1. Sterilization
Cassette Load : {Cassette Load::115}
Cassette Date : {Cassette Date::594}
Cavitron Tip Load : {Cavitron Tip Load::291}
Cavitron Date : {Cavitron Date::296}
Handpiece Load : {Handpiece Load::276}
Handpiece Date : {Handpiece Date::298}
X-ray Holder/XCP Kit Load : {X-ray Holder/XCP Kit Load::225}
XCP Date : {XCP Date::299}
2. Medical History
Medical history reviewed : {No changes:302.1} {Changes documented:302.2}
Medications : {No medications:303.1} {No changes:303.2} {Changes documented:303.3}
Medication list : {Medication list:304}
Allergies : {NKDA:305.1} {Allergies documented:305.2}
Allergy details : {Allergy details::306}
Blood Pressure : {Normal:350.1} {Taken:350.2}
Blood Pressure : {Blood pressure::307}
Taken Pulse : {Taken Pulse::308}
Respirations : {Respirations::309}
Contraindications : {None:310.1} {None:310.2
Premedication : {Not required:311.1} {Taken as prescribed:311.2} {Not taken:311.3}
3. Informed Consent
Discussed the objectives, questions answered, Informed Consent Taken. : {EO/IO exam:314.1} {Oral cancer screening:314.2} {Periodontal assessment:314.3} {Periodontal charting:314.4} {Radiographs:314.5} {Debridement:314.6} {Hand scaling:314.7} {Ultrasonic instrumentation:314.8} {Coronal polish:314.9} {Fluoride varnish:314.10} {Local anesthesia:314.11} {Oraqix:314.12} {Other:314.13} {Comments::121}
Periodontal assessment
Comments : {Comments:121}
Chief Concern : {Chief Concern:335}
Chief Concern : {Chief Concern:335}
4. Chief Complaint
Chief Concern : {Routine recare:335.1} {Sensitivity:335.2} {Bleeding gums:335.3} {Broken tooth:335.4} {Stain:335.5} {No concerns:335.6} {Other:335.7} {Comments:336}
5. EO/IO Examination
EO/IO Examination : {WNL:316.1} {Oral cancer screening completed:316.2} {TMJ WNL:316.3} {TMJ clicking:316.4} {Soft tissue findings discussed:316.5} {Xerostomia:316.6} {Referral recommended:316.7} {Comments::289}
6. Radiographs
Radiographs : {Reviewed:319.1} {None indicated:319.2} {2 BW:319.3} {4 BW:319.4} {PA(s):319.5} {FMX:319.6} {PAN reviewed:319.7}
Findings : {Findings::24}
7. Periodontal Assessment
Diagnosis : {Healthy:322.1} {Plaque-induced gingivitis:322.2} {Localized gingivitis:322.3} {Generalized gingivitis:322.4} {Stable periodontitis:322.5} {Periodontitis:322.6} {Periodontal Maintenance:322.7}
plaque : {plaque:323.1} {Supragingival calculus:323.2} {Subgingival calculus:323.3} {Bleeding:323.4} {Stain None:323.5} {Stain Light:323.6} {Stain Moderate:323.7} {Stain Heavy:323.8}
Recession : {None:324.1} {Localized:324.2} {Generalized:324.3}
Mobility : {None:326.1} {Present:326.2}
Furcation : {None:325.1} {Present:325.2} {Comment::34}
8. Patient Education
Patient Education : {Periodontal disease:327.1} {Bone loss:327.2} {Brushing:327.3} {Flossing:327.4} {Interdental aids:327.5} {Water Flosser:327.6} {Fluoride:327.7} {Diet:327.8} {Caries prevention:327.9} {Recession:327.10} {Root caries:327.11} {Sensitivity:327.12} {Smoking/vaping cessation:327.13} {Dry mouth:327.14} {Implant care:327.15} {Orthodontic hygiene:327.16} {Denture care:327.17} {Additional education:333}
9. Treatment
Instrumentation time : {30 min:329.1} {40 min:329.2} {45 min:329.3} {60 min:329.3}
Prophy paste : {None:330.1} {Fine:330.2} {Medium:330.3} {Coarse:330.4}
Fluoride : {5% NaF:331.1} {Clinpro:331.2} {Declined:331.3}
Treatment tolerated very well : {Yes:332.1} {No:332.2}
Complications : {Complications::328}
10. COE
Dentist : {Dentist::338}
COE Findings, see the chart : {No restorative needs:337.1} {Restorative treatment recommended:337.2} {Referral recommended:337.3} {Treatment plan reviewed:337.4} {Comments:339}
11. Recall
Recall : {3-month PM:341.1} {4-month recall:341.2} {6-month recall:341.3} {Other:341.4} {Other recall:342}
12. Standard Education Macros
Standard Education Macros : {Gingival recession discussed:344.1} {Brushing/flossing reviewed:344.2} {Black stain prevention:344.3} {Periodontal maintenance importance:344.4} {Sensitivity management:344.5}
Provider
Provider : {Provider::169}
Signature : {Signature::346}