Orthodontic New Patient Protocol – Clinical Preparation Guide

✔️ Orthodontic New Patient Protocol / Clinical Preparation Guide

🔹 Overview
This document outlines the comprehensive clinical workflow for the initial orthodontic intake and diagnostic process as practiced orthodontic new patient preparation. It provides a step-by-step guide for clinicians and dental staff involved in patient intake, diagnostic records collection, and treatment planning.

 

1. 📝 Patient Reception and Initial Consultation for orthodontic new patient preparation

• Reception:
• Diagnostic Data Collection: Executed based on charting
• Scheduling Diagnosis Appointment
• Informed Consent for Treatment Fees: Completed during diagnosis

 

 

2. 📷 Photographic Records

A. Extraoral Photography (EOP)

• Standard Views: Frontal, oblique (45°), lateral × rest & smile
• Asymmetry Cases: Additional contralateral views to capture both sides
• Surgical Cases: Occlusal canting check using a tongue depressor or Fox plate; mentalis muscle tension emphasized when lips are closed
• Edge-to-Edge & MI: Capture both positions for Ceph, IOP, and EOP
• Face Scan: Rest & smile views
• Key Techniques:
  • Head positioned naturally, with patient gazing at eye-level mirror
  • Condyle in centric relation, avoiding protrusion or muscle distortion
  • Lip relaxed unless otherwise indicated (e.g., mentalis observation)
  • Use consistent background and lighting conditions

 

B. Intraoral Photography (IOP)

• Standard 7 Views: Frontal, overbite/overjet, right & left buccal occlusion, maxillary & mandibular occlusal views
• CO-MI Discrepancy: Capture 5 additional images – frontal and lateral views in both CO and MI positions
• Camera Setup: From the 7 o’clock position for frontal views
• Technique Tips:
  • Teeth should be dry; use gentle air before capture
  • Frontal shot centered at the contact point of maxillary and mandibular central incisors
  • Buccal views must include 1st molars clearly; ensure occlusal plane is centered in frame
  • Occlusal views should show full arch to 2nd molars when possible; minimize tongue interference for mandible
  • Always avoid assistant’s hands, patient garments, or reflections

 

3. 🧪 Impression Taking and Wax Bite

• Materials: White alginate for upper/lower; ensure full coverage with finger pressure
• Wax Bite: In MI position; adjust size intraorally
• Gag Reflex Control: Instruct nasal breathing, upright posture
• Check by Residents if Taken by Hygienist

 

4. 📅 Appointment Scheduling and Imaging

• Assign Faculty and set diagnostic appointment with parent present
• Ceph Instructions: Relax lips, close molars
• CBCT for Special Cases: Impacted teeth, surgery; typically full-skull (approx. 200,000 KRW)
• Partial Ortho: IOP, EOP, pano, partial PA

5. 🖼️ Diagnostic Imaging

• Types: Ceph, pano, PA, intraoral films
• Ceph Tip: Attach button to Trichion during imaging

 

6. 📸 Clinical Photography Basics

• Purpose: Documentation, patient education, publication, legal protection
• Technical Aspects:
  • Shutter Speed: 1/80–1/250
  • Aperture: f/14–f/32
  • ISO: 200–400
  • White Balance: Custom recommended
  • Preferred Lens: Canon 100mm Macro, Nikon 85mm, Tamron 90mm

 

7. 🧑‍⚕️ Patient Positioning and Protocols

• Head Position: Natural head position using mirror
• Condyle Position: Centric Relation (CR) preferred
• Lip Posture: Relaxed lips for soft tissue assessment

 

 

8. 🖼️ Extra and Intraoral Shooting Tips

• EOP: Emphasize accurate angles, symmetry observation (Fox plate, tongue depressor)
• IOP: Ensure full tooth visibility; occlusal views show up to 2nd molars
• Occlusal Canting: Captured in frontal with bite reference
• Framing Consistency: Maintain horizontal alignment of occlusal and incisal planes; center the tooth or region of interest

 

9. Treatment Agreement for orthodontic new patient preparation

• After diagnosis, document agreement in chart
• Explain all risks including relapse, root resorption, etc.
• Obtain both clinician and guardian signatures

“From initial snapshot to final signature, every step in this protocol is a promise of precision, empathy, and responsibility.”

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