile IMPLANTS Procedure: Diagnosis: Anterior Porcelain EXTRACTIONS Implant Bridge Core Buildup Diagnosis: Lower Jaw Post & Core Decay Single Tooth Posterior Gold Dry Socket Upper Jaw Posterior Porcelain Periodontal Disease Procedure: Post-Op Instructions: Primary Teeth Immediate Placement Permanent Crown Wisdom Teeth Implant Bridge Temporary Crown Procedure: Lower Jaw Alternatives Single Tooth Single Implant—1 Stage Gallery Wisdom Teeth Single Tooth Post-Op Instructions Upper Jaw DENTURES Alternatives: Post-Op Instructions: Procedure: Single Tooth After Restoration Immediate Dentures Wisdom Teeth After Surgery Lower Partial Gallery Alternatives Overdentures Gallery Precision Partial Upper Partial INITIAL VISIT Alternatives: Co-Diagnosis Immediate HIPAA Notice Overdentures Infection Control Partial Dentures Insurance Information Denture Care Nitrous Oxide Problems with Dentures Oral Cancer Exam Gallery Oral Sedation Rubber Dam Initial Visit continued on back ➔ CE-4025-PD ed ed or/Staff or/Staff ed or/Staff ct ct ct tient tient tient Date View Pa Initials Do Initials Date View Pa Initials Do Initials Date View Pa Initials Do Initials INITIAL VISIT, CONT. PEDIATRICS, CONT. RESTORATIONS Common Conditions: Procedure: Diagnosis: Canker Sores Air Abrasion Abfractions Cold Sores Fillings Cavities Endodontic Abscess Fractured Anterior Tooth Failing Amalgam Fillings Gingival Recession Pulpectomy How Teeth Decay Pericoronitis Pulpotomy Overhangs Periodontal Abscess Rubber Dam Worn Anterior Resin Sensitive Teeth Space Maintainer Worn Posterior Resin X-ray: Stainless Steel Crowns Worn Silver Fillings Bitewing Kirby–Brushing Procedure: Complete Series Kirby–Flossing Advantages of Onlays Panographic Amalgam PERIODONTAL DISEASE Anterior Resins NEW TECHNOLOGIES Diagnosis: Comparisons Diagnostic: Gingivitis Gold Inlay DIAGNOdent Infective Endocarditis Gold Onlay Digital X-ray Periodontal Disease Porcelain Inlay Intraoral Camera Smoking & Perio Disease Porcelain Onlay Procedural: Three Month Recare Posterior Resins Air Abrasion Procedure: Post-Op Instructions: CAD/CAM Arestin Permanent Onlays CompuDent Atridox Temporary Onlays Hard Tissue Laser Microscope Alternatives Micro-Dentistry PerioChip Gallery Power Whitening Periostat Soft Tissue Laser Root Planing ROOT CANAL Ultrasonic Scaling Diagnosis:ROOT CANAL ORTHODONTICS Surgery: Cracked Tooth Syndrome Diagnosis: Bone Grafting Root Canal Orthodontics Crown Lengthening Crown Needs Root Canal Procedure: Flap Procedure: Adult Gingival Grafting Apicoectomy Braces Care Gingivectomy Post & Core Child Systemic Effects: Rubber Dam Invisalign Cardiovascular Health Single Visit Alternatives Diabetes Two Visits Gallery Low Birth Weight Post-Op Instructions Pregnancy Alternatives PEDIATRICS Respiratory Infections Gallery Diagnosis: Post-Op Instructions Ankylosis Alternatives TMD Bottle Decay Gallery Abfraction Cavities Bruxism Prevention: POST-OP INSTRUCTIONS Equilibration Braces Care Bridges: Permanent NTI Brushing Bridges:Temporary Occlusion Disclosing Tablets Crowns: Permanent TMD Flossing Crowns:Temporary Importance Primary Teeth Esthetic Dentistry Infant Teeth Homecare Extractions Mouthguards Fillings Implants: After Restoration Implants: After Surgery Onlays: Permanent Onlays:Temporary Periodontal Surgery Root Canal #7320 IH 4/21/04.
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