Dental Core FHIR Profiles (R4)
Version 0.9.2 - ci-build

Artifacts Summary

This page provides a list of the FHIR artifacts defined as part of this implementation guide.

Structures: Resource Profiles

These define constraints on FHIR resources for systems conforming to this implementation guide.

Dental Apical Diagnosis

Apical diagnosis for one FDI position. A source root may qualify the finding through bodySite locationDetail.

Dental Caries Finding

Surface-qualified dental caries assessment. The result is required from the Dental Core caries ValueSet; lesion activity and ICDAS severity are distinct components, and radiographic depth is a distinct DentalRadiographicCariesDepth observation. A finding without a surface is root caries only when its result says so (root-caries, cavitated-root-caries); with a caries or secondary-caries result it records a lesion whose surface was not recorded.

Dental Cephalometric Analysis

Imaging-derived cephalometric measurements and reference values without national billing or workflow semantics.

Dental Cephalometric Analysis Panel

A panel that groups atomic imaging-derived cephalometric measurements without changing the released component-based cephalometric analysis profile.

Dental Cephalometric Landmark

An imaging-derived cephalometric landmark with physical UCUM millimetre x and y coordinates, an optional z coordinate, a declared coordinate frame, and explicit source evidence. Pixel coordinates are out of scope.

Dental Cephalometric Measurement

An imaging-derived cephalometric measurement with explicit method and source evidence.

Dental Chart State

Lossless coded chart-state observation used alongside the truthful clinical resource when legacy or source distinctions are not carried by that resource. Properties and values are vendor-neutral Dental Core semantics, not application field names.

Dental Clinical Provenance

Provenance for dental clinical resources, including whether a final diagnosis or classification was derived or explicitly selected by a clinician.

Dental Device

Dental or orthodontic device, component, or retained pin located at one or more FDI tooth positions and optionally linked to a parent prosthesis.

Dental Finding

Country-neutral observed dental finding with patient, effective time, and optional FDI tooth and surface location.

Dental Gingival Assessment

Method-qualified gingival assessment at one tooth. The result is a Fischer 2017 category, a direct UCUM millimetre measurement, or binary periodontal-probe transparency; these result forms are not silently converted.

Dental Gingival Recession Assessment

Tooth-qualified gingival recession classification supporting Miller 1985 for existing records and Cairo 2011 as a distinct alternative. New surface-specific assessments should identify one surface; legacy odontogram records remain valid without one.

Dental Implant

Manufacturer-neutral identity for a dental implant at one FDI position. Product details remain ordinary Device properties and issuer identifiers.

Dental Mesiodistal Tooth Width

A measured mesiodistal tooth width with an explicit method. Image or document source evidence is optional for manual or cast measurements.

Dental Model Analysis Measurement

A provider-neutral derived model-analysis result whose raw observation inputs remain explicit references.

Dental Model Analysis Panel

A panel that groups atomic tooth-width or other model-analysis observations without embedding a named method or norm.

Dental Orthodontic Finding

Observed tooth position, occlusion, appliance, retention, or model-analysis finding. Clinical values use applicable issuer terminology directly.

Dental Orthodontic Photograph

A standardized orthodontic photograph used as exchangeable image evidence; the image content and acquisition protocol remain outside this profile.

Dental Peri-Implant Finding

Site-qualified periodontal measurements and implant-specific indices around one referenced dental implant.

Dental Periapical Index

Radiographic periapical index grade for one tooth. The grade is a reading of an image, so the source evidence is mandatory: a grade without its radiograph is not a reproducible measurement.

Dental Periodontal Finding

Site-qualified periodontal measurements and findings for one tooth. LOINC and SNOMED CT are referenced directly for applicable observables.

Dental Periodontitis Condition

Confirmed periodontitis diagnosis with stage, grade, and extent or distribution from the 2017 World Workshop classification. The final clinician-selected values are clinical facts; whether software derived or a clinician overrode them belongs in Provenance.

