Dental charting template 2026

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The document is a periodontal evaluation chart from Delta Dental of California, designed for state government programs. It includes sections for patient information, numerical charting of pocket depths, bone loss, tooth mobility, and details on teeth to be extracted or missing. The chart requires specific numerical data for both facial and lingual surfaces of each tooth.

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Click ‘Get Form’ to open the dental charting template in the editor.
Begin by entering the patient’s name, date of birth, and ID number in the designated fields. This information is crucial for accurate record-keeping.
Next, input the provider's name and their license number along with the National Provider Identifier. These details ensure proper identification of the healthcare provider.
For numerical charting, carefully document pocket depths, bone loss, mobilities, and any teeth that need extraction or are missing. Use at least two numbers for both facial and lingual surfaces of each tooth as specified.
In the mobility section, indicate the level of mobility for each tooth using the scale provided (None = 0 to Severe = 3).
Review all entries for accuracy before saving your completed chart. Utilize our platform’s features to easily modify any information if needed.

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

How do you document a teeth assessment?

Note the findings. Normal findings might be documented as: White teeth with no loose, missing, chipped or broken teeth. Gums are pink in colour with no swelling, bleeding, or pain. Abnormal findings might be documented as: Slight yellow discolouration of the teeth.

How to write a dental chart note?

Dental Treatment Notes They typically contain detailed descriptions of the treatment plans and specific procedures performed, materials and medications administered, clear instructions provided to the patient for aftercare, and schedules for follow-up visits or ongoing reviews.

How do you do dental charting?

Dental charting is typically performed by a hygienist or dental assistant during a dental checkup. Theyll start by counting and numbering the patients teeth on the chart, marking any issues with shorthand notes.

What is the 50-40-30 rule in dentistry?

The apparent contact dimension (ACD), a determinant of dental esthetics, has been purported to exhibit an esthetic relationship termed the 50:40:30 rule, implying that in an esthetic smile, the ACD between the central incisors, central and lateral incisors, and lateral incisor and canine would be 50, 40, and 30% of

What is a general dental charting?

A dental chart is a plot of your teeth. A dentist or hygienist will use a chart to track a patients history. This includes treatment notes, insurance information, X-rays, diagnosis codes, and more. Dental charts can be prepared in many ways, but youll most commonly find them laid out as an x-y plot.