Dental implant consultation note template
A consultation note records the assessment and the options. It is not the surgical record, and it should not promise a result you cannot guarantee.
Template
Tooth to replace How it was lost Medical history relevant to implants Smoking Smile and expectations Examination Space Soft tissue Opposing tooth Occlusion Imaging Bone, as assessed today Options 1. Leave the gap 2. Denture or bridge 3. Implant Risks discussed Costs and stages Patient decision Next visit
A filled-in example
Tooth to replace
LL5, extracted two years ago.
How it was lost
Root fracture. Healed uneventfully.
Medical history relevant to implants
No bisphosphonates. Type 2 diabetes, last HbA1c brought by the patient, 52 mmol/mol.
Smoking
Stopped 18 months ago.
Smile and expectations
Wants a fixed tooth. Understands it is private and staged.
Examination
Space: Adequate mesial-distal width.
Soft tissue: Keratinised tissue present. No infection.
Opposing tooth: UL5 present, unrestored.
Occlusion: No deep overbite.
Imaging
CBCT not taken today. Periapical shows the site only in two dimensions. Bone height not measured from this film.
Options
1. Leave the gap. 2. Resin bridge. 3. Implant after CBCT and a written plan.
Risks discussed
Failure to integrate, infection, need for grafting, a result that does not match the adjacent teeth, long-term maintenance.
Costs and stages
Written estimate to follow the CBCT. No start date booked.
Patient decision
Wants the CBCT and a second discussion before deciding.
Next visit
CBCT appointment.
Let Dentascribe fill this in from your appointment audio.