Dental Photostatic Analysis

A panel that groups atomic photostatic measurements from standardized image evidence without embedding a named norm or algorithm.

Dental Photostatic Measurement

A measurement derived from standardized orthodontic image evidence with an explicit method.

Dental Procedure

Performed dental work with patient, occurrence, performer, and one or more FDI tooth positions.

Dental Pulp Diagnosis

Pulpal diagnosis for one FDI position. The diagnosis is recorded independently of sensibility and percussion tests, which support but do not derive it.

Dental Radiographic Caries Depth

Radiographic depth of a caries lesion on one tooth surface. The surface is the single FDI surface on bodySite; the radiograph may be referenced through derivedFrom.

Dental Restoration Evaluation

Tooth- and surface-qualified evaluation of an existing restoration. The overall verdict is the FDI clinical evaluation score; observed defects and the resulting clinical action are separate axes so that a score is never inferred from a defect or an action from a score.

Dental Risk Evidence

Structured patient-level evidence used in dental diagnosis or grading, including cigarette count, periodontitis-attributed tooth loss, and imaging-derived maximum bone-loss percentage.

Dental Service Request

Requested dental intervention with explicit intent and FDI tooth location.

Dental Skeletal Maturity Assessment

A panel that groups atomic skeletal maturity observations with explicit method and source evidence.

Dental Skeletal Maturity Observation

An atomic skeletal maturity observation with explicit method and image or document source evidence.

Dental Target Chart State

Desired or proposed tooth state linked to a plan request. Recorded extensions preserve target descriptions without asserting that the state is currently observed or that treatment occurred.

Dental Tooth State

Structured observed state for one FDI position. Component codes identify structure; each component value is required from a Dental Core ValueSet with concrete codes. SNOMED CT may be sent as an additional coding.

Structures: Extension Definitions

These define constraints on FHIR data types for systems conforming to this implementation guide.

Periodontal Site

Identifies the location around a tooth for a periodontal or peri-implant measurement without defining a local clinical terminology.

Periodontitis Extent and Distribution

Localized, generalized, or molar-incisor pattern from the 2017 World Workshop periodontitis classification.

Periodontitis Grade

Progression grade A through C from the 2017 World Workshop periodontitis classification.

Recorded Apical Finding State

Preserves an unqualified target apical-finding description and its optional source root name as one assertion without inferring a diagnosis.

Recorded Bracket Surface

Preserves the tooth surface recorded for a bracket using the issuer-owned FDI buccal or lingual code. It does not establish that a Device exists when carried on chart or target state.

Recorded Cantilever Pontic Role

Preserves whether the source marked one tooth position as a cantilever pontic role. It does not establish that a Device exists or infer a bridge identity, supporting abutment, or support relationship.

Recorded Crown Fracture Description

Preserves an unqualified crown-fracture description without asserting tissue depth, crown-root extent, severity, or equivalence to a clinical terminology concept.

Recorded Implant Position Description

Preserves an unqualified description of an implant's schematic position within its FDI tooth site. The text is not a measurement or a coded anatomical location.

Recorded Orthodontic Progression Flag

Preserves whether the source explicitly marked a tooth's orthodontic state as progressive. It does not classify the change as pathological or intended treatment movement.

Recorded Papilla Loss Grade

Preserves one source-declared papilla-loss grade, its mesial or distal site, and the source's named classification attribution without publishing or claiming equivalence to a clinical scale terminology.

Recorded Root Endodontic State

Preserves one unqualified target endodontic-state description with its optional source root name. Absence of a root denotes the separate whole-tooth fallback and never a distinct canal.

Recorded Root Fracture State

Preserves an unqualified target root-fracture description and its optional source root name as one assertion without inferring a diagnosis.

Recorded Root Resection State

Preserves an unqualified root-resection chart description and its optional source root name as one assertion. It does not assert that a procedure was performed, requested, or scheduled.

