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Click ‘Get Form’ to open it in the editor.
Begin by entering the DATE at the top of the form. This helps in tracking the dental services provided.
Fill in the CLIENT’S NAME and CLIENT’S ID NUMBER to ensure proper identification and record-keeping.
Next, input the DENTIST/DENTURIST’S NAME and their PHONE NUMBER, including the area code, for any necessary follow-up communication.
Indicate whether all dental and periodontal services have been completed on all remaining teeth by marking 'Yes' or 'No'. If 'No', be sure to submit a treatment plan and periodontal chart as required.
Finally, mark the chart below according to your dentist's instructions, ensuring all relevant information is accurately recorded.
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The standard tooth numbering system is from 1 to 32. Tooth number 1 is the tooth farthest back on the right side of your mouth in the upper (maxillary) jaw. Numbering continues along your upper teeth toward the front, and across to the tooth farthest back on the top left side (number 16).
How to read a dental teeth chart?
The Universal Numbering System is one of the most common ways to chart adult teeth in the United States. In this system, each tooth gets a number from 1 to 32. The dentist starts with the upper right back tooth, moves around to the upper left back tooth, and then continues with the lower teeth.
How to chart teeth at the dentist?
Dental charting is the systematic recording of a patients oral health conditions, including the state of their teeth, gums, and any ongoing issues or concerns. The process involves creating a visual representation of the oral cavity, indicating existing problems and treatment options.
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.
Does Washington Medicaid cover dental?
Dental services for children age 20 and younger are covered directly by Apple Health (Medicaid) using your ProviderOne services card. The Academy of Pediatric Dentistry (AAPD) recommends all children see a dentist by 12 months of age.
Oral Health for Infants and Toddlers - UW School of Dentistry
Access to Baby and Child Dentistry program (ABCD) puts young children on a lifelong path to good oral health. It connects low-income families with dentists.
Tooth Chart. DATE. CLIENTS NAME. CLIENTS ID NUMBER If not, please submit treatment plan and periodontal chart. Mark the chart below. HCA 13-863 (2/15).
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