Perio Report {or AATF y Kendra Bruggink, Fox Valley Technical College
Gum Disease Risk and Health Assessment
Exam Date 4/137205
a
Prepared for
Proparod by:
Cotege
Kenara Brugaink, Fox Valley Technical
1825 N. Bluemound Drive Appleton, Vl 54912
920-735-248
S
‘Your Clinical Access Code: FFHMXTHDX
Gum
Disease 2
Risk Score
e out ors
‘Tho gum disease rik scoro
escrbes the lkethood tht
without appropriate hom
professional cae, th haath of
your gums may worsen resuking
Infection and infammaton of
nd“
your gums and the possible oes
Severe Gum
Disease
Moderate
‘Gum Disease
‘Mis Gum
Disease |
ingivtis
Hetty
Gum
Health
Stability
Score
0
‘out of 100,
ofteeth
Gum
Disease 5
Score
cout of 100,
‘Your score indicates you have some
bone loss andio gum tissue
Gamage ypicaly associated with
‘ils periodentis. This damage may
De the eau of curentactve
disease or the resus of damage
You experenced in te past Your
kaly treatment and on-going
maintenance needs are cuony
rmosest
“This score tan ineatlon of how long your gum
heath has been stable. You canbe sable if yOu
fe Mealy, oF you have recived therapy and
fcive dlsease has been conoid. Th longer
{YoU ae sabe, your sear wil snow an merease
‘ach time you ae reassessed,
httpsi/Secure.previser.com/ohis/Perio/repor/86990
Page | of 4
omer
V PreViser
Overview
Your Gum Forecast
Sunny, Congrauistons! You shouts expect to manta
‘sunny txecas yeu ko on ding rat you rave
00 cong
‘Your scores can help determine what
professional treatments and preventve
home care strategies may bene you
Gum Disease and You.
Knowing your gum healt sores the fst sep
In mprovng, o maitaning the heath of your
Gum. Hore are other simple steps you can
‘a
+ Talkte your dentist about managing any
‘actors ha conrbute to elevated isk of
cisenee
+ Ask your dentist how gum dsease may
impact other serious health aimens such
‘heat disease, Alcheimers,srkes and
diabetes.
+ Take advantage of new products and
technologies that may help you optimize
yur hea through improved nome care. A
‘ostomized home care resort is avaliable
‘at ean make recommendations based on
‘your gum neath scores.
4/20/2015Perio Report for SA by Kendra Bruggink, Fox Valley Technical College
Page 2 of 4
‘Treatment Options Prepared By: Kendra Bruggink Fox Valley Technical College Prepared For
Active intervention you may need, unle:
Generally Most
Effective
POCKETS LESS THAN 5M
Pe
F «deep can have the most thorough
e that are ls than Sm
removal of bacteria and ealeulus
However, all deep pockets were at
ona time ess than Sm with the
cptimal probing depth being Sm
POGKETS 6-7
Pocketsin the to 7 dep ange
cannot be cleaned wih a
toothorush and Foss, and
professional cesning instruments
ont aways each the batiom of
‘he pocket. Incomplete removal of
page
‘deeper packets and toot oss
lus results
https://secure. previser. com/ohis/Perio/report/86990
May Be Most
Effective
table and without inflammation:
Less Likely To Be Most
Effective
consioer
®ropny or Maintenance
CONSIDER
@®sap with adjunctive therapy as indicatod
Medicaments alone (Special Cicumstances), which may
inch:
+ System Anibioes
+ Host Moaultors
‘Surgery (Special Ckeumstances)
+ Gingival Flap Surgery
+ Osseous Surgery
+ Regenerative Therapy (Specal Creumstances)
eropry ar Maintenance without SRP or surg
@eseracion (Speci
reumstances)
4/20/2015Perio Report for [MB by Kendra Bruggink, Fox Valley Technical College Page 3 of 4
‘Treatment Options Prepared By: Kendra Bruggink Fox Valley Technical Collage Prepared For: a?
Clinical Access Code: FFHMXTHDXJ | Patient ID: 8213¢92a-cadb-42a3-90b1-016ae0bbed2a
Patient History:
Cra hygiene mproverenneedes (X]
Dental care tequony is NOT reguor XT
reo laring any tooth hasboon done]
Porisdontal Suge or pocketshas been done []
Frain ivonementsexat (]
‘bail restortons are present (]
Vera one sons]
Subangialealuhsceeceaby xray or exam ET
Cigarette Smoking:
Neverninoan (X]
Sroka)