Overview

The dental record, also referred to as the patient's chart, is the official dental office document that records all the treatment done and all patient-related communications that occur in the dental office . Dental records play an important role in identification of a dead body which has been grossly decomposed and is difficult to identify visually. When this occurs, a variety of methods of dental identification are used. This is due to the capability of dental tissues to withstand high temperature, humidity, and pressure. The American Academy of Paediatric dentistry has ad dressed the major elements of record-keeping which include, General charting considerations, Initial patient record, Components of a patient record, Patient medical and dental histories, Comprehensive and limited clinical examinations, Treatment planning and informed consent, Progress notes; correspondence, consultations and Ancillary documents; and confidential notes.

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