PERIODONTAL CARE PLAN

Patient Name: __________________________________Age________

Date of initial exam: September 19, 2017__________________ Date completed____12-7-17_______

1. Medical History: (systemic conditions altering treatment, pre-medication, medical clearance) explain steps to
be taken to minimize or avoid occurrence, effect on dental hygiene diagnosis and/or care.

The patient does not need any pre- medication or medical clearance for dental treatment. She is currently
taking Tramadol 50mg for chronic pain and inflammation. Tramadol causes xerostomia, therefore is a major
contributing factor to her periodontal disease. She is currently undergoing assessment with her physician to
determine if she has fibromyalgia or arthritis. Due to joint pain she experiences TMJ problems that can result in
headaches/ migraines, and obstruction of brushing and flossing properly. Not being able to properly remove the
bacteria causes accumulation of plaque and inflammation resulting in periodontal disease. Occasionally she will
experience cold sores. Cold sores are considered to be a herpetic lesion; therefore her immune response is
weakened. This contributes to poor healing of the periodontal tissues. She had asthma growing up as a kid, but is
not carrying an inhaler or currently being treated for asthma. Asthma can be a contributing factor in periodontal
disease, so the patient should be encouraged to receive a yearly physical to prevent having systemic conditions
unknowingly. She last had a physical August of 2017. She has been using tobacco products for 6 years, and
smokes about half a pack per day. Smoking has a tremendous effect on the oral cavity. Slowed healing process,
as well as calculus formation and bone resorption is a result of long term smoking. When a patient smokes, their
oral tissues appear to not bleed as normal, and not have the inflammation present due to lack of blood flow. The
patient could go for years without ever knowing that anything was wrong. Tobacco cessation is advised. She is
considered to be a periodontal case 3, while each of these findings in her medical history are all contributing
factors to her periodontal disease, it is not just 1 problem that causes periodontitis alone: it is caused because of
these factors all together and how the body reacts to it.

2. Dental History: (past dental disease, response to treatment, attitudes, dental I.Q., chief complaint, present oral
hygiene habits, effect on dental hygiene diagnosis and/or care)

The patient’s chief complaint and reason for visiting is an overall oral health check, and routine cleaning. Her
last dental visit was in 2010 where she received a check up and cleaning. Infrequent dental visits can result in
calculus build up, infection, bone loss, and other systemic health issues. The patient should be advised to
schedule routine cleanings. She feels okay about her teeth and smile, but she is eager to start treatment and
improve her periodontal health. She has not had any x-rays since 2010. This tells me that the patient is unaware
or her periodontal condition: bone levels, contributing factors, and proper hygiene care. My hope is to spread my
knowledge through patient education. She does not floss, which has made her gingiva sensitive, and periodontal
tissues diseased. It is in my interest to teach my patient how proper brushing and flossing can lead to halting the
progression of periodontal disease.

3. Oral Examination: (lesions noted, facial form, habits and awareness, consultation)

Her oral tissue appeared to be generally healthy at first glance (due to smoking habit.) Architecture
of the gingiva was scalloped, red at the gingival margin which indicated inflammation. So, the
consistency of the gingival margin was edematous and spongy. To me, this reflected that the patient had
more infection going on under the gingiva than what appeared. Margins were rolled in the lingual
posterior, and had a smooth appearance. Papillae were within normal limits. Attached gingiva appeared
stippled.
4. Periodontal Examination: (color, contour, texture, consistency, etc.)

The gingival margins were red, inflamed and the surface texture of the papillary and marginal
gingiva was smooth. This reflects that inflammation and possible disease process (periodontal disease)
was taking place. When disease/infection as well as inflammation is present, the patient could
experience deep pockets around the tooth. She had generalized periodontal pockets in the posterior
teeth. This indicated some sort of infection, bone loss, or possibly pathologic findings. There was no
suppuration or exudate present. She had generalized bleeding points throughout the oral cavity. Her
bleeding score was 5.8%. I am hoping to reduce the pocket depths and bleeding score with treatment.

a. Case Classification _VIII__ Periodontal Case Type _III__

b. Gingival Description: Generalized marginal inflammation.