Restoration Renewal

States whether a requested crown, bridge, or denture fitting renews an existing restoration of the same kind at the requested tooth positions. true means the existing restoration is to be replaced; false means a first provision. SNOMED CT has no precoordinated renewal concept for these fittings, and the distinction is a clinical decision recorded with the order, never inferred from the charted state. Absence asserts neither.

Sub-tooth Location Detail

Exact source text for a sub-tooth location when tooth, surface, and six-site periodontal position are insufficient and no admitted coded locator is available.

Tooth Position

Identifies one permanent or primary tooth using ISO 3950 FDI notation when the containing resource has no bodySite element.

Tooth Surface

Identifies one tooth surface with the issuer-owned HL7 Terminology FDI-surface CodeSystem. Repeat the extension for multiple surfaces.

Terminology: Value Sets

These define sets of codes used by systems conforming to this implementation guide.

2017 World Workshop Periodontitis Extent and Distribution

Localized, generalized, and molar-incisor pattern results.

2017 World Workshop Periodontitis Grades

Periodontitis Grades A through C.

2017 World Workshop Periodontitis Stages

Periodontitis Stages I through IV.

Angle Occlusal Classes

Angle classes I, II division 1, II division 2, and III.

Apical Diagnoses

Apical diagnosis recorded by DentalApicalDiagnosis.

Bolton Discrepancy Types

Overall, anterior, and not-applicable Bolton analysis types.

Bracket Tooth Surfaces

FDI buccal and lingual surfaces used to locate a bracket on one tooth.

Cairo Gingival Recession Classification 2011

Cairo recession types RT1 through RT3.

Caries Findings

Result of a DentalCariesFinding. The lesion surface is the FDI surface on bodySite; activity and ICDAS severity are separate components. Root caries is stated only by root-caries or cavitated-root-caries; a caries or secondary-caries result without a surface records a lesion whose surface was not recorded and is never read as root caries.

Caries Lesion Activity

Active and arrested lesion activity.

Cervical Involvement Kinds

What extends into the cervical region when a cervical-involvement finding names no tooth surface: a caries lesion or a direct filling. Such a finding states that the side was not recorded; it is never a root caries finding and never a surface of its own.

Cervical Vertebral Maturation Stages

Stages CS1 through CS6.

Crowding Severity

Mild, moderate, and severe crowding categories.

Dental Chart Properties

Properties admitted by DentalChartState.

Dental Chart Values

Results admitted by DentalChartState.

Dental Clinical Findings

Open dental finding selection. Producers use applicable issuer terminology directly; this guide does not republish an external code list.

Dental Finding Codes

Codes for what a DentalFinding observes: applicable SNOMED CT concepts plus the Dental Core observation codes that the chart findings use where no verified issuer observable exists.

Dental Materials

Open selection for dental materials coded in applicable issuer terminology.

Dental Provenance Activities

Activities admitted by DentalClinicalProvenance.

Dental Risk Evidence Types

Patient-level evidence axes used by periodontal diagnosis and grading.

Dental Tooth-Level Orders

The issuer concepts a DentalServiceRequest uses for the tooth-level orders that prosthetic planning reads: fitting of a crown, fitting of a bridge, fitting of a denture, and extraction. Codes are bare SNOMED CT identifiers; whether a fitting renews an existing restoration is stated by the restoration-renewal extension, not by the code.

FDI Restoration Evaluation Scores

FDI scores 1 through 5.

FDI Tooth Positions

Permanent and primary tooth positions expressed in ISO 3950 notation.

FDI Tooth Surfaces

Tooth surfaces referenced directly from the HL7 Terminology FDI-surface CodeSystem.

Fischer 2017 Gingival Phenotype Results

Thin, medium, and thick results admitted only with the Fischer 2017 method.

Furcation Grades

Horizontal furcation involvement grade on DentalPeriodontalFinding.component[furcation]. No named classification is claimed.

