First Choice Dental SOC Portal

OHT STANDARD OF CARE

Contents

1. Appointment Overview

1.1 Appointment Duration

2. Pre‑Appointment Requirements (DA + OHT)

2.1 Radiographs & Imaging

2.2 OPG Records

3. Clinical Workflow (OHT)

3.1 Extra‑Oral Evaluation

3.2 Oral Cancer Screening

3.3 Intra‑Oral Evaluation

3.4 Record Updates

3.5 Disclosing

3.6 Prophy / Airflow

3.7 Ultrasonic & Hand Scaling

3.8 Flossing

3.9 Fluoride Application

3.10 Oral Hygiene Instructions

3.11 Raise Areas of Concern

3.12 Review Period & Rebooking

3.13 Clinical Notes & Voice Memo

4. Appointment Protocol (Clinician + DA)

4.1 Step 1 — Patient Arrival

4.2 Step 2 — Review

4.3 Step 3 — Seating

4.4 Step 4 — Extra‑Oral Exam

4.5 Step 5 — Oral Cancer Screening

4.6 Step 6 — Intra‑Oral Evaluation

4.7 Step 7 — Disclosing

4.8 Step 8 — Prophy

4.9 Step 9 — Ultrasonic + Hand Scale

4.10 Step 10 — OHI

4.11 Step 11 — Areas of Concern

4.12 Step 12 — Rebooking + Handover

4.13 Step 13 — Notes & Uploads

Contents: Section 1
Duration

Patient Type

Duration

Adult

30–40 min

Child <5 yrs

20 min Two children from the same family 30 mins

Child >5 yrs

20–30 min

Note: Times are flexible depending on patient needs.

Clinician: Oral Health Therapist

Contents
Medical History

When

  • First appointment: Written form completed
  • Every 1 year: Updated written form
  • Every appointment: Verbal confirmation

How / Protocol

  • Provide written form at first visit
  • Update written form every 1 year (CareStack automates this)
  • Confirm verbally at each appointment and document in notes

Why

  • Ensures accurate, up‑to‑date medical profile
  • Legal requirement
  • Identifies risks (medications, allergies, systemic conditions)
Radiographs: OPG

When

  • First evaluation appointment (age 18+)
  • Every 5 years routinely
  • Perio patients: every 2 years until stable
  • Wisdom tooth symptoms
  • Orthodontic records

How / Protocol

  • Confirm patient is not pregnant
  • Select full arch (P1) and correct patient size
  • Take OPG
  • Fee: $120

Why

  • Baseline record
  • Legal requirement
  • Monitor pathology, bone levels, wisdom teeth
Radiographs: Bitewings

When

  • First evaluation appointment
  • Risk‑based intervals:
    • Low: 18–24 months
    • Medium: 12–18 months
    • High: 6–12 months
  • Children 6–12 years:
    • First set when 6‑year molars erupt
    • Mixed dentition: 18–24 months
    • Primary dentition: 12–18 months if high risk
  • After IP restoration or crown

How / Protocol

  • Use size 2 film with paralleling device
  • Children/sensitive: size 1 film
  • If unable to tolerate: use OPG BW setting
  • Fee: $45 per x‑ray

Why

  • Detects caries, calculus, restoration integrity
  • Essential for monitoring
Radiographs: Periapicals

When

  • Limited exam with symptoms:
    • Cold test negative
    • Tender to percussion
    • Irregular EPT
  • Implant or RCT sites:
    • Day of placement
    • 3 months
    • 6 months
    • Every 12 months
  • Trauma cases: follow trauma guidelines

How / Protocol

  • Take PA using paralleling technique
  • Ensure full apex capture

Why

  • Baseline and diagnostic imaging
  • Monitoring healing and pathology
Extra‑Oral Photographs

When

  • First visit
  • Orthodontic or cosmetic consultations
  • Every 5 years

How / Protocol

  • Use plain white wall
  • Match patient head height
  • Use portrait mode
  • Required photos:
    • Front relaxed + smile
    • Left profile relaxed + smile
    • Right profile relaxed + smile
  • For smile design/lab work:
    • Use retractors
    • Full occlusion photos
    • Natural smile

Why

  • Baseline profile
  • Treatment planning
Intra‑Oral Photographs

When

  • First visit
  • Orthodontic/cosmetic consultations
  • Updated annually at OHTx

