ZFA Ausbildung · Year 3

Befund und Dokumentation

Complete study guide for ZFA trainees — from the FDI tooth numbering system to German legal documentation requirements.

Level: Foundation + Advanced Reading time: 20 min ZFA · Germany
01

What is a Befund?

A Befund is the result of a clinical examination. The dentist systematically examines the oral cavity and records everything observed. The assistant's job is to accurately document this data as dictated.

A Befund is taken at every first visit and regularly updated. Without a current Befund, no treatment plan can be created.

Three types of examination:

Zahnbefundstatus of each individual tooth, recorded in the tooth chart.
Parodontalbefundcondition of the gums, periodontium and surrounding bone.
Mundschleimhautbefundexamination of the oral mucosa, tongue and lips.
02

FDI Tooth Numbering System

Germany uses the FDI system. Each tooth has a two-digit number. First digit = quadrant, second = position from midline outward.

Q1 · 11–18 Q2 · 21–28 Q4 · 41–48 Q3 · 31–38 18 17 16 15 14 13 12 11 21 22 23 24 25 26 27 28 48 47 46 45 44 43 42 41 31 32 33 34 35 36 37 38 midline
FDI tooth map — view as if facing the patient. The first digit is the quadrant (1–4), the second is the tooth position.
Primary teeth: Quadrants 5–8, numbers 51–85. Example: 64 = upper left second primary molar.
Examples to remember:
11 — upper right central incisor
36 — lower left first molar
48 — lower right wisdom tooth
03

Zahnbefund — Complete Symbol Reference

The assistant must know these symbols by heart. The dentist dictates fast — no time to think.

Tooth status

SymbolGermanMeaning
egesundHealthy tooth
xfehlendMissing tooth
xkkariesbedingt fehlendExtracted due to caries
xpparodontal fehlendExtracted due to periodontitis
nnicht angelegtCongenitally absent
WWurzelRoot only
retiniertImpacted tooth
verlagertDisplaced tooth

Restorations and prosthetics

SymbolGermanMeaning
fFüllungFilling
fkKunststofffüllungComposite filling
faAmalgamfüllungAmalgam filling
KKroneCrown
TKTeilkronePartial crown
VKVollkeramikkroneAll-ceramic crown
BBrückeBridge
IImplantatImplant
VVeneerVeneer
InlInlayInlay
OnlOnlayOnlay

Pathological conditions

SymbolGermanMeaning
kKariesCaries
InitialkariesInitial caries
DentinkariesDentine caries
Pulpanahe KariesDeep caries
k⁴PulpaeröffnungPulp exposure
wsWurzelspitzePeriapical pathology
WBWurzelbehandlungRoot canal treatment
WFWurzelfüllungRoot filling
AAbrasionAbrasion
EErosionErosion
Example — dictation 18 — x, 17 — K, 16 — K, 15 — f, 14 — e, 13 — e, 12 — VK, 11 — VK
46 — WB, WF, K, 45 — k², 44 — e, 43 — e
04

Parodontalbefund

The periodontal assessment records the condition of the supporting structures — gums, periodontal ligament and alveolar bone. Performed using a Parodontalsonde with millimetre markings.

pocket tooth gum bone probe
Probing depth (Taschentiefe): the probe measures the distance from the gum margin to the bottom of the pocket, at 6 points per tooth.
What is measured:

Taschentiefe (TT)probing depth in millimetres, measured at 6 points per tooth.

Attachmentverlust (AV)attachment loss — indicates the extent of bone destruction.

BOPbleeding on probing — sign of inflammation, recorded as + or –.

Normal probing depth values:

DepthStatusAction
1 – 3 mmNormalPrevention
4 mmBorderlineMonitor
≥ 5 mmPathological pocketTreatment required

PSI — Periodontal Screening Index:

0Healthy, no bleeding
1Bleeding on probing
2Calculus / overhanging margins
3Pocket 4–5 mm
4Pocket ≥ 6 mm

Furcation involvement: F1 — probe enters up to 3 mm. F2 — more than 3 mm, not through. F3 — probe passes through.

05

Oral Mucosa Examination

The dentist examines not only the teeth but the entire oral cavity. The assistant records any mucosal changes.

What is examined: lips and oral commissures, buccal mucosa, tongue (dorsal and ventral), floor of the mouth, palate (hard and soft), tonsils and pharynx.

Every pathological change is documented with a precise description: size, shape, colour, location. Special attention to suspicious lesions that may indicate malignancy.

06

X-Ray Documentation

Radiographs are mandatory documentation. Every exposure must be justified under the Strahlenschutzgesetz (Radiation Protection Act).

