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HEALTH HISTORY QUESTIONNAIRE Date - Dr Joe Dentistry

HEALTH HISTORY QUESTIONNAIRE Date - Dr Joe Dentistry 2025

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The document is a comprehensive Health History Questionnaire used by a dental practice to collect personal, medical, and insurance information from patients. It includes sections for general information, medical health history, allergies, medications, and specific questions for women regarding pregnancy. Additionally, it outlines policies on cancellations, privacy practices under HIPAA, arbitration agreements for disputes related to dental malpractice, and financial agreements detailing payment responsibilities and options. The document emphasizes the importance of accurate information for effective dental treatment.

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How often should health history be updated in a dental office?

All patients of record should be asked to complete a new health history form every two years. This process can greatly reduce the possibility that the patient will inadvertently neglect to advise the dentist and staff of recent changes to his/her health status.

What are the questions on dental history?

Have you had orthodontic treatment (braces/retainers) or had your bite adjusted? Have you had any teeth removed? Do you have sore or bleeding gums when brushing or flossing? Have you been treated for periodontitis or told you have bone loss around your teeth?

What is a health history questionnaire?

A health history questionnaire is a practical way to learn about a patients general information, health status, medications, or allergies.

What are some questions about teeth?

Top 10 Tooth Talk Questions and Answers About Your Teeth What holds my teeth in my mouth? How many teeth do I have? What can I do to prevent getting cavities? What are dental sealants? What should I do if I knock out a tooth? What is fluoride? What does a dentist actually do?

What is included in the dental history?

The dental history should include past dental difficulties, name and address of current or most recent treating clinician, chief complaint (including duration, frequency, type and intensity of any pain), relevant prior dental treatment, and attitude regarding teeth retention.

What are the questions for dental health history?

Have you had previous unfavorable dental treatment? Have you had complications following past treatment? Have you had orthodontic treatment (braces/retainers) or had your bite adjusted? Have you had any teeth removed?

What are common dental health problems?

Oral health Key facts. Overview. Dental caries (tooth decay) Periodontal (gum) disease. Edentulism (total tooth loss) Oral cancer. Oro-dental trauma. Noma.

How often should a health history questionnaire be completed?

TDIC advises that the patient (or the legal guardian if the patient is a minor) review, update and sign a health history form at every appointment or at least every six months. A new form should be completed every two years by active patients.

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