First Visit- Child Non-Emergency

What to Bring:

• List of Current Medication, if applicable
• Dental Insurance Card, if applicable
• Previous xrays and records or fax Authorization of Release of Information form to previous dental provider
• Please print and fill out following forms:
  • Welcome Child Health History
  • Authorization to Release Health Information
    ** this form is to be sent to previous dental offices for records and x-rays. For this form, please add to the Please Forward/release my health information to:
  Dr. Ellis K. List
  1014 Lamond Ave
  Durham, NC 27701
  Drlist1014@aol.com
  • Authorization for Release of Information
  • Consent for Treatment
  • Consent for Use and Disclosure of Health Information
  • Directions to the office
  • Notice of Privacy Practices (read only)
  • Acknowledgement of Receipt of Notice of Privacy Practices

What to Expect:

We will treat your child with respect. You may be present in the room for hygiene visits. Our hygienist will introduce your child to getting their teeth cleaned.
Fluoride Varnish will be applied to all teeth.

We begin recommending digital x-rays when a child reaches 7 years old. If there is a particular concern, an appropriate x-ray can be taken at an earlier age. Cavity-detecting x-rays are taken at age 7 to check between the back teeth. It is important to preserve baby teeth until nature tells us they are ready to be replaced with adult teeth. This occurs anytime from age 5-14. A baseline Panorex is recommended at age 8 to be certain all the adult tooth buds are forming correctly.

Your child will leave with a photo of them sitting in the chair and a bag of goodies and a selection from the prize basket.