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New Patient Visit and Forms

 

 

NEW PATIENT FORMS

The first step toward a healthy smile is to reserve a visit with our doctors.  

Please call our office at (215) 293-0909

We look forward to speaking with you!


DOWNLOAD NEW PATIENT FORM:

Please click our dental Health History Form to print, complete at home, and bring to your visit.  


Plan to arrive 10 minutes early with your completed Health History Form to
give us time to enter your information into our computer database. 

If you are coming for a 3-Dimensional Cone Beam Scan (also known as CT Scan or CAT Scan), please click our Conebeam Scan Intake Form to print, complete at home, and bring to your visit.

 


OPTIONAL (You can fill out these four forms when you check in.)

Click (if you wish) our
Guarantee and Payment Options to read at home prior to your visit.

Click (if you wish) our HIPAA privacy practice policy.

Click (if you wish) our Mercury-Safe Protocol Consent to review prior to arrival if you have mercury amalgam fillings.  You will sign the actual consent on a sticker when you arrive at the office.

Click (if you wish) our VELscope Oral Cancer Screening information to review prior to arrival.  You will sign the actual consent on a sticker when you arrive at the office.

NOTE:

We are an adult practice.  We will answer questions and offer advice about your younger children's oral health, but we accept children into the dental practice as patients at age 16.   We do welcome children younger than age 16 for nutritional consultation regarding a balanced oral biome and regarding remineralization of incipient decay in tooth enamel.   Whole food nutrition is absolutely foundational for effective biologic (holistic) dentistry at any age, but it is especially so for children.

 
 

 

 

APPOINTMENTS 

What to expect during your new patient comprehensive exam with our dentists:

 

Full Mouth Series of X-rays (FMX) - Required

Low exposure DIGITAL RADIOGRAPHY greatly reduces radiation exposure while acquiring the necessary Full Mouth Series of 18 x-rays.  If you have an FMX from a previous office taken within the past three years, you may have it transferred to our office. You might request your FMX be sent to your e-mail (so that you have a copy for your records), or you may have it sent directly to us at meetinghousedental@comcast.net.  If your FMX is more than a year old, we wil take four bitewing x-rays to update it.

 

3D Cone Beam Computed Tomography (CBCT) – recommended on a case by case basis

Low exposure 3-D imaging by our VATECH Green Machine produces a highly diagnostic CBCT scan (commonly referred to as a cone beam scan). The scan allows us to evaluate areas of unexplained pain, to identify silent bone infection (abscesses) on old root canaled teeth, and to assess extraction sites for areas of dissolved (demineralized) bone. CBCT scan is also used prior to any ceramic implant placement.

 

Digital Pictures 

Digital photography creates a virtual tour of your mouth on your personal overhead screen, and it allows our dentist to possibly review and examine your teeth in the future if you are not present in the office.

 

Oral Potentiometer (Oral Galvanism)

The potentiometer measures galvanic current generated by dissimilar metals in the conducive (slightly acidic) environment of the saliva of the mouth.  Basically, it is a fancy electrician's tool designed to measure the micro current generated by the tiny batteries (teeth with metal restorations) dentists have created.  A potentiometer is performed on those with multiple metal restorations and may not be required for those with minimal prior dentistry.

 

Preventative Biologic Dental Nutrition Education 

Patient educational handouts are provided during exams based on individual needs. (Possible topics include cavity reversal / remineralization, oral microbiome, root canals, extractions, and implants).  All exams include a short consult with our Dental Nutritionist on holistic dental nutrition with the goal of long-term oral stability and cavity prevention using our Salivary pH Handout.  Home care techniques are reviewed and tweaked to maintain an alkaline oral environment.

 

Comprehensive Dental Exam

At Meetinghouse Dental Care, we value education and patient participation.  Our goal is to provide you with the information and tools required to make an informed decision regarding your oral and systemic health.  Our biologic dentists thoroughly review your mouth, charting and checking the stability of existing dentistry and screening for any new areas of breakdown.  Decay will be charted and treatment recommended.  Any areas of beginning breakdown (incipiencies) that have not broken through the enamel wall will be noted, and a cooperative plan will be recommended to attempt to remineralize the enamel.  Proper home care techniques will be recommended.  All exams are individualized, and additional topics will be addressed based on your personal dental health (quality of dental restorations materials, replacement options for missing teeth like partials and ceramic implants, root canals and related meridians).

 

Periodontal Screening

The Florida Probe provides computerized measurements from the top of the gum to the top of the bone, giving a thorough diagnosis of tooth pocket depths.  Proper monitoring of pocket depths promotes appropriate preventive or therapeutic periodontal care and lets the dentist determine what type of professional cleaning is required.

 

Early Detection Oral Cancer Screening  

VELscope early detection blue light technology identifies any kind of abnormal tissue, allowing us to discover and monitor any suspicious area in the mouth.  Picking up precancerous tissue and beginning-stage oral cancer allows for effective early intervention.

 


 


 

 This web site uses files in Adobe Acrobat Portable Document Format  (pdf) which require Adobe® Acrobat® Reader for viewing and printing. It is available to download free.

Contact Us

We encourage you to contact our office with any questions! However, please do not use this contact form to create or cancel appointments. We cannot alter the schedule through online messages. Please call the office and someone at the front desk will be happy to assist you 215.293.0909.