The Patient’s gingiva reflects that there is infection going on in the periodontal tissues. To halt the
progression of periodontal disease, the patient should practice oral hygiene home care: brushing,
flossing, and rinsing.

App't 1:

The gingival margins were red, inflamed and the surface texture of the papillary and marginal
gingiva was smooth. This reflects inflammation that could have something to do with the periodontal
disease process taking place. Consistency was edematous and spongy, and the margins were rolled in
the posterior lingual. No suppuration or exudate was present. The plaque score was 2.16 fair, and the
bleeding score was 5.8%. Architecture of the gingiva was scalloped, red at the gingival margin which
indicated inflammation. So, the consistency of the gingival margin was edematous and spongy. Papilla
was within normal limits, and the attached gingiva was stippled.

App't 2:

There was no significant change in the gingiva. The papillary and marginal gingiva was red and
smooth indicating inflammation. Margins were rolled in the posterior lingual and anterior mandibular
lingual. This is most likely due to her periodontal disease. No suppuration was present but there was
generalized moderate bleeding. Papilla was within normal limits and the attached gingiva was stippled.

App't 3:

There was no significant change in the gingiva. The papillary and marginal gingiva was red and
smooth indicating inflammation. Margins were rolled in the posterior lingual and anterior mandibular
lingual. This is most likely due to her periodontal disease. No suppuration was present but there was
generalized moderate bleeding. Papilla was within normal limits and the attached gingiva was stippled.
The plaque score was 2.0 fair and the bleeding score was 1 %.
 App't 4:

Today I did notice some changes in the gingiva where I worked last week in the maxillary right. The
gingiva seemed less swollen and irritated than the rest of the mouth. However, the inflammation has
gone down, but is still present. Although there was some improvement throughout the rest of the mouth,
the gingiva was edematous and spongy with rolled and red margins. Papillary and marginal gingiva was
smooth and shiny indicating inflammation. No suppuration present, but there was moderate bleeding.
The bleeding score was 1.6 and the plaque score was 2.3 fair. The plaque score reflected that the patient
was not practicing good oral home care to remove the plaque. The plaque and inflammation in her case
has contributed to her periodontal disease.

App't 5:

Today I have noticed some changes in the maxillary arch versus the mandibular arch. The maxillary
arch has shown some improvement in the inflammation, as well as the color of the gingiva. I started to
see some pinkish color change in the maxillary. The mandibular arch was still generalized edematous
and spongy with red margins in the posterior. There was marginal inflammation and generalized
moderate bleeding points. The plaque score was 1.5 good and the bleeding score was 2.1%. There are
still signs of bleeding and inflammation reflecting her periodontal disease.

App't 6:

Although the inflammation has gone down, I was still noticing signs of inflammation and irritation
in the gingiva. There was generalized mild inflammation with smooth and shiny/ edematous margins.
More inflammation and irritation was noted in the mandibular left (the untreated area.) The plaque
score was .13 excellent and the bleeding score was 2%. Over all I am gradually seeing some changes
towards improvement. There are still signs of bleeding and inflammation reflecting her periodontal
disease.

App’t 7:

Today I did not notice significant changes in the gingiva. The mandibular left was still inflamed and
had red and edematous margins. I have noticed that inflammation in the maxillary arch has gone down
some, but there are still signs of bleeding and inflammation reflecting her periodontal disease. I cannot
wait to compare the changes in her post evaluation.

