UK Shine Dental Confidential Medical History Form 2025

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The document is a Confidential Medical History Form designed to collect personal and medical information from patients prior to dental treatment. It includes sections for personal details, medical history, dental history, and consent for communication. Key questions address past medical conditions, current medications, allergies, and lifestyle habits such as smoking and alcohol consumption.
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  1. Click ‘Get Form’ to open the UK Shine Dental Confidential Medical History Form in the editor.
  2. Begin by filling out your personal information. Enter your full name, address, date of birth, and contact details including home and mobile phone numbers, and email.
  3. Answer the medical history questions regarding blood donation, joint replacements, smoking habits, alcohol consumption, and any current treatments. Be sure to provide accurate responses for effective dental care.
  4. In the medical history section, indicate if you have suffered from any listed conditions such as asthma or diabetes by selecting 'Yes' or 'No'.
  5. Complete the dental history section by providing the name of your last dentist and date of your last visit. Also, express any concerns you may have about dental treatment.
  6. Finally, review all entered information for accuracy before signing and dating the form at the bottom.

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The last thing to ask is Past Dental History If youre seeing the patient at a hospital you want to ask are you registered with a dentist? and how often do you visit the dentist. This gives you an idea of how much they care for their oral health.
A dental record should provide an accurate picture of the patients general health, as well as oral/dental status and any patient concerns and requests. It should include the proposed treatment plan and any treatment performed, as well as all supporting documentation.
You can get a copy of your NHS dental records from your dental practice. Your dental practice keeps records for a minimum of 2 years from the date a treatment is completed. You can request: copies of your clinical records.

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People also ask

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
The dental history is a review of previous dental experiences and current dental problems. Review of the dental history often reveals information about past dental problems, previous dental treatment, and the patients responses to treatments.
Dental records consist of documents related to the history of present illness, clinical examination, diagnosis, treatment done, and the prognosis.

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