Designing patient's data sheet

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Akam ahz

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Hello,
I am a dental student, and I am trying to design a data sheet for my future patients.

I want my data sheet to be as brief as possible, but still I want it to provide sufficient information.

I have designed a sample of it, and I would like that you give it a glance and tell me what do you think about it.

You will find it attached to this thread.

Please feel free to give any comments related and suggestions.

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Seems limited to me. If you just do a quick google search, you can find many offices (especially corporate) have their forms online. You would be missing out on a lot of vital information with your draft. In regards to its medical hx, they are poor record keepers and will likely not list something if not asked. So like a you dont hx of cancer or osteoporosis on there, both of which could have major effects of oral health and how you treat these patients. Likewise with the dental hx, would be beneficial to have more like sensitivity, pain, TMJ, sleep apnea/snoring, mouth breathing, etc.
 
But isn't the 'others' section in the dental/ medical history indicates that the patient should list whatever other condition that they have?

I want my data sheet to be of one page, so I listed the most common conditions and left space for other uncommon cases.

Thanks for your comment though :)
 
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But isn't the 'others' section in the dental/ medical history indicates that the patient should list whatever other condition that they have?

I want my data sheet to be of one page, so I listed the most common conditions and left space for other uncommon cases.

Thanks for your comment though :)

Yes ideally they would list everything. But patients are either bad historians, dont think medically hx is related to dental tx, or both. Just a little risky to rely on them to read your mind and know what you're looking for IMO
 
Hello,
I am a dental student, and I am trying to design a data sheet for my future patients.

I want my data sheet to be as brief as possible, but still I want it to provide sufficient information.

I have designed a sample of it, and I would like that you give it a glance and tell me what do you think about it.

You will find it attached to this thread.

Please feel free to give any comments related and suggestions.


Is this for a new patient? an existing patient to fill out every 6 months? etc... I'm not sure what the intended audience is. I'm going to assume it's for new patients that you want to get to know/establish care with in your practice. I would consider adding things such as - long term goals of the patient, which they won't know, but it helps stimulate their mind/think about their teeth a bit more and helps you tailor an appropriate treatment plan based on their goals. I would add when their last prophy was, perhaps if they floss and brush regularly, if they have jaw pain/headaches in the morning and if they wear a niteguard. You could ask if they've ever had a dental emergency before or have any cosmetic concerns.
 
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Use the ADA health history form. You don't need to read all the no's, and your staff should be transcribing what's a "yes" on those forms so you can review in few seconds rather than reading a long sheet. Less things to write, the better. For the patient to write, it takes a long time. It also helps you screen medically complex patients. If the patient is really medically complex and your simple sheet isn't sufficient, you have to ask yourself if you are comfortable in treating medically compromised/complicated patients.

For periodic exams, just need to know if any changes in medical history or medications. 2 checkboxes and 2 lines to write changes. sig + date from pt.
 
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When you get to clinic you’ll have your own data sheet, it’s called Axium. Axium is a lot more detailed than the sheet you drafted. Just use that, go through a couple years of clinic and then you’ll learn what’s pertinent and what isn’t.
 
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