Version 9.0.4 of the R4+ software includes the following enhancements:
For courses of treatment with an acceptance date from April 1st, 2026, there are changes to the Dental Nurse user role.
Dental Nurses with an NHS Number can now be selected as Performers on claims and apply fluoride varnish (Code 711) for children up to the age of 16 years old between examination appointments. They also have the ability to open and close this course of treatment within the NHS contract.
Fissure Sealant (Code 1441 & 701) and Pre-formed (Codes 4402 & 6002) Crown Treatments now start as Band 2a treatments and allow the Chart to calculate up through 2b and 2c when needed. This corrects for NHS Courses of Treatments, immediately jumping to Band 2b and skipping Band 2a during the Appointment.
The new Patient Registration Forms are available for eSignature Users in England and Wales. R11 PR Form is being implemented for England, and the new R13 PR Form is being implemented for Wales.
These forms support the New Ethnicity Groups and UK-Resident / Not Resident NHS Number Settings, as introduced in the April 2026 Payment Reforms.
The Stabilisation Care Package is now supported in the R4+ software. This Care Package is meant for patients with unstable dental disease with seven or more carious teeth, and at least two teeth that have caries extending close to or into the nerve of the tooth.
This package includes the following treatments:
Select the new Stabilisation option when creating an NHS treatment plan from the Create Plan window. This option is disabled if the treatment plan is non-NHS or if the plan is orthodontic in nature.
On the FP17 claim form, the Stablisation Package check box is selected in the CDS Tab > Care Packages Sub tab. The Clinical Data tab must be populated for Risks, Perio Health, Tooth Decay Status, Other Dental Needs, and an ACORN Assessment Carried Out to ensure successful Stabilisation claim transmission.
NHS Wales: CCN 89 Introduction of Laboratory FeesNHS Wales: CCN 89 Introduction of Laboratory Fees
Laboratory fees can now be added to applicable Care Packages within NHS treatment plans. Lab fees are chargeable to patients in certain circumstances, and they will need to be recorded when charting.
Two new Laboratory Fee DPB Codes are now available for General Dental and Replacement Appliance Treatment Plans:
A Trauma Related Injury flag option is now available from the Clinical Chart to mark any treatments that stem from trauma related injury. Since Trauma Related Injury could be recorded from the Exam, Advice, or Treatment, and is not derived from any specific item, the new Flag option provides flexibility.
When you are charting an NHS Course of Treatment, right-click on an item in the Treatment Plan, and a new Trauma Related Injury option is available. Select this option to mark the Treatment Plan item as Trauma Related Injury.
The description for the item updates and is appended with “- Trauma Injury" to distinguish which treatments in the course relate to Trauma Care. The Trauma Related Injury option is disabled for non-NHS Scheme treatment items.
The Miscellaneous Trauma Care Package is automatically triggered when an applicable treatment item is charted (and the Trauma Related Injury option is applied to it).
See the R4+ Workflow Changes in Version 9.0.4 Handout in the Resource Library and the Release Notes for more information.