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Printable dental examination form 2026

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The document is a Dental Examination Record for students at Ateneo de Manila High School, detailing the dental health status, oral health conditions, periodontal examination results, and recommendations for dental treatment. It includes sections for recording the student's personal information, dental health metrics such as tooth count and conditions like caries and gingival inflammation, as well as a space for the examining dentist to provide treatment details.

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Click ‘Get Form’ to open the printable dental examination form in the editor.
Begin by entering the student's name, year, section, and date at the top of the form. This information is essential for identifying the patient.
In the 'Dental Health Status' section, mark the appropriate boxes corresponding to each tooth number based on your examination findings.
Proceed to fill out the 'Oral Health Condition' section. Indicate any presence of debris, inflammation, or calculus by checking 'Y' for yes or 'N' for no.
Complete the 'Initial Periodontal Exam' by assessing gingival inflammation and plaque buildup. Choose from slight, moderate, or severe as applicable.
In the 'Clinical Data' section, document any conditions observed during your examination and provide recommendations for treatment as necessary.
Finally, ensure that a dentist signs and dates the form before submission to complete the process.

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

What is included in an oral examination?

Oral exams typically involve the entire mouth, as a component of a first-time visit or a regular 6-month check-up. Oral exams can also be used to identify a specific issue in one particular area of the mouth, such as pain, swelling, broken teeth, or other dental problems.

What is a complete dental examination?

A complete dental exam looks at your oral history in detail. It also does diagnostics to examine your current situation. From there, the dentist can plan a long-term strategy for your oral health. It can happen every three to five years, depending on the need.

What does a dental examination include?

When you see your dentist for a checkup, the visit usually includes three parts: A dental cleaning to remove the buildup of plaque, a sticky film of bacteria that coats your teeth. X-rays of your teeth on certain visits, depending on the health of your teeth. An exam of your teeth and mouth by a dentist.

What is done during a dental exam?

After your teeth have been cleaned, your dentist will do the following: Complete a quick teeth check-up. Examine your gums, soft palette, throat and neck, and check for any abnormalities. Review any X-rays that may have been taken.

What is a 2813 form?

PURPOSE: To collect patient information necessary to determine the patients readiness to participate in a military deployment. ROUTINE USES: Information in your records may be disclosed to other components within the Department of Defense to determine your readiness to participate in a military deployment.

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What does a dental check-up include?

At each check-up, your dentist should: examine your teeth, gums and mouth. ask about your general health and any problems youve had with your teeth, mouth or gums since your last visit. ask about, and give you advice on, your diet, smoking and alcohol use, and teeth-cleaning habits.

What is a full dental exam?

Every full dental exam may be slightly different based on the patients situation. However, most full dental exam services include dental X-rays, an oral examination, a check for signs of oral cancer, and a teeth cleaning and polishing.

How long is a DD Form 2813 good for?

The DD Form 2813 must be dated within 6 months of your appointment and the classification will stay valid for 1 year from the date on the form. Soldiers can obtain free dental examination and/or treatment by the Army contracted provider Logistics Health Incorporated (LHI).