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Clinic Note Gen
Clinic Note Gen
Dr. Mirdamadi
2024-06-25T23:36:42+00:00
Note Type
Consult Note
Procedure Note
Follow Up Note
Prescriptions
Consult Note
Extraction
Wisdom Teeth
Implant
TMJ
Pain Scale
0/10 no pain
1/10 mild pain
2/10 mild pain
3/10 moderate pain
4/10 moderate pain
5/10 severe pain
6/10 severe pain
7/10 severe pain
8/10 very severe pain
9/10 very severe pain
10/10 worst pain
Age
Sex
Male
Female
Exam Type
Wisdom teeth
Decayed maxillary teeth
Decayed mandibular teeth
Decayed maxillary/mandibular teeth
Maxillary lesion
Mandibular lesion
Dental implant rehabilitation
Other
*Other:
** leave PMH, medications and allergies blank and it will output 'As reviewed and documented in pts chart'
PMH
Medications
Allergies
HPI
Neuro Exam
Extra-Oral Exam
Intra-Oral Exam
Radiograpahic Exam
Additional Notes
Sedation Plan
Local Anesthesia
Nitrous
IV Sedation
Mallampati
I
II
III
IV
TM Distance
<3 FB
>3 FB
Neck ROM
Full
Limited
Mouth Opening
<3 FB
>3 FB
ASA
I
II
III
IV
V
VI
Plan
Follow-Up Note
Extraction F/U
Implant F/U
Ortho Sx F/U
Reason for F/U
Pain Scale
0/10 no pain
1/10 mild pain
2/10 mild pain
3/10 moderate pain
4/10 moderate pain
5/10 severe pain
6/10 severe pain
7/10 severe pain
8/10 very severe pain
9/10 very severe pain
10/10 worst pain
Post Op Course
Neuro Exam
Extra Oral Exam
Intra Oral Exam
Procedure
Sutures
Removed
Left in Place
Dissolved
Additional Notes
Next Visit
Procedures
Extraction
Wisdom Teeth
Implants
Uncovering
Sinus Lift
Alveoloplasty
Biopsy
Bone Graft
Tori
Apico
Incision & Drainage
Expose & Bond
CRIMF
Sinus Closure
Sialolithotomy
Implant debride
Sedation
Nitrous Sedation
IV Sedation
Macro
Extraction
Wisdom Teeth
Sedation
Procedure Note
Procedure
Pain Scale
0/10 no pain
1/10 mild pain
2/10 mild pain
3/10 moderate pain
4/10 moderate pain
5/10 severe pain
6/10 severe pain
7/10 severe pain
8/10 very severe pain
9/10 very severe pain
10/10 worst pain
Risks
Mand Ext
Max Ext
Referral
Yes
No
Time Out Witness
Angiocath Size
18g
20g
22g
24g
Angiocath Lat.
Left
Right
Angiocath Loc.
Hand
Forearm
ACF
Wrist
Blood PRP
15cc
30cc
60cc
90cc
120cc
Decadron Dose
4mg
8mg
12mg
16mg
20mg
Abx Dose
600mg of Clindamycin
2g of Ampicillin
3g of Unasyn
1g of Cefazolin
1g of Ceftriaxone
500mg of Zithromax
Xylocaine
34mg
68mg
102mg
136mg
170mg
204mg
Septocaine
34mg
68mg
136mg
202mg
270mg
Marcaine
9mg
17mg
26mg
34mg
Carbocaine
51mg
102mg
153mg
204mg
Simple Extractions
Simple Extraction
Surgical Extractions
Surgical Extraction
Options
FTF
Handpiece
Alveoloplasty
URQ
ULQ
LRQ
LLQ
Maxillary Wisdom Teeth Extractions
Tooth #1
Erupted
Soft Tissue
Partial Bone
Complete Bone
Tooth #16
Erupted
Soft Tissue
Partial Bone
Complete Bone
Max WT
Distal Release
Vertical Release
FTF
Tuberosity
Palatal Tear
Mandibular Wisdom Teeth Extractions
Tooth #17
Erupted
Soft Tissue