Zahnfilm
Periapical X-ray
One or more teeth. Caries, root canals, treatment control.
BWA
Bitewing X-ray
Proximal caries and bone level assessment.
OPG
Panoramic X-ray
Full jaw. First visit, implants, wisdom teeth.
DVT
CBCT (3D scan)
Volumetric scan. Implant planning, complex endodontics.

Mandatory documentation per X-ray:

FieldExample
Date14.03.2025
TypeOPG
IndicationRoutine check
RegionFull jaw
Radiation dose0.025 mSv
Dentist signatureDr. Müller
Strahlenschutzkurs required! Assistants helping with X-rays must hold a radiation protection certificate. Without it — illegal practice.
07

Medical History (Anamnese)

The Anamnese is the collection of patient health information before treatment begins. Legally mandatory. Completed in writing by the patient and reviewed with the dentist.

Medications important in dentistry:

Bisphosphonate
Risk of jaw osteonecrosis during extractions — must inform the dentist!
Blutverdünner
Marcumar, Xarelto, Eliquis — increased bleeding risk during surgical procedures.
Cortison
Delayed wound healing, increased infection risk.
Antibiotika
Possible resistance, affects treatment selection.
Allergies — always confirm!
Latex (the assistant wears latex gloves!), local anaesthetics (lidocaine, articaine), metals (nickel, chromium), antibiotics (penicillin), pregnancy and breastfeeding.
Systemic conditions: Hypertension (important before anaesthesia), diabetes (delayed healing), heart defects (may need antibiotic prophylaxis), previous heart attack or stroke.
08

Documentation Software

Most German practices use specialist software. The assistant must be able to work with these programs.

Evident
Most widely used. Integrates with X-ray and scanner.
Dampsoft
For smaller practices. Simple and reliable.
CGM Z1
Popular in large practices and MVZ centres.
Charly
Modern cloud-based system.

Assistant tasks in the software:

TaskDetails
New patientCreate record, enter personal data
AnamneseEnter health information
BefundRecord as dictated by dentist
X-raysDocument with date and indication
BillingGenerate invoices per BEMA and GOZ
09

Treatment Plan

After the examination, the dentist creates a Behandlungsplan — a detailed plan of all necessary treatment.

What the treatment plan includes: list of all required procedures, treatment sequence, estimated costs, signatures of dentist and patient.
Important! The patient must sign the treatment plan BEFORE any procedures begin. This is a legal requirement.
10

Patient Consent

Before any major procedure, the patient signs a written consent form — Aufklärung und Einwilligung.

ProcedureConsent
Tooth extractionWritten consent required
Implant placementWritten consent required
Oral surgeryWritten consent required
X-rayWritten consent required
AnaesthesiaWritten consent required
Time to consider! Consent must be obtained in advance. Never ask the patient to sign immediately before the procedure.
11

Treatment Documentation

A record of everything that happened at each appointment. Must be completed the same day.

FieldExample
Date and time14.03.2025, 10:30
Patient complaintPain at tooth 46 when biting
ProcedureCaries excavation, composite restoration
MaterialsTetric EvoCeram A2, batch #2547
AnaesthesiaUltracain D-S forte 1.7 ml
ComplicationsNone
Dentist signatureDr. Schmidt
Example entry 14.03.2025 — Zahn 46. Lok. Anästhesie: Ultracain D-S forte 1,7 ml.
Kariesexkavation. Kompositfüllung Optibond FL + Tetric EvoCeram A2.
Occlusion checked. Patient pain-free.
12

Legal Requirements

Golden rule: If it is not documented, it did not happen. The assistant's accuracy protects both the patient and the practice.
13

Common Mistakes

Inaccurate charting. Confusing tooth numbers is a serious error. Always ask if you did not hear clearly.
Incomplete Anamnese. The assistant must check the form is fully completed. A missed allergy can be life-threatening.
Missing patient signature. A document without a signature has no legal validity.
Late documentation. Entries must be made the same day, not days later.
Non-standard abbreviations. Use only accepted symbols — no one should have to guess what you wrote.
Discussing patients. Never discuss patients in corridors, outside, or on social media. Schweigepflicht always applies.
14

Glossary

Key German terms the assistant must know by heart:

Befund
Clinical examination
Dokumentation
Documentation
Zahnschema
Tooth chart
Anamnese
Medical history
Behandlungsplan
Treatment plan
Einverständniserklärung
Patient consent
Aufklärung
Informed consent
Taschentiefe
Probing depth
Attachmentverlust
Attachment loss
Blutung auf Sondierung
Bleeding on probing
Schweigepflicht
Professional secrecy
Aufbewahrungspflicht
Record retention obligation
Datenschutz
Data protection
Strahlenschutz
Radiation protection