Assessments and orthodontics

Record structured patient and orthodontic assessments (BPE, risks, IOTN, PAR), track ortho courses and complete the NHS FP17(DC0).

Who it is for: practice managers and administrators, clinicians, dental nurses.

In this guide:

1. Record a patient assessment
2. Customise assessment drop-down choices
3. Complete an orthodontic assessment
4. Track an orthodontic course in the Orthodontic Details panel
5. Complete the NHS orthodontic treatment plan (FP17DCO)

1. Record a patient assessment

You can add a patient assessment and complete its history, extra-oral and intra-oral sections.

Why this matters: a structured assessment makes sure every exam covers the same ground: complaint, medical and social history, soft tissues, radiographs, BPE, caries and perio risk, and tooth wear. It is the evidence behind your diagnosis and your recall interval (NICE CG19), and it supports FGDP record-keeping standards.

Where to find it: the Assessment tab in the patient record or the appointment editor. The panel is titled Patient Assessment.

How to

1. In Assessment History, click + (Add Patient Assessment). A new row appears with today’s date and your name. If the fields are greyed out, right-click the row and choose Edit Assessment.
2. Complete Medical History – Social History: Complains Of, HPC (history of presenting complaint), Medical History Update (No Change or Updated), Smoker and Per Day, Ex Smoker and How Long Ago (Years), and alcohol.
3. Extra Oral: TMJ, Lymph Nodes, Symmetry, Lips.
4. Intra Oral: Soft Tissue Exam, X Rays Taken, Justification, X Quality, Action Taken, BPE/CPITN, BPE RX Indicated, Caries Risk, Perio Risk, Oral Hygiene, OHI Given, Flosses Regularly?, Occlusion.
5. Record tooth wear and mobility on the tooth grids, and the BEWE score (the guide shows the repeat interval for each risk level).
6. Save on the toolbar.

Good to know

• To change an earlier assessment, right-click it and choose Edit Assessment.
• Delete Assessment on this menu does not currently delete a patient assessment.
• The drop-down choices come from your practice’s Assessment Category Forms.
• Show Patient Assessment and Print Patient Assessment are not available yet.

More detail: Patient assessment 2.

2. Customise assessment drop-down choices

You know where the assessment drop-down lists are set up and how to change them.

Why this matters: the options in each assessment drop-down (for example Caries Risk: Low / Medium / High, or Lips: Competent / Incompetent) come from category forms. If your practice uses particular wording, or a specialist needs extra categories, these lists are where it is changed. Consistent choices make records easier to audit.

Where to find it: Utilities › Housekeeping › Assessment Category Forms. You need the Housekeeping permission and the assessment-categories permission.

How to

1. Use the Categories drop-down (Select a Category) to pick the type: Patient, Orthodontic, Endodontic, Periodontic, Paediatric, Implant, Prosthodontic, Botox, FacialAesthetic or Any.
2. Click a category in the list (columns Name and Description).
3. The Items panel shows its choices with Name and Report Text.
4. Click + to add an item (Create Category Item), giving it a Name, Report Text and colour.
5. Right-click an item to Edit Category Item or Delete Category Item (confirm Are you sure you want to delete this category item?).
6. Use Up and Down to change the order shown in the drop-down.
7. Save.

Good to know

• Agree changes with your clinical team first. Removing an item that older assessments used can make those records harder to read.
• Report text is the wording that appears when an assessment is printed or reported.

More detail: House keeping.

3. Complete an orthodontic assessment

You can record a full orthodontic assessment, including IOTN and investigations.

Why this matters: an orthodontic assessment records the starting malocclusion, the need for treatment and the plan of investigations. For NHS orthodontics, eligibility rests on the Index of Orthodontic Treatment Need: generally IOTN Dental Health Component (DHC) grade 4 or 5, or grade 3 with an Aesthetic Component (AC) of 6 or more, for patients under 18. Recording it accurately protects the practice at contract review and audit.

Where to find it: the Ortho tab. The panel is titled Orthodontic Assessment.

