Dental Treatment Record

Who this is for

Your own record of what has been done to your teeth. Each line takes the date, who you saw, the treatment carried out in the words your dentist used, the tooth or area they noted, what you paid and the date you were given to come back — so the history travels with you rather than sitting on one practice's system.

Anyone who changes dentist, moves town or moves country, people part-way through a course of treatment, parents keeping the record for a child, and anybody who has been asked what work they have had done and had to guess.

What this helps you track

• Every visit in date order, with the practice and the dentist or hygienist you saw
• Treatment carried out, written the way it was described to you
• The tooth or area noted at the time, so a later question has something to point at
• What each visit cost and whether it has been paid
• The next check date you were given, and where the x-rays and letters are

How to use it

1. Fill in your details, your practice and your dentist at the top of the sheet.
2. Add a line on the way out of each visit, while the words are still fresh.
3. Write the treatment as it was described to you, and note the tooth or area if one was mentioned — practices use their own numbering, so copy whatever you were told.
4. Enter what you paid in the cost column and tick it once it is settled; the browser and spreadsheet versions total the column for you.
5. Put the next check date in as soon as it is given — the sheet counts the days to it, and nothing more.
6. Keep the sheet with your documents, or fill it in on screen and save it in your own browser.

Formats

• Printable PDF (A4 and US Letter)
• Fillable PDF with form fields
• Fill in online, saved in your browser
• Excel / Google Sheets workbook

The printable is laid out inside a box that fits both A4 and US Letter, so the two files are identical and neither one is scaled. The fillable PDF has real form fields. The workbook uses plain formulas only — SUM, IF, COUNTIF and the like — so it opens in Excel, LibreOffice and Google Sheets without anything breaking, and every calculated cell is grey so you can see which figures it worked out.

How to print

Download the A4 or US Letter file to match the paper in your printer, open it in a PDF reader and print at 100% — not "fit to page", which shrinks the writing space. Both files leave a 14 mm margin, which clears the unprintable edge on home printers. To print the online version with your entries in it, use the Print this sheet button, which prints only the sheet and none of the page around it. More on printing.

Questions

Does the sheet say how often I should have a check-up?

No. There is no interval anywhere on it. The next date column is for the date your own dentist gave you, and the days figure is simply arithmetic between today and that date.

What should I write in the treatment column?

What you were told was done, in those words. If you were given a written estimate or treatment plan, copy the wording across. The sheet explains nothing and recommends nothing — it records.

Why note the tooth?

Because a filling on one particular tooth is the thing a new dentist, or you in four years, will want to identify. Numbering systems differ, so write down exactly what you were told rather than converting it.

Is the cost column any use where treatment is not paid for directly?

Leave it blank. Charges differ from country to country and person to person, so the sheet supplies no figure at all and only adds up what you actually enter.

Can I keep the family on one sheet?

One per person is cleaner, because the record tends to be handed to a practice. If you hold the paperwork for several people, print a sheet each and file them together.