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Oral Health Exam Recordb-TP-NTP

The document is an Oral Health Examination Record for teaching and non-teaching personnel in the Philippines, detailing personal information, medical history, and dental status. It includes sections for dentition status, treatment records, and periodic conditions, along with symbols for mouth examination and accomplishment. The form is designed to assess and document the oral health of individuals within the educational system.

Uploaded by

JENNIFER BLANDO
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We take content rights seriously. If you suspect this is your content, claim it here.
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187 views1 page

Oral Health Exam Recordb-TP-NTP

The document is an Oral Health Examination Record for teaching and non-teaching personnel in the Philippines, detailing personal information, medical history, and dental status. It includes sections for dentition status, treatment records, and periodic conditions, along with symbols for mouth examination and accomplishment. The form is designed to assess and document the oral health of individuals within the educational system.

Uploaded by

JENNIFER BLANDO
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Republic of the Philippines

Department of Education
HEALTH AND NUTRITION CENTER
Pasig City

ORAL HEALTH EXAMINATION RECORD FOR TEACHING


AND NON-TEACHING PERSONNEL

Name: Age: Gender:


Date of Birth: Marital Status:
Region: Division: District: School:
Designation:

Medical History:
Hypertension Epilepsy Allergies
Diabetes Bleeding Disorder Others:
Cardio Vascular Dis. Asthma
Please Specify

DENTITION STATUS INDEX: DMFT

Status X-
No. of T/Decayed
18 17 16 15 14 13 12 11 21 22 23 24 25 26 27 28 F-
No. of T/Missing

No. of T/Filled
48 47 46 45 44 43 42 41 31 32 33 34 35 36 37 38
Total
Status

TREATMENT RECORD
DATE TOOTH NO. NATURE OF OPERATION REMARKS DENTIST

Periodical Condition: DENTAL PROSTHESES


Normal Denture wearer: Y N Remarks: ____________
Gingivitis Please Specify:
Periodontal Disease Need for Denture: Y N Remarks: ____________
Other Abnormal Conditions Please Specify: Remarks: ____________

Please Specify

SYMBOLS FOR MOUTH EXAMINATION Artificial Restoration: SYMBOLS FOR ACCOMPLISHMENT


X - Carious tooth indicated for F2 - Permanently filled tooth JC - Jacket crown OP - Oral Prophylaxis
extraction with recurrence of decay AB - Abutment Xt - Extracted permanent tooth
F - Carious tooth indicated for Heavy shade - Permanent P - Pontic Ag F - Amalgam Filling
filling filling I - Inlay Sy F - Synthetic porcelain
RF - Root fragment Outline of filling - tooth with RPD - Removable Partial Denture GIC - Glass Ionomer Cement
O - Missing tooth temporary filling FB - Fixed Bridge ZnO F - Zinc Oxide Filling
CD - Complete Denture R - Referred to private dentist

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