How / Protocol

  • Use SLR camera, retractors, mirrors
  • Standard set:
    • Lips closed
    • Lips partially open (“Emma”)
    • Full smile
    • Retracted occlusion
    • Retracted slightly open
  • Bite views:
    • Right bite
    • Left bite
  • Arch views:
    • Upper arch + sextants 1–3
    • Lower arch + sextants 4–6

Why

  • Baseline record
  • Monitoring changes
  • Diagnosis and planning
iTero Scan

When

  • First visit
  • Orthodontic consultations
  • Lab cases
  • Updated annually at OHTx

How / Protocol

  • Create or locate patient file
  • Complete full arch scan
  • Capture natural bite + open bite

Why

  • Baseline digital record
  • Monitoring changes
  • Required for ortho, splints, crowns, aligners
Summary Table

8. Quick Reference

Record Type When Why
Medical History First visit, 2‑year written update, every visit verbal Legal requirement, safety
OPG First eval (18+), 5‑yearly, perio 2‑yearly Baseline, pathology, bone levels
BW Risk‑based intervals, children, post‑restoration Caries detection, monitoring
PA Symptoms, implants, RCT, trauma Diagnosis, healing monitoring
EO Photos First visit, ortho/cosmetic, 5‑yearly Baseline profile
IO Photos First visit, ortho/cosmetic, annually Monitoring, diagnosis
iTero Scan First visit, ortho, lab cases, annually Digital baseline, planning
Contents
Medical History

When

  • First appointment: Written form completed
  • Every 1 year: Updated written form
  • Every appointment: Verbal confirmation

How / Protocol

  • Provide written form at first visit
  • Update written form every 1 year (CareStack automates this)
  • Confirm verbally at each appointment and document in notes

Why

  • Ensures accurate, up‑to‑date medical profile
  • Legal requirement
  • Identifies risks (medications, allergies, systemic conditions)
Radiographs: OPG

When

  • First evaluation appointment (age 18+)
  • Every 5 years routinely
  • Perio patients: every 2 years until stable
  • Wisdom tooth symptoms
  • Orthodontic records

How / Protocol

  • Confirm patient is not pregnant
  • Select full arch (P1) and correct patient size
  • Take OPG
  • Fee: $120

Why

  • Baseline record
  • Legal requirement
  • Monitor pathology, bone levels, wisdom teeth
Radiographs: Bitewings

When

  • First evaluation appointment
  • Risk‑based intervals:
    • Low: 18–24 months
    • Medium: 12–18 months
    • High: 6–12 months
  • Children 6–12 years:
    • First set when 6‑year molars erupt
    • Mixed dentition: 18–24 months
    • Primary dentition: 12–18 months if high risk
  • After IP restoration or crown

How / Protocol

  • Use size 2 film with paralleling device
  • Children/sensitive: size 1 film
  • If unable to tolerate: use OPG BW setting
  • Fee: $45 per x‑ray

Why

  • Detects caries, calculus, restoration integrity
  • Essential for monitoring
Radiographs: Periapicals

When

  • Limited exam with symptoms:
    • Cold test negative
    • Tender to percussion
    • Irregular EPT
  • Implant or RCT sites:
    • Day of placement
    • 3 months
    • 6 months
    • Every 12 months
  • Trauma cases: follow trauma guidelines

How / Protocol

  • Take PA using paralleling technique
  • Ensure full apex capture

Why

  • Baseline and diagnostic imaging
  • Monitoring healing and pathology
Extra‑Oral Photographs

When

  • First visit
  • Orthodontic or cosmetic consultations
  • Every 5 years

How / Protocol

  • Use plain white wall
  • Match patient head height
  • Use portrait mode
  • Required photos:
    • Front relaxed + smile
    • Left profile relaxed + smile
    • Right profile relaxed + smile
  • For smile design/lab work:
    • Use retractors
    • Full occlusion photos
    • Natural smile

Why

  • Baseline profile
  • Treatment planning
Intra‑Oral Photographs

When

  • First visit
  • Orthodontic/cosmetic consultations
  • Updated annually at OHTx

How / Protocol

  • Use SLR camera, retractors, mirrors
  • Standard set:
    • Lips closed
    • Lips partially open (“Emma”)
    • Full smile
    • Retracted occlusion
    • Retracted slightly open
  • Bite views:
    • Right bite
    • Left bite
  • Arch views:
    • Upper arch + sextants 1–3
    • Lower arch + sextants 4–6

Why

  • Baseline record
  • Monitoring changes
  • Diagnosis and planning
iTero Scan

When

  • First visit
  • Orthodontic consultations
  • Lab cases
  • Updated annually at OHTx

