STANDARDS FOR AN

ACCEPTABLE CHARTING
SYSTEM
 UNCOMPLICATED

Easily understood by dentist and staff

and should be effective and accurate
means of recording dental conditions
 COMPREHENSIVE

All dental conditions, both normal and

abnormal, including a detailed
representation of location, nature and
size of all restorations should be noted.
 ACCESSIBLE

A dental chart should be a part of the

permanent patient record which be
easily accessible for reference during
treatment planning or during recall
appointments.
 UPDATED

A chart should allow for continued

updating as treatment is rendered
and medical and dental conditions
change.
ADJUNCTIVE AIDS FOR
EXAMINING TEETH AND
RESTORATION
 PERCUSSION TEST

Is performed by gently tapping the

occlusal or incisal surfaces of the teeth
with the end of the mirror handle to
determine the presence of tenderness
 PALPATION TEST

Is performed by rubbing the index

finger along the facial and lingual
mucosa over the region of the apex of
the tooth
 THERMAL TEST

Is conducted by either a small rod-

shaped piece of ice or hot gutta percha
applied directly to the tooth.
HYPEREMIA - pain of less than approximately 10
sec. duration elicit by heat and cold.

IRREVERSIBLE PULPITIS intense pain of

longer duration from ice usually.

REVERSIBLE PULPITIS- pain that results from

heat but is quickly relieved by ice.

NON VITAL lack of response to thermal test

 ELECTRIC PULP TESTER

Is placed on the tooth not on the

restoration
 TEST CAVITY
By using round bur and no anesthetic.
A test cavity is made through the
restoration into the dentin. Lack of
sensitivity when the dentin is cut with a
bur may indicate a non vital pulp.
EXAMINATION OF PATIENT IN
PAIN

ONSET AND DURATION OF PAIN

STIMULI CAUSING PAIN
SPONTANIETY OF THE PAIN
INTENSITY OF THE PAIN
FACTORS THAT RELIEVE THE
PAIN
 TREATMENT PLANNING

Is a carefully sequenced series of

services designed to eliminate or
control etiological factors, repair
existing damage, create a functional,
maintainable environment.
SOUND TREATMENT PLAN

Depends on thorough patient evaluation,

dental expertise, understanding of
indications and contraindications and a
prediction of the patients response to
treatment.
TREATMENT PLAN
SEQUENCING
 CONTROL PHASE
eliminate pain
Eliminate active disease such as caries
and inflammation
Remove conditions preventing
maintenance such as overhanging
restorations
Eliminate potential causes of disease
such as impacted third molars
Begin preventive dentistry instruction
 HOLDING PHASE

A time between the control and definite

phases that allows resolution of
inflammation and time for healing
 DEFINITIVE PHASE

Includes some forms of endodontic,

periodontic orthodontic, oral surgery
and operative procedure prior to fixed
or removable prosthetic treatment
 MAINTENANCE PHASE

Includes regular recall examination

 Reasons for Recording exact location and
conditions of all teeth, restorations,
caries, etc:
Quality Care
a thorough charting of existing conditions
provides basic information for an accurate,
comprehensive treatment plan

Third Party Communication

accurate records of the patients conditions
are useful in communicating with third-
party agencies
 Malpractice the dental record
the dental record is considered legal,
admissible evidence in case of
contended negligence or
malpractice

Forensic Uses
in many instances, is the only means of
identifying the deceased person
 Simple things are easy to
understand.

BY: Nelson P. Angeles, DMD, MEM