info@maxillomauricie.com
819 378-4353
Treatments
Maxillofacial surgery
Oral surgery
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Surgery without sedation
Surgery with conscious sedation
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Suggested diet
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Wide range of treatments
Conscious sedation
Hospital access
Complete perioperative management
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REFER A PATIENT
1
Step 1
Refering dentist/physician name
Patient name
Refering dentist/physician email
a valid email
email
Patient telephone number
phone
Birth date
Birth date
date_range
Upload your X-rays
upload
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Upload your X-rays
Consultation reason
Extraction
Wisdom teeth
Pre-prosthetic surgery
Implantology
Bone graft
Laser
Impacted tooth exposition and traction
Orthognathic surgery
TMJ
Pathology
Fracture
Infant frenotomy
Scan
Reason for referral
Suspicion of dysplasia/carcinoma
Lichen planus
Vesiculobullous disease/desquamative gingivitis
Other
What is your specialty ?
Dentist
Family Doctor
Physiotherapist
Other
Reason for the consultation
Main complaint
Is the patient currently in pain ?
Yes
No
Does the patient frequently experience headaches ?
Yes
No
Has the patient ever had a jaw or facial trauma ?
Yes
No
Does the patient feel a limitation in their mouth opening ?
Yes
No
Medication tried
How many different medications has the patient tried ?
0
1
2
3
4
Previous dental treatments
Occlusal splint
Yes
No
Occlusal adjustment
Yes
No
Oral medicine consultation
Yes
No
Orthodontic treatment
Yes
No
Previous biomechanical treatments
Physiotherapy
Yes
No
Chiropractic
Yes
No
Massage therapy
Yes
No
Osteopathy
Yes
No
Acupuncture
Yes
No
What is the indication for frenotomy according to your assessment?
plus de détails
0
/
Have the patient and parent met with a breastfeeding consultant?
Such a consultation is required before proceeding with a frenotomy.
Yes
No
What does the tongue-tip look like ?
0
1
2
Where is it fixed to the gum ?
0
1
2
How high can it lift (wide open mouth) ?
0
1
2
How far can it stick out ?
0
1
2
Have the patient and parent met with a breastfeeding consultant?
Such a consultation is required before proceeding with a frenotomy.
Yes
No
What is the patient's TABBY score?
Here's how to interpret the score: 8 and above = normal score; 6 to 7: limit score; 5 and below : possible tongue dysfunction
We will only meet patients with a score of 5 and below.
8 and above
6 to 7
5 and below
Suspicion of Dysplasia / Carcinoma
White lesion appearance
Induration
Ulceration
Leukoplakia
Erythroplakia
Region in the mouth
Date of onset
Risk factors
Alcohol
Smoking
Repeated trauma
Other
Have you attempted treatment?
Yes
No
If yes, which one?
Lichen planus
Reason for consultation
White lesion
Leukoplakia-erythroplakia lesion
Other
Symptoms
Yes
No
Have you attempted treatment?
Yes
No
If yes, which one?
Dexamethasone elixir to be taken for 2 weeks + follow-up in 1 month
Vesiculobullous disease/desquamative gingivitis
Reason for consultation
White lesion
Leukoplakia-erythroplakia lesion
Other
Symptoms
Yes
No
Have you attempted treatment?
Yes
No
If yes, which one?
Dexamethasone elixir to be taken for 2 weeks + follow-up in 1 month
Other
Reason for consultation
votre nom complet
Symptoms
Yes
No
Have you attempted treatment?
Yes
No
If yes, which one?
Select a doctor
Any doctor
Dr Max Miller
Dr Olivier Handfield
Dre Annie Quesnel
Dre Archambault
Level of emergency
Code 1 very urgent
Code 2 semi urgent (4 to 8 weeks)
Code 3 according to our availability
Code 4
Code 5
Level of emergency
Comments
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