Orthodontic notes template

An orthodontic visit note is short. The useful part is what changed on the appliance, and what the patient has to do before the next visit.

Template

Date and clinician
Appliance and stage
What was changed today
Oral hygiene
Breakages or teeth not tracking
Instructions given
Next appointment

A filled-in example

            2 May 2026
Fixed appliance, both arches. Alignment stage.
Changed to a 16 NiTi upper. Lower wire left. Elastics as before.
OH: plaque around the brackets, lower 3s. Showed brushing.
No breakages. UR2 still rotated.
Instructions: elastics full time, avoid hard food on the new wire.
Next: 6 weeks.
          

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