How / Protocol

  • Create or locate patient file
  • Complete full arch scan
  • Capture natural bite + open bite

Why

  • Baseline digital record
  • Monitoring changes
  • Required for ortho, splints, crowns, aligners
Summary Table

8. Quick Reference

Record Type When Why
Medical History First visit, 2‑year written update, every visit verbal Legal requirement, safety
OPG First eval (18+), 5‑yearly, perio 2‑yearly Baseline, pathology, bone levels
BW Risk‑based intervals, children, post‑restoration Caries detection, monitoring
PA Symptoms, implants, RCT, trauma Diagnosis, healing monitoring
EO Photos First visit, ortho/cosmetic, 5‑yearly Baseline profile
IO Photos First visit, ortho/cosmetic, annually Monitoring, diagnosis
iTero Scan First visit, ortho, lab cases, annually Digital baseline, planning
Contents
Medical History

When

  • First appointment: Written form completed
  • Every 1 year: Updated written form
  • Every appointment: Verbal confirmation

How / Protocol

  • Provide written form at first visit
  • Update written form every 1 year (CareStack automates this)
  • Confirm verbally at each appointment and document in notes

Why

  • Ensures accurate, up‑to‑date medical profile
  • Legal requirement
  • Identifies risks (medications, allergies, systemic conditions)
Radiographs: OPG

When

  • First evaluation appointment (age 18+)
  • Every 5 years routinely
  • Perio patients: every 2 years until stable
  • Wisdom tooth symptoms
  • Orthodontic records

How / Protocol

  • Confirm patient is not pregnant
  • Select full arch (P1) and correct patient size
  • Take OPG
  • Fee: $120

Why

  • Baseline record
  • Legal requirement
  • Monitor pathology, bone levels, wisdom teeth
Radiographs: Bitewings

When

  • First evaluation appointment
  • Risk‑based intervals:
    • Low: 18–24 months
    • Medium: 12–18 months
    • High: 6–12 months
  • Children 6–12 years:
    • First set when 6‑year molars erupt
    • Mixed dentition: 18–24 months
    • Primary dentition: 12–18 months if high risk
  • After IP restoration or crown

How / Protocol

  • Use size 2 film with paralleling device
  • Children/sensitive: size 1 film
  • If unable to tolerate: use OPG BW setting
  • Fee: $45 per x‑ray

Why

  • Detects caries, calculus, restoration integrity
  • Essential for monitoring
Radiographs: Periapicals

When

  • Limited exam with symptoms:
    • Cold test negative
    • Tender to percussion
    • Irregular EPT
  • Implant or RCT sites:
    • Day of placement
    • 3 months
    • 6 months
    • Every 12 months
  • Trauma cases: follow trauma guidelines

How / Protocol

  • Take PA using paralleling technique
  • Ensure full apex capture

Why

  • Baseline and diagnostic imaging
  • Monitoring healing and pathology
Extra‑Oral Photographs

When

  • First visit
  • Orthodontic or cosmetic consultations
  • Every 5 years

How / Protocol

  • Use plain white wall
  • Match patient head height
  • Use portrait mode
  • Required photos:
    • Front relaxed + smile
    • Left profile relaxed + smile
    • Right profile relaxed + smile
  • For smile design/lab work:
    • Use retractors
    • Full occlusion photos
    • Natural smile

Why

  • Baseline profile
  • Treatment planning
Intra‑Oral Photographs

When

  • First visit
  • Orthodontic/cosmetic consultations
  • Updated annually at OHTx

How / Protocol

  • Use SLR camera, retractors, mirrors
  • Standard set:
    • Lips closed
    • Lips partially open (“Emma”)
    • Full smile
    • Retracted occlusion
    • Retracted slightly open
  • Bite views:
    • Right bite
    • Left bite
  • Arch views:
    • Upper arch + sextants 1–3
    • Lower arch + sextants 4–6

Why

  • Baseline record
  • Monitoring changes
  • Diagnosis and planning
iTero Scan

When

  • First visit
  • Orthodontic consultations
  • Lab cases
  • Updated annually at OHTx

How / Protocol

  • Create or locate patient file
  • Complete full arch scan
  • Capture natural bite + open bite

Why

  • Baseline digital record
  • Monitoring changes
  • Required for ortho, splints, crowns, aligners
Summary Table

