AF Form 935A: Periodontal Maintenance Record Download

AF Form 935A: Periodontal Maintenance Record Download – AF Form 935A, officially titled Periodontal Maintenance Record, is a specialized U.S. Air Force dental form used to document ongoing periodontal maintenance procedures for patients in Air Force dental treatment facilities (DTFs). It supports the tracking of clinical findings, treatments, and maintenance visits for individuals with a history of periodontal disease, helping ensure compliance with Air Force dental readiness standards and long-term oral health management.

This form is part of the AF Forms 935 series, which includes AF Form 935 (Periodontal Diagnosis and Treatment Plan) and AF Form 935B (Plaque Index/Bleeding Point Record). It is filed within the patient’s dental health record alongside standard forms like SF 603/603A and is referenced in Air Force dental assistant training materials.

What Is AF Form 935A Used For?

Periodontal maintenance (often coded as D4910 in civilian practice) involves regular follow-up care after initial periodontal therapy to prevent disease progression, control inflammation, and maintain attachment levels. In the Air Force context, AF Form 935A provides a structured way to record:

  • Clinical periodontal charting over time
  • Bleeding on probing or exudate sites
  • Tooth mobility (graded 1, 2, or 3)
  • Furcation involvement (incipient, cul-de-sac, or through-and-through)
  • Plaque and calculus findings
  • Treatment provided during maintenance visits
  • Dates of full charting and maintenance procedures

The form helps dental teams monitor changes in periodontal status, support readiness classifications, and document care for active duty, reserve, and other eligible beneficiaries. Proper use contributes to overall Dental Individual Medical Readiness (DIMR) by reducing the risk of dental emergencies that could impact mission readiness.

Key Sections and Layout of AF Form 935A

The official one-page form (available as a PDF from Air Force e-Publishing) includes patient identification fields at the top and a detailed charting grid. Typical elements visible on the form include:

  • Patient Information: Name, SSN (or DoD ID), and other identifiers (subject to Privacy Act of 1974).
  • Charting Fields: Multiple columns or rows for recording data across visits or sextants/teeth.
  • Clinical Indicators:
    • Bleeding on probing (BOP) or exudate sites (often marked with “X”).
    • Mobility grades (1 = slight, 2 = moderate, 3 = severe).
    • Furcation involvement notations (V for incipient, etc.).
  • Full Charting Date: Space to note when comprehensive periodontal charting was performed.
  • Maintenance Visit Details: Dates, procedures performed (scaling, root planing, oral hygiene instructions, etc.), and provider notes.
  • Legend or Codes: Abbreviations for findings such as plaque, calculus, recession, or other observations.

The form is designed for repeated use over multiple maintenance intervals, allowing side-by-side comparison of periodontal parameters. It is typically completed in pencil for charting (with ink for final entries) as outlined in dental assistant qualification training.

Official Download: Access the current version of AF Form 935A directly from the Air Force e-Publishing site:
https://static.e-publishing.af.mil/production/1/af_sg/form/af935a/af935a.pdf

How AF Form 935A Fits Into Air Force Dental Workflow?

Air Force dental services follow AFMAN 47-101, Managing Air Force Dental Services, along with relevant Clinical Practice Guidelines (CPGs) and the Dental Management Guide. The 935 series forms are initiated as needed for patients requiring periodontal care:

  1. Initial Assessment — Use AF Form 935 for diagnosis and treatment planning.
  2. Active Therapy — Document surgical or non-surgical treatment.
  3. Maintenance Phase — Switch to AF Form 935A for ongoing recall visits (typically every 3–6 months, depending on risk).
  4. Supporting Records — Pair with AF Form 935B for plaque/bleeding indices and integrate into the overall dental record (e.g., SF 603A).

Dental assistants and providers use standardized abbreviations and charting conventions. Entries support periodontal screening and recording (PSR) data that may influence readiness classifications.

Note: The form was originally released on October 1, 1984. While the core structure remains consistent, always verify you are using the latest edition from e-Publishing, as minor revisions or digital integration with systems like MHS GENESIS may apply in modern facilities.

Importance of Periodontal Maintenance in Military Dental Care

Gum disease (periodontitis) can progress silently and contribute to tooth loss, systemic inflammation, and reduced deployability. Regular maintenance helps:

  • Control bacterial biofilm and calculus
  • Monitor for disease recurrence
  • Educate patients on oral hygiene tailored to military life (e.g., deployment conditions)
  • Support overall force readiness — untreated periodontal issues can lead to dental emergencies during missions

Air Force periodontists and general dentists provide both nonsurgical and surgical care when needed, with emphasis on prevention. Eligible beneficiaries (active duty, retirees, and families through TRICARE) benefit from standardized documentation like AF Form 935A to ensure continuity of care across bases.

Tips for Proper Completion and Compliance

  • Use black or blue ink for permanent entries; pencil for initial charting.
  • Include date, provider signature/initials, and clear legends.
  • Attach or reference radiographs and clinical photos as needed.
  • Maintain patient privacy per HIPAA-equivalent Air Force policies (AFI 41-200).
  • File the form in the dental health record jacket for long-term retention.

For training on dental forms, refer to the Dental Assistant Specialty Qualification Training Package (QTP), which explicitly lists the AF 935 series as essential tools.

Additional Resources

  • Air Force e-Publishing Forms Page: Search for AF Form 935A
  • AFMAN 47-101 – Managing Air Force Dental Services
  • TRICARE Dental Information for beneficiaries
  • Air Force Dental Clinical Practice Guidelines (available through official medical channels)

Download AF Form 935A PDF Here:
Official Air Force Link

If you are an Air Force dental provider, assistant, or patient needing clarification on periodontal records, consult your local Dental Treatment Facility or the Air Force Dental Service for site-specific guidance. Accurate documentation with forms like AF Form 935A plays a vital role in maintaining warfighter readiness and long-term oral health.

This article is for informational purposes and reflects publicly available information on Air Force dental practices as of 2026. Always refer to official e-Publishing sources and current instructions for the most accurate guidance.