Gingival Assessment Codes

Distinct observable axes for categorical gingival phenotype, measured gingival thickness, and periodontal-probe transparency.

Gingival Assessment Methods

Methods admitted by the Dental Core gingival assessment profile.

ICDAS Caries Severity Codes

ICDAS codes 0 through 6, bound required on DentalCariesFinding.component[cariesSeverity].

Miller Gingival Recession Classification 1985

Miller Classes I through IV.

Papilla Loss Sites

FDI mesial and distal surfaces used to associate a preserved papilla-loss grade with one interdental site.

Peri-Implant Status

Peri-implant health or disease state on DentalPeriImplantFinding.component[periImplantStatus].

Periodontal Measurement Sites

Structural six-site positions used to locate periodontal and peri-implant measurements around one tooth.

Prosthetic States

Prosthetic element at the tooth position, bound required on DentalToothState.component[prostheticState].

Pulp Diagnoses

Pulpal diagnosis recorded by DentalPulpDiagnosis.

Radiographic Caries Depths

Radiographic depth of a caries lesion in enamel halves and dentin thirds, recorded by DentalRadiographicCariesDepth.

Restoration Actions

Actions admitted as the conclusion of a restoration evaluation.

Restoration Defect Types

Defect axes admitted on a restoration evaluation.

Restoration Materials

Material class of a direct or indirect restoration, bound required on DentalToothState.component[restorationMaterial]. Values name material classes, not products.

Restoration Status

Status or defect of an existing restoration, bound required on DentalToothState.component[restorationStatus].

Restoration Types

Type of restoration at the tooth position, bound required on DentalToothState.component[restorationType].

Root Endodontic States

Endodontic state of the tooth or one of its roots, bound required on DentalToothState.component[rootEndodonticState]. Root-post type is a separate value from the canal filling; a combined post-and-filling value is not defined.

Skeletal Maturity Assessment Methods

Methods admitted on a Dental Core skeletal maturity observation.

Tooth Mobility Grades

Observed tooth mobility grade on DentalPeriodontalFinding.component[toothMobility]. Absence of mobility is not recorded as a grade.

Tooth Presence

Presence or absence of a tooth at one FDI position, bound required on DentalToothState.component[toothPresence]. SNOMED CT may be sent as an additional coding.

Tooth Substrate

Condition of the clinical crown substrate, bound required on DentalToothState.component[toothSubstrate].

Ørstavik Periapical Index Scores

PAI scores 1 through 5.

Terminology: Code Systems

These define new code systems used by systems conforming to this implementation guide.

2017 World Workshop Periodontitis Classification

Reference-only canonical metadata for the 2017 World Workshop periodontitis classification. The underlying expressions are not distributed in Dental Core.

Angle Occlusal Class

Reference-only canonical metadata for Angle's occlusal classification, including Class II divisions. The underlying expressions are not distributed in Dental Core.

Bolton Discrepancy Type

Owner-authored identifiers for overall versus anterior Bolton analysis. Source wording is not distributed.

Cairo Gingival Recession Classification 2011

Reference-only canonical metadata for Cairo's 2011 gingival recession classification. The underlying expressions are not distributed in Dental Core.

Caries Lesion Activity

Active versus arrested caries lesion activity, the axis orthogonal to ICDAS lesion severity. The identifiers are owner-authored because the ICDAS lesion activity assessment publishes criteria rather than a consumable code list; source wording is not distributed.

Cervical Vertebral Maturation Stage

Reference-only canonical metadata for the cervical vertebral maturation staging used to locate the pubertal growth peak on a lateral cephalogram. The underlying expressions are not distributed in Dental Core.

Crowding Severity

Owner-authored categorical crowding severity used with a measured arch-length discrepancy. Source wording is not distributed.

Dental Chart Property

Vendor-neutral properties needed to preserve clinically reviewed dental chart state when the primary FHIR resource does not retain the original distinction.

