dental smiles - perio chart

dental smiles

Periodontal Examination Record

Tooth Number
PD (D / F / M)
GM (D / F / M)
BOP (D / F / M)
Tooth Number
PD (M / F / D)
GM (M / F / D)
BOP (M / F / D)

Perio Assessment

Gingival Color:
Inflammation:
Calculus:
Case Type:

Treatment Plan

ProcURULLLLR
SRP
Gingivectomy
Osseous/MG
Notes: