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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. 4/20/2015 Perio 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) 4/20/2015 Perio 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)

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