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Oral Health Care: A Whole New Language

Patricia J. Nunn, RDH, MS

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You can decrease the amount of time spent on paperwork by using abbreviations for patient treatment records.  While patient treatment records are important for good patient treatment and follow-up; records also legal documents, so abbreviations and their meanings should be the same in every record.  To be certain that everyone in the office uses the same abbreviations and understands what the abbreviations mean, it is a good idea to create a “key” to the abbreviations used in your office so that way anyone writing or reading a record can understand exactly what is being conveyed.  A good idea is to post an abbreviation “key” where all employees can see it to help ensure that all of your records contain consistent and accurate information.  The key will help all employees, past, present and future, as well as serve as a part of the legal record.

The following list is a compilation of some commonly used abbreviations:

– Increase

– Decrease

adv– Advanced

anes – Anesthetic (e.g., local anesthetic)

ant – Anterior

approx – Approximately

appt – Appointment

ASA – Aspirin

ASA – Anterior superior alveolar

ASAP – As soon as possible

B – Buccal

bid – Twice a day

bilat – Bilateral

BP – Blood pressure

BW – Bitewing x-rays

BW, BWX (outdated) – Bitewing radiographs

c – With (usually written with a bar on top of the “c”) from the latin word “cum”

C/C – (Complete/complete) maxillary denture over mandibular denture

C/P – Complete maxillary denture and mandibular partial denture

CAL – Clinical attachment level

Cau – Caucasian

CC – Chief complaint

cc – Cubic centimeter

CHD – Congestive heart disease

CHF – Congestive heart failure

CHX – Chlorhexidine

CNS – Central nervous system

cont – Continue, continued

COPD – Chronic Obstructive Pulmonary Disease

CP – Cerebal palsy

CVA – Cerebral vascular accident (stroke)

D – Distal

DA – Dental assistant

DC – Discontinue

DH – Dental hygienist or dental hygiene

DOB – Date of birth

Dx – Diagnosis

e.g. – For example

ea – Each

EBV – Epstein Barr virus

ECG or EKG – Electrocardiogram

Echo – Echocardiogram

EIE – Extraoral intraoral examination

Emer – Emergency

Endo – Endodontic

ER – Emergency room

eval – Evaluation

EX – Examination

ext – Extract, extraction

fen-phen – Fenfluramine and Phentermine

Fl, Fl2 – Fluoride

FMR, FMX (outdated), FMS – Full mouth radiographs

FPD – Fixed prosthodontics

freq – Frequent, frequency

Fx – Fracture

gen – General, generalized

GI – Gastrointestinal

ging – Gingivitis, gingiva

H2O – Water

H2O2 – Hydrogen peroxide

HAV – Hepatitis A virus

HBP – High blood pressure, hypertension

HBV – Hepatitis B virus

HCV – Hepatitis C virus

HIV – Human immunodeficiency virus

hr – Hour

HS – At bedtime

Hx – History

IDDM – Insulin Dependant Diabetes Mellitus (Type I)

IM – Intramuscular

imp – Impression

inc – Incisal, incisive, incise

inf – Inferior

Irreg – Irregular

Irrig – Irrigation

IV – Intravenous

L, Ling – Lingual

LA – Lower anterior

LL – Lower left quadrant

loc – Local, localized, local anesthetic

LR – Lower right quadrant

M – Mesial

mand – Mandibular

marg – Marginal

max – Maxillary or maximum

meds – Medication

MHx – Medical history

MI – Myocardial Infarction (heart attack)

min – Minimum, minute

mm – Millimeter

mo – Month

MO – Mesiocclusal

MOD – Mesiocclusodistal

mod – Moderate

MRI – Magnetic resonance imaging

MSA – Middle superior alveolar

MVP – Mitral Valve Prolapse

N/A, NA – Not applicable

N2O – Nitrous oxide

nec – Necessary

neg – Negative

NIDDM – Non-Insulin Dependent Diabetes Mellitus (Type II)

NPO – Nothing by mouth

NV – Next visit

O, occ – Occlusal

O2 – Oxygen

OD – Oral diagnosis

OH – Oral hygiene

OHI – Oral hygiene instructions

OP – Operative

ORL – Otorhinolaryngology

OS – Oral surgery

OTC – Over the counter (drug that can be obtained without a prescription)

P – Pulse

P/P – Partial over (maxillary) over partial (mandibular)

PA – Periapical radiograph

pano – Panoramic radiograph

Path – Pathology

PCN or PEN – Penicillin

PD – Periodontal debridement

perio – Periodontal, periodontitis

PFM – Porcelain fused to metal

PMT, PMTx – Periodontal maintenance therapy

PO – Orally; by mouth

post – Posterior, After

postop – After surgery

PRN, prn – As needed; as necessary

PSA – Posterior superior alveolar

PSR – Periodontal screening and recording

Pt, pt – Patient

Px, PX, prog – Prognosis

q – Every

qd – Every day

qid – Four times a day

Quad – Quadrant

R – Respiration

rc – Rubber cup

RCTx or RCT – Root canal treatment

rec – Recession

Re-eval, reeval – Re-evaluation, re-evaluate

ref – Referral

reg – Regular

RHD – Rheumatic heart disease

RPD – Removable partial denture

Rx – Prescription

s – Without (usually written with a bar on top of the “s”) from the Latin word “sine”

SBE – Subacute bacterial endocarditis

Sig – Write on label

slt – Slight

SOB – Short of breath

STAT – Immediately

STD – Sexually transmitted disease

Surg – Surgery

TB – Tuberculosis

tb – Toothbrush

temp – Temperature

tid – Three times a day

TLC – Tender loving care

TMD – Temporomandibular Joint Dysfunction

TMJ – Temporomandibular Joint

to – Toothpaste

Tx – Treatment

UL – Upper left quadrant

UR – Upper right quadrant

URO – Upper respiratory infection

UTI – urinary tract infection

w/ – With

w/o – Without

WNL – Within normal limits

wt – Weight

y/o – Year(s) old

yr – Year






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