dental classifications of patients, a standard color code, utilizing a strip of appropriately colored cellophane tape shall be placed on the record so that it will be readily visible when filed.
White tape indicates a Dental Class l— Patients who do not require dental treatment.
Green tape indicates a Dental Class 2— Patients who have dental conditions that are unlikely to result in a dental emergency within 12 months.
Yellow tape indicates a Dental Class 3— Patients who have oral and/or dental conditions that are likely to result in a dental emergency within 12 months.
Red tape indicates a Dental Class 4— Patients whose oral classification is unknown because the patient has not received a dental examination in the past 12 months or the patient’s dental record is not held by the responsible medical department activity.
The military health (dental) treatment record shall be verified annually by Medical Department personnel maintaining the record. In addition, verification shall be accomplished upon reporting and upon detachment from a duty station, and at the time of physical examination. A signed, dated entry to the effect that the verification has been accomplished shall be recorded on the current SF 603 and the appropriate year block on the treatment record jacket front leaf shall be blocked out.
Each member’s military health (dental) treatment record shall consist of NAVMED 6150/10-19, Treatment Record Jacket, containing the health care treatment forms prescribed below. The forms shall be arranged in top to bottom sequence with the most recent placed on top of each previous form.
1. Record Identifier for Personnel Reliability Program, NAVPERS 5510/1, when appropriate
2. Health Record-Dental Continuation, SF 603A (If applicable)
3. Health Record-Dental, SF 603
4. Consultation Sheet, SF 513 (when related to dental treatment)
5. Narrative Summary, SF 502; Doctor’s Progress Notes, SF 509; and Tissue Examination, SF 515
6. Request for Administration of Anesthesia and for Performance of Operations and other Procedures, SF 522; and Anesthesia, SF 517
7. Navy Periodontal Screen Exam
1. Unmounted radiographs in envelopes
2. Sequential bitewing radiograph mounts
3. Panographic and/or full mouth radiographs
4. Dental Health Questionnaire, NAVMED 6600/3
5. Privacy Act Statement, DD Form 2005
6. Record of Disclosure-Privacy Act of 1974, OPNAV 5211/9
The Health Record-Dental (SF 603) is an aid to diagnosis, treatment, planning practice management. It is a means of identification and a record of the initial examination showing missing teeth, existing restorations, diseases, and other abnormalities. It is also a record of diseases and abnormalities occurring after the initial examination; a chronological record of dental care; and a basis for dental statistical information.
The Dental Health Questionnaire (NAVMED 6600/3, fig. 2-24) is a self-explanatory form. The first part is used to record the patient’s chief complaint. The second part is the Check and Sign section and is normally completed by the patient. It is a simplified statement of the patient’s medical history. All positive responses require explanation, especially the items for “any allergies or sensitivities, ” “ill effects from injections of Novocaine or Xylocaine,” and “heart disease/ rheumatic fever/murmur.” You must make sure the responses are marked in red in prominent letters across the top of SF 603. Also, on the NAVMED 6150/10-19 record jacket immediately below the name, indicate in the alert box whether the member has sensitivities or allergies by entering an “X” in the appropriate box or boxes. The third portion of NAVMED 6600/3 is used to record dental radiographs. The fourth portion is the Routing/Treatment Plan and is used to consult with other Medical and dental personnel in the facility and to plan a course of examination leading to a diagnosis. The Patient Identification section must be completely filled out and updated as necessary.