Dental Chart Value

Owner-authored Dental Core values for tooth state, chart findings, and chart properties. Dental Core owns these primary codes; SNOMED CT equivalents, where they exist, are stated only in the ConceptMap dental-chart-value-to-snomed-ct (ADR-002). Codes do not claim equivalence to issuer terminology by themselves.

Dental Observation Component

Structural component identifiers for Dental Core observation slices. Component values carry clinical meaning in applicable external terminology or primitive FHIR values.

Dental Provenance Activity

Activities distinguishing software-derived clinical output from explicit clinician selection.

FDI Restoration Evaluation Score

Reference-only canonical metadata for the FDI World Dental Federation clinical evaluation score for restorations. The underlying expressions are not distributed in Dental Core.

FDI Tooth Position

FHIR coding namespace for permanent and primary tooth positions expressed in ISO 3950 two-digit notation. This is a structural locator, not a replacement for a clinical terminology.

Fischer 2017 Three-Level Gingival Phenotype

Reference-only canonical metadata for the Fischer 2017 double-ended periodontal-probe classification. The underlying expressions are not distributed in Dental Core.

Gingival Assessment Method

Methods that distinguish direct gingival-thickness measurement, periodontal-probe transparency, and the Fischer 2017 three-level protocol. The method is part of the result semantics.

ICDAS Caries Severity

Reference-only canonical metadata for the International Caries Detection and Assessment System (ICDAS) coronal caries severity codes 0 through 6. The underlying expressions are not distributed in Dental Core.

Miller Gingival Recession Classification 1985

Reference-only canonical metadata for Miller's 1985 gingival recession classification. The underlying expressions are not distributed in Dental Core.

Restoration Action

Clinical consequence drawn from a restoration evaluation. The identifiers are owner-authored because the FDI criteria publish action tiers rather than a consumable code list; source wording is not distributed.

Restoration Defect Type

Defect axes assessed on an existing restoration. The identifiers are owner-authored because the FDI criteria publish evaluation dimensions rather than a consumable code list; source wording is not distributed.

Skeletal Maturity Assessment Method

Named methods that establish skeletal maturity from radiographic evidence. The identifiers are owner-authored because no issuer publishes a consumable code list for the method axis; source wording is not distributed.

Ørstavik Periapical Index 1986

Reference-only canonical metadata for the Ørstavik periapical index. The underlying expressions are not distributed in Dental Core.

Terminology: Concept Maps

These define transformations to convert between codes by systems conforming with this implementation guide.

Dental Chart Value to SNOMED CT

Relates the Dental Core tooth-state and chart-finding value codes to SNOMED CT. A code is equivalent only where an active SNOMED CT concept with the same clinical meaning was verified; every other code is listed as unmatched. Dental Core codes remain the primary coding.

Example: Example Instances

These are example instances that show what data produced and consumed by systems conforming with this implementation guide might look like.

Crown renewal ordered on tooth 36

A crown fitting on tooth 36 that renews an existing crown (restoration-renewal true).

Dental Core example absent gingival assessment result

A method-qualified gingival assessment whose expected result was not obtained.

Dental Core example apical diagnosis

An apical diagnosis qualified by its source root.

Dental Core example apical finding

Observed apical finding with its exact source root location preserved as text.

Dental Core example cantilever device

Tooth-scoped device preserving an explicitly recorded cantilever pontic role.

Dental Core example caries finding

A surface-qualified caries finding with lesion activity and ICDAS severity.

Dental Core example cephalometric analysis

A cephalometric measurement derived from the example imaging study.

Dental Core example cephalometric analysis panel

Synthetic panel grouping atomic cephalometric measurements.

Dental Core example cephalometric landmark

Synthetic imaging-derived landmark observation.

Dental Core example cephalometric measurement

Synthetic imaging-derived cephalometric measurement.

Dental Core example cephalometric source

Imaging source referenced by the cephalometric analysis example.

Dental Core example chart state

Exact vendor-neutral chart values supplementing truthful clinical resources.