How to

1. In Assessment History, click + (Add Ortho Assessment). It opens ready to edit.
2. Write General Notes (complaint, motivation, medical history changes).
3. Extra-Oral: Skeletal Class and Severity, FMPA, LAFH, Asymmetries, Chin Point (mm), Naso-Labial Angle, Lips, Lip Line, Incisor Show (At Rest, mm / Smiling).
4. Intra-Oral: Incisor Relationship, Overjet (mm), Overbite, Openbite, Molar Relationship, Canine Relationship, Centerlines (Upper / Lower mm), Crossbites, Displacements, Crowding by segment, Spacing, Midline Diastema, plus oral hygiene, teeth missing and doubtful prognosis.
5. Triage: choose the Option. IOTN: choose the DHC grade (and sub-category) and the AC. Developmental Stage: choose the Stage.
6. Other Investigations Required: tick OPG, Ceph., Occlusal, Vitality Testing, Photographs, Study Models.
7. Save.

Good to know

• Right-click a past assessment to Edit Assessment or Delete Assessment (confirm). Only delete one made in error.
• Show Ortho Assessment and Print Ortho Assessment are not available yet.

More detail: Patient orthodontic assessment.

4. Track an orthodontic course in the Orthodontic Details panel

You can review dates, counts, PAR scores and units for a patient in orthodontic treatment.

Why this matters: orthodontic courses run for many months. The Orthodontic Details panel gives you the course at a glance: when it started, how many visits and missed appointments, and the PAR scores that show the outcome. NHS orthodontic contracts are monitored on completion rates and PAR improvement, so these numbers matter.

Where to find it: Appointment Treatments tab › Orthodontic Details panel. It only fills in when the plan contains an orthodontic appointment type.

How to

1. Expand Orthodontic Details.
2. Check the dates: Referral Date, Treatment Start, Treatment End, Last Appointment, Next Appointment.
3. Check the counts: FTA Count, Visit Count, Cancel Count. Repeated failed appointments may need a discussion with the patient and parent, and following your practice’s FTA policy.
4. The IOTN panel here is read-only and shows the patient’s recorded IOTN.
5. Enter Pre-Treatment Par at the start and Post-Treatment Par at debond.
6. For NHS courses, check Claimed Units and Allocated Units (UOAs).
7. Save.

Good to know

• If the panel is empty, check the appointment type is set up as an orthodontic type in Housekeeping › Diary Types.
• PAR should be measured on study models or scans by a calibrated clinician.

More detail: Patient orthodontic assessment.

5. Complete the NHS orthodontic treatment plan (FP17DCO)

You can complete the FP17DC(O) orthodontic personal treatment plan from the appointment.

Why this matters: for NHS orthodontic treatment, the patient (or parent) must be given a written personal treatment plan setting out the proposed treatment, appliances, retention and charges, and they must sign to say they understand it. It is the orthodontic equivalent of the FP17DC and is part of valid consent.

Where to find it: the NHS FP17(DC0) button on the appointment editor toolbar. It only appears for NHS patients.

How to

1. Click NHS FP17(DC0).
2. Under The following Treatment is Proposed: tick what applies: correction of the prominence of the front teeth, Alignment of teeth, Correction of occlusal or bite problems, Closure of spacing, Correction of impacted teeth (see diagram), Permanent teeth to be removed (see diagram), Other objectives (see below).
3. Under Treatment appliances (“braces”) to be used: tick Fixed, Removable, Headgear or Other appliances, and enter Estimated treatment time (months).
4. Under Retention appliances: tick Fixed or Removable, and Estimated time Up to 12 months, Long-term or Permanent.
5. Under Dental Charges, choose the Charge Band. Pick the Performer from Available Performers.
6. Add Additional Information. Under Declarations, tick I am the patient or I am the Patients Parent / Guardian.
7. Click OK, then print and get it signed.

Good to know

• Patients under 18 at the start of treatment are exempt from NHS charges.
• Long-term retention is the patient’s responsibility. Make sure this is explained and recorded.

More detail: Patient nhs claim history.