Medical Clearance Form for Dental

Medical Clearance Form for Dental

As patients age, they are bound to develop medical conditions that can act as a hindrance during the time they avail of dental care. Hence they are required to disclose their dental health history to their respective dental practitioners during each visit. Dentists review their patient’s medical history and understand their current medical condition to ensure their safety.

In some cases, dentists often require medical clearance from the patient’s medical provider to commence dental treatment. Similarly, medical providers might need dental clearance from the patient’s dental provider to undertake a medical procedure. For either of the cases, a medical clearance form for dental needs to be filled out by the practitioner who is supposed to perform the procedure. 

What is Dental Medical Clearance?

Medical clearance is a type of communication that occurs between two medical providers to validate the existing condition of a patient and to assess whether he/she is fit to perform a certain procedure. Medical clearance is generally advised when a patient’s medication or diagnosis can pose a risk to dental procedures. This includes risks pertaining to anesthesia or sedation. Dentists need to seek clearance for patients who: 

• Use intravenous or oral bisphosphonate
• Suffer from sleep apnea 
• Have symptoms of coronary artery disease
• Use a CPAP device 
• Have any pulmonary compromise 

Why is Medical Clearance Necessary? 

A medical clearance form for dental serves the purpose of identifying the medical conditions and health needs of the patients and determine whether any follow-up or monitoring is required. 

Medical clearance is necessary to ensure that a patient is healthy enough to undergo a medical procedure or surgery. This is important because certain medical conditions, such as heart disease or uncontrolled diabetes, can increase the risk of complications during and after surgery. By obtaining medical clearance, doctors can identify and address any potential health issues that could affect the success of the procedure. This helps to ensure the safety and well-being of the patient.

What should a Medical Clearance Form for Dental Include?

A medical clearance form for dental includes the questions mentioned as under: 

• Name and contact details of the patient
• Name of the dentist 
• Dental office address 
• Phone number 
• Last dental exam: DATE
• Existing medical condition 
• Recent surgeries/hospitalizations 
• Bleeding/clotting issues 
• Respiratory/ cardiac conditions 
• Any known allergies
• Any known drug sensitivities: 
• Pregnant/breastfeeding: 
• Proposed procedure/treatment: 
• Should Prophylactic antibiotics be prescribed? 
• Is Local anesthesia prescribed?
• Type of antibiotics recommended 
• Type of painkiller recommended 
• Additional comments 
• Name of the physician 
• Signature 
• Date of signature 

By answering these questions, the dentist will get an overview of the existing health status of the patient, which would be enough to assess whether the patient can be treated.