Dental report and treatment plan form


What it contains

Dental providers must complete and submit this form to a WorkSafe authorised Agent prior to any treatment being completed on an injured worker (excluding emergency treatment*).

This form is used to report the damage caused to an injured worker's teeth and mouth because of their workplace injury, and to propose a treatment plan.

* Emergency dental treatment refers to immediate and time-sensitive dental care to address acute oral health issues requiring urgent attention to alleviate pain, control bleeding, and prevent further complications, including infection. Emergency dental treatment can significantly impact the dentition and the soft tissues of the gum, lips, cheeks, and tongue. The urgency of intervention often arises from the potential for adverse consequences if immediate care is not provided. For example, quick intervention is crucial for preserving damaged or displaced teeth resulting from trauma or injury.