First Clinic Appointment (Synopsis)

Disinfect the operatory.

Check the medical history and understand the purpose of all the medications. Does your patient need a medical consult? Make sure the Consent to Treatment form has been filled out. Have your instructor write out the cost of the denture on the financial form.

Take the blood pressure. You will need the blood pressure record if there is a medical emergency. To be sure an emergency is rare since the patient has to be ambulatory (reasonably healthy) to come to you. Let us say you get a reading of 120/80 during the emergency. This reading may be a significant decrease in your elderly patient. However, it may be a substantial increase in your young female patient. How will you know what to do for this patient? How will you justify not taking the blood pressure when you are being sued?

Did you put a bib on the patient?

Examine the patient. EXAMINE THE PATIENT. Is there any pathology, anywhere? Do you need to do surgery? What do the ridges look like? What do the ridges feel like? Do you feel knife-edge ridges, tori, large tuberosities, flabby tissue, thin delicate tissue?

Did they have recent extractions? Do they have old dentures? Do they have problems with the old dentures? What problems do you anticipate with the new dentures? Find out what the patient wants. Most important, are their expectations in line with reality? First time denture wearers usually expect too much. There is literature available to help them understand what dentures can do for them. I would give them this material (if you have it) on the first visit. Your instructor can help you.

Look on the face of the chart and make sure the patient is Cleared for Treatment.

Take the primary impressions. (If alginate you should know the difference between edentulous and dentulous alginate trays.)

(I like to take an alginate of any existing maxillary denture. I use it as a reference for selecting teeth.)

You should also have trays for compound impressions if needed. Compound requires the use of a compound heater. Compound impressions are only used for the edentulous.

Show the impression to your instructor. Disinfect the impression. Pour up the impressions. (Do not bead and box alginate impressions.)

Write your progress notes and you sign it. Get your progress notes and the individual steps on the white card signed by the instructor.

Review fees with the patient and collect fee if necessary. Go to the cashier with the patient. (The cashier is on the first floor in the Removable Section.)

Check insurance and take care of preauthorization if needed. Preauthorization takes three to six weeks. Always check with your instructor before you dismiss the patient. You may have missed something. Did you shut the light of the x-ray view box?

Clean up the operatory.

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1999 by Julius Rosen, D.D.S.