Dental Health Questionnaire

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are forwarded to the personnel officer/personnel support detachment for transfer as a unit record with the service record.

The SF 603 is brought up to date by entering in section III all dental restorations, any unrecorded dental treatment, and any dental defects discovered (fig. 10-14A). When all the spaces in section III have been filled, an SF 603A, (Dental Continuation) will be used for additional entries (fig. 10-14B).

Special Entries on SF 603:

When dental treatment is refused by a patient, appropriate entries will be made and signed by the dental officer.

In cases involving dental injuries or diseases incurred not to the member’s own misconduct, or not in the line of duty, a notation to that effect will be made and signed by the dental officer. The commanding officer and the member concerned will be informed in writing whenever such an entry is made in the member’s dental record (see NAVREGS, art. 1111.2).

Suitable entries are made whenever a member of the Navy or Marine Corps receives dental treatment in a activity other than the permanent duty station.

Hypersensitivity to a local anesthetic or any other substance, and valvular or congenital heart disease will be entered in red pencil across the top of SF 603. Examples: HYPERSENSITIVE TO PROCAINE. MITRAL STENOSIS.

The dental officer will inform the person concerned whenever an entry is made in that person’s dental record that may adversely affect, in other than a temporary degree, his or her efficiency in the performance of duty (see NAVREGS, art 1111. 1).

For instructions relative to the recording of dental examination, see MANMED, chapter 6. It is extremely important that the charted record of dental examination be in exact conformity with the provisions set forth in the manual. The Veterans Administration depends on the dental record in determining the claim of a veteran for a service-connected dental disability.

Dental Health Questionnaire (NAVMED 6600/3)

The Dental Health Questionnaire (fig. 10-15) is self-explanatory. 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 injection 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, the Treatment 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.