Dental Core example clinical provenance

Clinician selection provenance for a clinical result.

Dental Core example clinician-selected skeletal maturity provenance

Synthetic clinician selection provenance for a skeletal maturity assessment.

Dental Core example device

Dental device located at one FDI position.

Dental Core example direct gingival thickness

A direct transgingival thickness measurement with method, instrument, surface, and exact location.

Dental Core example filled tooth state

A surface-qualified direct filling with its material and a marginal defect.

Dental Core example finding

A partial generic clinical finding that demonstrates the base Dental Finding profile.

Dental Core example gingival assessment

A Fischer 2017 method-qualified categorical gingival assessment.

Dental Core example gingival recession assessment

A surface-qualified recession assessment carrying distinct Miller and Cairo classifications.

Dental Core example implant

A manufacturer-neutral implant device located at one FDI position.

Dental Core example implant tooth state

An implant in a tooth position carrying a stud attachment for a removable prosthesis.

Dental Core example legacy Miller recession assessment

A tooth-level Miller classification without a fabricated surface, retained for odontogram interoperability.

Dental Core example mesiodistal tooth width

Synthetic tooth-width measurement with explicit source evidence.

Dental Core example model-analysis measurement

Synthetic derived model-analysis result with raw observation input.

Dental Core example model-analysis panel

Synthetic panel grouping atomically measured tooth widths.

Dental Core example orthodontic analysis software

Synthetic provider-neutral software agent used only for provenance demonstration.

Dental Core example orthodontic finding

A tooth-position orthodontic finding using issuer terminology directly.

Dental Core example orthodontic photograph

Synthetic standardized orthodontic image evidence.

Dental Core example patient

Minimal patient referenced by the clinical Dental Core examples.

Dental Core example peri-implant finding

A site-qualified peri-implant observation focused on the example implant.

Dental Core example periodontal finding

A site-qualified periodontal probing and bleeding observation.

Dental Core example periodontal probe

A periodontal probe referenced by method-qualified gingival assessments.

Dental Core example periodontal-probe transparency

A binary periodontal-probe transparency assessment with method, instrument, surface, and exact location.

Dental Core example periodontitis condition

A confirmed periodontitis diagnosis with 2017 World Workshop stage, grade, and extent.

Dental Core example photostatic analysis

Synthetic panel grouping image-derived photostatic measurements.

Dental Core example photostatic measurement

Synthetic measurement derived from image evidence.

Dental Core example practitioner

Minimal practitioner recorded as performer in the clinical examples.

Dental Core example procedure

Completed dental work at one FDI position.

Dental Core example pulp diagnosis

A pulpal diagnosis for one FDI position.

Dental Core example radiographic caries depth

Radiographic caries depth on one tooth surface.

Dental Core example raw model-analysis input

Synthetic unprofiled source observation for a derived model-analysis result.

Dental Core example risk evidence

Structured evidence used for dental diagnosis or grading.

Dental Core example service request

Planned dental intervention at one FDI position.

Dental Core example skeletal maturity assessment

Synthetic panel grouping skeletal maturity observations.

Dental Core example skeletal maturity observation

Synthetic imaging-derived skeletal maturity observation.

Dental Core example software-derived model-analysis provenance

Synthetic software agent provenance for a derived orthodontic panel.

Dental Core example target chart state

Desired tooth state preserving each requested source distinction and its tooth, root, or papilla-site association.

Dental Core example target-state care plan

Plan linking a target tooth state to the dental service request that addresses it.

Dental Core example tooth state

A complete tooth-presence observation for one FDI position.

DentalCoreExampleCervicalInvolvement

The distal filling of 26 reaches the cervical region (the source names the side).

DentalCoreExampleCervicalSideNotRecorded

Tooth 36 has a cervical caries lesion whose side the source did not record. Not root caries, and not a surface of its own.

Extraction ordered on tooth 47

A tooth extraction ordered on tooth 47, coded with SNOMED CT 55162003.