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Patient Forms
Welcome!
We would like to thank
you for the opportunity to provide dental care for your child.
Whether this is a new experience or one you have been through
previously, we will strive to make it a positive one.
Our Mission
at Pediatric Dental
World: to develop a lifetime goal of optimum oral health within
our patients and their families by offering them a dental home.
Our dental home provides education, prevention of dental
disease, and positive dental experiences for children as they
grow from infants through their teenage years.
Our Goal
at Pediatric Dental
World: to have your child leave our office with a healthy smile
and a positive attitude toward lifelong dental care.
Before the
first visit:
If it is your child’s first visit to the dentist or just the
first time to a new office, we want your child to feel
comfortable and have a good time in our office. Before your
visit it is good to inform your child where they are going and
always be positive. It is important to refrain from the use of
negative words that will cause unnecessary fear. Please do not
tell your child that the “dentist will not hurt” as this may
never have entered his/her mind. Also, please avoid using such
words as needle, shot, pull or any other word suggesting an
unpleasant experience. Our staff will tell your child exactly
what is going to happen in a pleasant non-threatening manner.
Expect your child to do well and enjoy their visit to our office
and chances are they will do exactly that!
New patient 3 years
of age and over:
As a three year old your child will most likely be ready for a
“Big Kid Cleaning”. This appointment is usually scheduled with
our hygienist. The appointment will entail the taking of
necessary radiographs, removal of plaque and tartar, polishing,
flossing and application of topical fluoride. The hygienist will
also give your child any necessary oral hygiene instruction in
an age appropriate manner. Dr. Clapp or Dr. Bell will then
perform a thorough head and neck examination and evaluate the
health of your child’s teeth, gums, and bite.
New patient
under 3 years of age:
The purpose and goal of this visit is to provide the foundation
for a lifetime of optimum oral health. We will discuss dietary
habits that may not be healthy for your child, how to keep your
child’s mouth clean, and discuss any other issues or concerns
that you may have. A thorough examination will be performed by
one of the doctors and topical fluoride will be applied to your
child’s teeth. The examination will be done with your toddler
sitting or laying in your lap. With this and following visits
your child will mature and become more trusting in us. When they
reach the age of three we will begin regular continuing care as
explained above.
Does my child
go back alone?
Parents are welcome to accompany their child to the treatment
area for their initial visit. This gives you the opportunity to
see our staff in action. We do ask that if you decide to
accompany your child back at the first visit that you assume the
role of a silent observer. Your presence is greatly enhanced if
you play a passive role. If more than one person is speaking to
the child at once they may become confused. This is so that
cooperation and trust become established between your child and
our staff. After the first visit your child will be encouraged
to come back alone. This builds autonomy and trust between us
and your child. This will also help us establish a closer
rapport with your child while building his/her confidence.
Additional
appointments:
If any additional treatment is diagnosed at the first
appointment, we will review any available radiographs and the
treatment plan with you. Our new patient coordinator will
discuss the financial aspects of your child’s treatment and
review your dental benefits as needed. We will then schedule an
appointment to complete the treatment for a later date.
Patient Forms
For your
convenience, we have provided the following patient forms.
Please print and complete the forms and bring them with you on
your first visit to the office.
You will need Adobe
Acrobat Reader to view and print these forms. If you do not have
Adobe Acrobat Reader then
click here to download it.