8. Quick Reference

Record Type When Why
Medical History First visit, 2‑year written update, every visit verbal Legal requirement, safety
OPG First eval (18+), 5‑yearly, perio 2‑yearly Baseline, pathology, bone levels
BW Risk‑based intervals, children, post‑restoration Caries detection, monitoring
PA Symptoms, implants, RCT, trauma Diagnosis, healing monitoring
EO Photos First visit, ortho/cosmetic, 5‑yearly Baseline profile
IO Photos First visit, ortho/cosmetic, annually Monitoring, diagnosis
iTero Scan First visit, ortho, lab cases, annually Digital baseline, planning
Contents
Medical History

When

  • First appointment: Written form completed
  • Every 1 year: Updated written form
  • Every appointment: Verbal confirmation

How / Protocol

  • Provide written form at first visit
  • Update written form every 1 year (CareStack automates this)
  • Confirm verbally at each appointment and document in notes

Why

  • Ensures accurate, up‑to‑date medical profile
  • Legal requirement
  • Identifies risks (medications, allergies, systemic conditions)
Radiographs: OPG

When

  • First evaluation appointment (age 18+)
  • Every 5 years routinely
  • Perio patients: every 2 years until stable
  • Wisdom tooth symptoms
  • Orthodontic records

How / Protocol

  • Confirm patient is not pregnant
  • Select full arch (P1) and correct patient size
  • Take OPG
  • Fee: $120

Why

  • Baseline record
  • Legal requirement
  • Monitor pathology, bone levels, wisdom teeth
Radiographs: Bitewings

When

  • First evaluation appointment
  • Risk‑based intervals:
    • Low: 18–24 months
    • Medium: 12–18 months
    • High: 6–12 months
  • Children 6–12 years:
    • First set when 6‑year molars erupt
    • Mixed dentition: 18–24 months
    • Primary dentition: 12–18 months if high risk
  • After IP restoration or crown

How / Protocol

  • Use size 2 film with paralleling device
  • Children/sensitive: size 1 film
  • If unable to tolerate: use OPG BW setting
  • Fee: $45 per x‑ray

Why

  • Detects caries, calculus, restoration integrity
  • Essential for monitoring
Radiographs: Periapicals

When

  • Limited exam with symptoms:
    • Cold test negative
    • Tender to percussion
    • Irregular EPT
  • Implant or RCT sites:
    • Day of placement
    • 3 months
    • 6 months
    • Every 12 months
  • Trauma cases: follow trauma guidelines

How / Protocol

  • Take PA using paralleling technique
  • Ensure full apex capture

Why

  • Baseline and diagnostic imaging
  • Monitoring healing and pathology
Extra‑Oral Photographs

When

  • First visit
  • Orthodontic or cosmetic consultations
  • Every 5 years

How / Protocol

  • Use plain white wall
  • Match patient head height
  • Use portrait mode
  • Required photos:
    • Front relaxed + smile
    • Left profile relaxed + smile
    • Right profile relaxed + smile
  • For smile design/lab work:
    • Use retractors
    • Full occlusion photos
    • Natural smile

Why

  • Baseline profile
  • Treatment planning
Intra‑Oral Photographs

When

  • First visit
  • Orthodontic/cosmetic consultations
  • Updated annually at OHTx

How / Protocol

  • Use SLR camera, retractors, mirrors
  • Standard set:
    • Lips closed
    • Lips partially open (“Emma”)
    • Full smile
    • Retracted occlusion
    • Retracted slightly open
  • Bite views:
    • Right bite
    • Left bite
  • Arch views:
    • Upper arch + sextants 1–3
    • Lower arch + sextants 4–6

Why

  • Baseline record
  • Monitoring changes
  • Diagnosis and planning
iTero Scan

When

  • First visit
  • Orthodontic consultations
  • Lab cases
  • Updated annually at OHTx

How / Protocol

  • Create or locate patient file
  • Complete full arch scan
  • Capture natural bite + open bite

Why

  • Baseline digital record
  • Monitoring changes
  • Required for ortho, splints, crowns, aligners
Summary Table

8. Quick Reference

Record Type When Why
Medical History First visit, 2‑year written update, every visit verbal Legal requirement, safety
OPG First eval (18+), 5‑yearly, perio 2‑yearly Baseline, pathology, bone levels
BW Risk‑based intervals, children, post‑restoration Caries detection, monitoring
PA Symptoms, implants, RCT, trauma Diagnosis, healing monitoring
EO Photos First visit, ortho/cosmetic, 5‑yearly Baseline profile
IO Photos First visit, ortho/cosmetic, annually Monitoring, diagnosis
iTero Scan First visit, ortho, lab cases, annually Digital baseline, planning
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