Partial Bone
Complete Bone
Tooth #32
Erupted
Soft Tissue
Partial Bone
Complete Bone
Mand WT
Distal Release
FTF
Handpiece
Coronectomy
Sinus Lift
Laterality
Left
Right
Bilateral
Schneid. Membrane
Intact
Perforated
Membrane used
Chorion/Amnion
Surgicel
Biomend Xtend
Immediate Implants
Implant #s
Buccal Plate
Intact
Not Intact
Screw
Healing Abutment
Cover Screw
White Caps
Multiunit Abutment
Membrane
Biomend Xtend
Straumann Jason
Collagen Plug
Standard Implants
Implant #s
Screw
Healing Abutment
Cover Screw
White Caps
Multiunit Abutment
Implant Log
Implant
Alveoloplasty
Quadrants
URQ
ULQ
LRQ
LLQ
Hard Tissue Biopsy
Site
Incision
Biopsy Type
Incisional
Excisional
Soft Tissue Biopsy
Site
Biopsy Type
Incisional
Excisional
Closure
Primary Closure
Secondary Healing
Uncovering
Implant #s
Implant Type
Straumann BLX
Straumann BLT
NobelReplace Conical Connection
NobelReplace Select Tapered
Keystone TiLobeMaxx
Ridge Graft
Recipient Site
Bone Graft
Cancellous
Cortical
BioOss
Bone Graft
X Small
Small
Medium
Large
Chin Graft
Recipient Site
Recipient Site Incision
Block Size
Screw
Stryker
Straumann
Osteomed
Ramal Graft:
Recipient Site
Recipient Site Incision
Block Size
Screw
Stryker
Straumann
Osteomed
Palatal Torus
Incision
Double Y Mid-Palatal Incision
Intrasulcular/Crestal Incision
Splint
Yes
No
Mandibular Torus
Incision Area
Lateral Exostosis
Incision Area
Apico
Tooth #
Incision Type
Intrasulcular
Semilunar
Incision Area
Root
Buccal
Palatal
Distal
Buccal & Palatal
Mesio-Buccal
Disto-Buccal
Mesio-Lingual
Retrograde Fill
Amalgam
Super EBA
IRM
Incision & Drainage
Tooth #
Incision Type
Sulcus
Vestibule
Palate
Drainage Type
Purulent
Serosanguinous
Serous
Penrose
Yes
No
Expose & Bond
Tooth #
Localization
Palatally
Facial/Buccal
Incision
CRIMF
Arch Bar (Max)
Arch Bar (Mand)
Closed Reduction TMJ
Laterality
Left
Right
Both
Sinus Closure
Tooth #
Perforation
Root
Entire Socket
Mesio-Buccal
Disto-Buccal
Mesio-Lingual
Buccal & Palatal
Buccal
Palatal
Distal
Incision
Fat Pad
Yes
No
Sialolithotomy
Gland
Lac Probe
4-0
3-0
2-0
1-0
Incision
Implant Debride
Implant #
Status
Salvageable
Non-Salvageable
Bone Graft
50/50 HA/CortCanc
Stryker Cort/Canc Allograft
Bio-OSS with PRP
Stryker with PRP
Post-Op Imaging
PA
Panorex
CBCT
Midazolam Dose
Fentanyl Dose
Propofol Dose
Ketamine Dose
Precedex Dose
Sedation Type
Minimal Sedation
Moderate Sedation
Deep Sedation
General Anesthesia
Toradol Dose
Zofran Dose
Additional Notes
Follow-Up
Prescriptions
Pain Rx
OTC Analgesics
Motrin 400mg
Motrin 600mg
Motrin 800mg
Tylenol 500mg
Tylenol 1,000mg
Tylenol #3
Vicoden
Percocet
Oxycodone
Tramadol
Antibiotic Rx
Amoxicillin
Augmentin
Clindamycin
Cephalexin
Azithromycin
Bactrim
Doxycycline
Moxyfloxacin
Decongestant Rx
Sudafed
Afrin
Mucinex
Misc Rx
Peridex
Medrol Dose Pack
Flexeril
Robaxin
Pentoxifylline
Tocopherol
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