PROBLEMS LIST, AIMS & TREATMENT PLAN

Problem Yes (Y) or If Yes, then Are you going to Accept (A)
No (N)? describe? or Treat (T)? Explain
General problems

Accept or Treat by:

Oral hygiene Y N

Pathology (caries,
trauma, Accept or Treat by:
resorption, Y N
retained teeth)

Extra-oral problems

Anterio-posterior
Accept or Treat by:
skeletal Y N
relationship

Vertical skeletal Accept or Treat by:

relationship Y N

Transverse skeletal Accept or Treat by:

relationship Y N

Extra-oral soft Accept or Treat by:

tissue Y N

Intra-arch problems

Accept or Treat by:

Upper ALD Y N

Accept or Treat by:

Lower ALD Y N

Accept or Treat by:

Upper TSD Y N

Accept or Treat by:

Lower TSD Y N

Upper local Accept or Treat by:

problems Y N

Lower local Accept or Treat by:

problems Y N

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 Inter-arch problems

Incisors Accept or Treat by:

relationship Y N

Accept or Treat by:

Overjet Y N

Right molar Accept or Treat by:

relationship Y N

Left molar Accept or Treat by:

relationship Y N

Right canine Accept or Treat by:

relationship Y N

Left canine Accept or Treat by:

relationship Y N

Accept or Treat by:

Overbite Y N

Transverse Accept or Treat by:

discrepancy Y N

Accept or Treat by:

Upper centreline Y N

Accept or Treat by:

Lower centreline Y N

Other problems

Accept or Treat by:

Retention and stability

Enhance and maintain by:

Upper arch

Enhance and maintain by:

Lower arch

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