SF603.pdf

Instructions for SF-603 Page 1 of 2

DENTAL HEALTH RECORD

1. Purpose. The purpose of this form is to provide Job Corps with a record of the student’s dental health status and of dental services provided while the student is in Job Corps.

2. Originator. This form is completed by a member of the center health staff when on-center dental services are provided, or in the case of off-center dental care, the form is provided by the center health staff to the dental provider for completion and returned to the center health staff.

3. Frequency. Upon initial examination of a student. Entries are made at all subsequent visits.

4. Distribution. Maintained as part of the Student’s Health Record. Dental records may be maintained in separate folders or at separate locations to facilitate procedures at individual centers.

5. General Instructions. The dentist providing the examination or other dental services will fill-in or provide the instructions for completing the form and designate the symbols that he/she normally uses. All health personnel filling in Job Corps dental records will use the standard Job Corps dental abbreviations (listed in the Job Corps dental guidelines).

6. Detailed Instructions. Each student must be classified according to the urgency of need for dental care and this dental classification will be recorded in space No. 3 on the form.

The following classification will be utilized by all Job Corps centers and center dentists:

PRIORITY CLASSIFICATION SYSTEM FOR JOB CORPS STUDENTS

a. Priority I (P1).

Students with one or more of the following conditions belong in the first priority category and shall be the first to receive dental treatment.

(1) An oral condition which, if left untreated, would probably cause pain in the immediate future.

(2) An oral infection or an oral condition which, if left untreated, would probably become acutely infectious.

(3) An oral condition (such as edentulousness or missing upper anterior teeth) which presents a major social-psychological or physical barrier to the student’s well-being and for which corrective treatment would help the student adapt to Job Corps and increase his/her employability.

(4) An undiagnosed or suspect oral condition; e.g., an ulcerative lesion or growth of tissue.

Instructions for SF-603 Page 2 of 2

b. Priority II (P2).

Symptoms and conditions which would place a student in the second priority category are:

(1) Presence of medium to large non-painful carious lesions.

(2) Gingival involvements of localized nature.

(3) Fractured anterior teeth.

(4) Presence of temporary, sedative, or intermediate restorations.

(5) Broken or ill-fitting prosthetic appliances.

c. Priority III (P3).

Symptoms and conditions which would place a student in the third priority category are:

(1) Small carious lesions presenting no imminent threat to the pulp.

(2) The need for restorative and prosthetic procedures involving a significant laboratory fee; e.g., cast partial dentures or acrylic partial dentures with wrought gold claps or cast metal clasps.

(3) The need for restorative procedures utilizing precious metals.

(4) Severe nonfunctional bite and malaligned teeth that do not involve social-psychological or employability factors considered under Priority I (3).

d. Priority IV (P4).

A student would be placed in the fourth category if examination showed the following:

(1) Lack of clinically visible carious lesions.

(2) Lack of clinically visible gingival irritation.

7. Disposition. Dental Records and dental X-rays shall be filed in the Student’s Health Record folder at the time of closing of the Health Record as part of the student’s transfer or separation procedure. The complete Health Record will be sent to the ETA Regional Office for disposition after a student separates from the Job Corps.