It is very important that your dental team has an up-to-date medical history.

Many health conditions and medicines can affect the dental treatment you receive. Even if a question seems unrelated, there is always a clinical reason for asking it.

Being open and honest helps your dental team:

• Treat you safely.
• Avoid unwanted reactions or complications.
• Choose the most appropriate treatment for you.

Your information is kept confidential.

What will my dental team ask about?

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Personal details

Your dental team will first ask for basic information, such as:

• Your full name.
• Your address.
• Your date of birth.
• Your phone number.
• Your email address.
• Your doctor’s details.
• An emergency contact.

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Questions about your health

You will then be asked questions about your general health, including whether you:

• Are receiving treatment from a doctor, specialist, hospital or clinic.
• Take any prescribed or regular medicines.
• Have taken or are taking bisphosphonates.
• Have had or are having radiotherapy or chemotherapy.
• Have any allergies to medicines or materials.
• Carry a medical warning card.
• Are pregnant or think you might be pregnant.
• Have ever had a bad reaction to local anaesthetic, general anaesthetic or sedation.
• Have taken steroid medication in the last two years.
• Have diabetes, or have close family members with diabetes.
• Have asthma, bronchitis or other chest conditions.
• Have allergies such as hay fever or eczema.
• Bruise easily or bleed more than expected.
• Are living with HIV.
• Have had heart surgery or a pacemaker fitted.
• Have ever had a stroke.
• Have angina or high or low blood pressure.
• Have had rheumatic fever.
• Have liver, kidney disease, hepatitis or a history of jaundice.
• Experience blackouts, seizures or epilepsy.
• Have headaches, facial pain or jaw clicking.
• Have fainting episodes or dizziness.
• Have had joint replacements or other implants.
• Regularly have a dry mouth.
• Get mouth ulcers often.
• Have ongoing bad breath.
• Smoke or use tobacco products.
• Drink alcohol, and roughly how much per week.
• Have concerns about the appearance of your teeth.
• Have any other health issues you think your dental team should know about.

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Why do I need to update this every visit?

Your dental team will usually ask you to:

• Check your medical history at each appointment.
• Confirm whether anything has changed.
• Sign the form to say the information is correct.

Health conditions and medications can change over time, so keeping this information up to date helps your dental team continue to care for you safely.