Dental Charting for Beginners: The Ultimate UK Guide

We've all been there. The last patient has left and the clinical records still need finishing. Accurate dental charting isn't clerical busywork: it is the base of good patient care and your best protection if your care is ever questioned.

This guide walks through UK dental charting from the start, for dental students, new graduates, therapists, hygienists and dental nurses: how teeth are named, how surfaces and findings are recorded, how periodontal charting works and how to write it all up clearly.

The General Dental Council expects you to make and keep contemporaneous, complete and accurate patient records. A good chart is where that starts.

What a dental chart records

A dental chart is a map of the mouth and part of the patient's permanent clinical record. A complete chart shows:

• Which teeth are present, missing, unerupted or retained roots
• Existing restorations, their materials and the surfaces they cover
• Caries and other findings, recorded by tooth and surface
• Periodontal screening (the BPE) and, where needed, a full pocket chart
• The treatment you have planned

Accurate charting does three jobs:

• Continuity of care. The next clinician can pick up exactly where you left off.
• Defending your care. If a patient complains, the record is your first line of defence. If it isn't written down, it didn't happen.
• Audits. Clinical record audits and CQC inspections look closely at the quality of records.

Tooth notation: Palmer and FDI

The UK uses three notations side by side. Palmer's grid is the traditional paper chart and is examined by NEBDN, the dental nurse exam board. The alphanumeric form (UR6, LL1, URE) uses the same quadrant logic written out, and is now the most used in UK dental hospitals and referral letters (Pemberton & Ashley, 2017). FDI two-digit numbering (16, 31) is the international standard, BS EN ISO 3950, and is how the BSP writes BPE sextants.

In Palmer and alphanumeric notation, the mouth is divided into four quadrants, upper right (UR), upper left (UL), lower left (LL) and lower right (LR), and the teeth in each are numbered from the midline outwards:

• Permanent teeth: 1 to 8, from the central incisor to the third molar. The upper right first molar is UR6.
• Primary teeth: A to E. The lower left primary second molar is LLE.

Remember that the quadrants are the patient's right and left, not yours. Facing the patient, their right is on your left.

In the FDI two-digit system, the first digit is the quadrant and the second is the tooth:

Our Palmer notation guide has a full adult and primary reference with a free printable chart.

Surfaces and charting symbols

Findings and restorations are recorded against the surfaces of each tooth:

• O Occlusal: the biting surface of premolars and molars
• I Incisal: the biting edge of incisors and canines
• M Mesial: the surface nearest the midline
• D Distal: the surface furthest from the midline
• B Buccal (or labial on front teeth): the surface facing the cheek or lip
• L Lingual: the surface facing the tongue, or P Palatal on upper teeth

Surfaces combine for larger restorations, so MOD is mesio-occluso-distal.

The most common symbols are:

• Caries: often marked in red, recorded by surface
• Restorations: the material and surfaces, for example MOD Comp or DO Am
• Missing teeth: a line through the tooth or an X, depending on the key. In the NEBDN exam key, a horizontal line means missing, a single / means to be extracted and an X means recently extracted. In US teaching, an X means missing.
• Crowns, root canal treatment and implants: their own abbreviations, such as Cr, RCT and IMP

Conventions vary between practices and software, so always follow your practice's key. Our UK dental charting symbols cheat sheet lists the common symbols and abbreviations, with a free printable PDF, and lets you try them on a chart.

Periodontal charting: BPE and six-point pocket charts

The Basic Periodontal Examination (BPE) is the standard periodontal screen in the UK, guided by the British Society of Periodontology. The mouth is divided into six sextants and the highest code in each is recorded, from 0 to 4, with an asterisk (*) for furcation involvement.

• Code 3 (pockets of 3.5 to 5.5mm): after initial therapy, record a 6-point pocket chart in that sextant only (BSP, 2019).
• Code 4 (pockets over 5.5mm): a full six-point pocket chart is needed for the whole mouth.

A six-point pocket chart (6PPC) measures six sites on every tooth (mesio-buccal, buccal, disto-buccal, mesio-lingual, lingual and disto-lingual). The BSP requires pocket depths of 4mm or more and bleeding on probing to be recorded. Mobility, furcation involvement and attachment loss come from the Healthy Gums DO Matter template, and many charts also record recession.

Our six-point pocket charting guide covers the full method, and the BSP staging and grading cheat sheet explains how the findings feed into a periodontal diagnosis.

Writing charted findings in your notes

A good charting entry names the tooth, the surface and the finding, then says what happens next:

UR6 MOD Comp (placed 12/2024). UR7 distal caries, planned MOD composite. BPE: 1 1 2 / 2 1 1.

Keep each finding on its own line, use the same notation throughout the record, and date anything you place or plan.

Common beginner mistakes

1. Mixing up the patient's right and left. Chart as the patient, not as you see them.
2. Recording a tooth without a surface, or a surface without a tooth. Both are needed for the entry to mean anything.
3. Mixing Palmer and FDI in one record. Pick the system your practice uses and stick to it.
4. Recording a BPE code without the next step. A code 3 or 4 needs a pocket chart and a plan.
5. Leaving the charting until the end of the day. Records should be contemporaneous, and details fade fast.

Charting by voice

Charting takes a lot of typing and clicking, and a full six-point pocket chart takes longer still.

With AI Notes, you say your findings the way you would to your nurse: "upper right six, MOD composite, A2 shade". AI Notes drafts the note in your own template, using Palmer or FDI as you prefer. Voice Perio Charting turns spoken readings such as "LL6 buccal 4, 3, 5, bleeding" into a chart you can check, edit and export.

You review everything before it goes into your PMS. Dentists using AI Notes save hours of typing every week.

Frequently asked questions

Is Palmer or FDI notation used in the UK?

Both, alongside a third. UK dental hospitals and referral letters now mostly use the alphanumeric form (UR6), which writes out Palmer's quadrants. Palmer's grid is the traditional paper chart, and FDI (16) is the international standard and how the BSP writes BPE sextants. Use whichever your practice uses and don't mix them in one record.

What does a BPE code of 3 mean?

A code 3 means the deepest pocket in that sextant is between 3.5mm and 5.5mm. After initial therapy, a 6-point pocket chart is recorded for that sextant only.

What colour is used for caries on a dental chart?

Red is commonly used for caries and treatment needed, with blue or black for existing restorations. UK software such as Dentally and EXACT shows planned treatment in blue by default. Conventions vary between practices and software, so follow your practice's key.