Dental Trauma Questionnaire
What a dental trauma questionnaire asks, why each part matters, and how dental practices collect it.
A dental trauma questionnaire records how a tooth or mouth injury happened, which teeth were hurt, and any signs of a head injury. The questions on this page are a typical set built from a published dental trauma history proforma.
Dental trauma questionnaire, handled by the AI Doctor avatar
AI Doctor, a real-time AI healthcare assistant avatar, asks the questions on a dental trauma questionnaire in the patient's own language, strictly following the practice's instructions.
- Intake before the visit. Patients answer online before they arrive, or at a kiosk when they check in.
- Answers ready for the clinician. Clinicians see what the patient said before the visit starts.
- Less workload at the front desk. Staff spend less time handing out forms and entering answers by hand.
- Key details at a glance. The care team sees what matters up front and decides who needs attention first.
The form becomes a natural conversation: patients answer by talking, in their own words. AI Doctor is an information and patient-assistance interface. It collects answers for the care team to review. It doesn't diagnose, triage, or give treatment advice.
Sample dental trauma questionnaire questions
Typical questions, written out so you can see the level of detail. Every practice words its own form differently.
- When and where did the injury happen?Injury details
- How did the injury happen?Injury details
- Was a tooth knocked out completely?Tooth injuries
- How was the tooth stored, and for how long?Tooth injuries
- Did you lose consciousness or vomit afterward?Head injury
- Do you have a headache or neck pain?Head injury
- Does it hurt to open or close your mouth?Mouth symptoms
- Does your bite feel different than before?Mouth symptoms
- When was your last tetanus shot?Medical history
- Do you have any allergies or take medicines?Medical history
- Have you been seen anywhere else for this injury?Previous care
- Have you injured your teeth before?Previous care
These are examples to read, not a form to fill in.
Dental trauma questionnaire: FAQ
What does a dental trauma questionnaire ask?
The sample questions on this page cover six areas: injury details, tooth injuries, head injury, mouth symptoms, medical history, and previous care.
Who fills in a dental trauma questionnaire, and when?
The patient, or a parent for a child, answers the history questions. The dentist then examines the mouth.
Why does the dentist ask how long a tooth was out of the mouth?
For a knocked-out tooth, trauma records ask for the time out of the mouth and how the tooth was stored. The dentist uses both when planning care.
Does the AI Doctor avatar decide how urgent the injury is?
No. AI Doctor only asks the questions and collects the answers. The practice's team reads them and decides how soon the patient is seen.
Is there a standard dental trauma questionnaire template?
The sample questions on this page show a typical set. The British Endodontic Society publishes a dental trauma history and examination proforma that the dentist completes with the patient.
What happens after the questionnaire?
The dentist reads the answers, examines the injury, and decides on treatment. The head injury questions put those signs on record for the dentist.
Does AI Doctor give medical advice?
No. It collects information for the care team. It doesn't diagnose, triage, or recommend treatment.
Can patient answers stay on our own servers?
Yes. RAVATAR offers on-prem deployment: the platform can run inside your own perimeter, so patient answers stay there. RAVATAR complies with GDPR and the EU AI Act.
Set up your AI Doctor in Genesis AI Avatar Studio
Genesis AI Avatar Studio is where you set up, test, and publish AI avatars for your website, mobile app, or Holobox. No coding or technical skills needed.
- 01Choose the AI Doctor avatar.
- 02Add your practice's FAQs and visit information.
- 03Talk to it, then publish it.