App’t 8:

Today I saw significant changes in the gingiva. Throughout the entire mouth the gingiva and papilla
had a light pink color. The only places that I saw red and inflammation was at the lingual margins of the
maxillary molars: numbers 1, 2, 14, 15, and 16. Along with the inflammation, there was bleeding in
these areas. This evidence of inflammation and bleeding reflects her periodontal disease.
 c. Plaque Index: App’t 1: 2.16 fair 2: ___ 3__2.0 poor 4: _2.3_ 5:_1.5 good 6: .13 good 7: .83 good
8: 2.0 fair
d. Gingival Index: Initial _2.0 poor Final _1.2 fair____

e. Bleeding Index: App’t 1: 5.8% 2:____ 3:_1%____ 4_1.6%__ 5_2.1% 6 2.0% 7 2.0% 8: 8.3%

f. Evaluation of Indices:

1. Initial:
The evaluations of indices are signs and contributing factors to the patient’s prognosis of case III periodontal
disease. She has chronic moderate periodontitis with moderate bleeding upon probing. The patient has plaque on
the facial and more commonly on the lingual of the posterior teeth. The plaque accumulates in the interproximal
space of the anterior teeth. Plaque and inflammation play a role in gingivitis. In her case, gingivitis, smoking, and
plaque are contributing factors in the development and severity of her periodontal disease. The initial indices are
higher than normal, because of the inflammation, plaque and bleeding. The gingival index is 2.0 which is fair.
Hopefully by the end of treatment we can lower the gingival index to 1.0.

2. Final:
The patient still has generalized moderate plaque build-up. The plaque score has improved some from 2.16 to
2.0. The patient displayed more plaque in the maxillary molar area, as well as some inflammation along the
margins on the maxillary posterior lingual. This plaque accumulation, inflammation, bleeding, and the host
response are all contributing factors to her periodontal disease. Although I did see some improvement of color
and inflammation in some areas, the perio still remains. The gingival index has improved from 2.0 poor to 1.25
fair.

g. Periodontal Chart: (Record Baseline and First Re-evaluation data)

1. Baseline:
She has generalized periodontal pockets in the anterior and posterior. Multiple bleeding points indicate
inflammation throughout the mouth. Although the patient does not have any recession, or attachment loss it is
still important to remove the plaque and calculus to hopefully reduce the depth of the periodontal pockets. In the
posterior she has some pockets that read between 6-8 millimeters. There is a pocket depth of 8 millimeters on the
mesiolingual of tooth #1. Having that bacterial plaque and calculus sit on that tooth for so long caused
inflammation, a deeper pocket, and bone loss. The patient does experience joint pain she has trouble reaching far
back to tooth #1. Unable to clean that tooth properly is a major contributing factor to the development of
periodontal disease, as well as smoking and mediations that the patient is taking. The patient currently does not
have any suppuration or exudate upon probing.

2. First Evaluation
Her periodontal pockets have reduced in the anterior tremendously, while the posterior molars still have
signs of 4-5mm pockets. These deeper pockets, and bleeding reflect her periodontal disease. The pocket depth on
the mesiolingual of tooth #1 has reduced by 2mm.This area has responded well to the treatment. The anterior
gingiva looks pinker, and the pockets have shrunk by about 1mm. I was surprised today to see the amazing
progress my patient had in response to the treatment. There was no signs of mobility, suppuration, or sensitivity.

5. Dental Examination: (caries, attrition, midline position, mal-relation of groups of teeth, occlusion,
abfractions)
She has 2 occlusal metal restorations on tooth #1. She also has abfraction on the following teeth:
5,6,11,12,13. She has attrition on teeth 8 and 9 as well as 24, 25, and 26. On her mandibular teeth she has an
occlusal metal restoration on tooth 18, and an occlusal tooth colored restoration on #19 and #20. She also had 2
occlusal sealants on #30 and #31. Tooth number 32 is unerupted, and not visible on x-rays. She currently has all
other wisdom teeth, but was advised to have them removed by Dr. Wiggins. The patient has about a 1-millimeter
midline shift to the left and has class 1 occlusion in all molar and canine areas. Overbite and overjet measure 2
millimeters. She has an open bite including tooth numbers 11,12,4,5, and 6, this contributes to her periodontal
disease because these teeth do not have opposing teeth in the occlusion. In her case along these teeth more plaque
and calculus builds up faster in these areas.

6. Treatment Plan: (Include assessment of patient needs and education plan)

App't 1:
Review medical/ dental health history, pre-rinse, FMX survey to view patients bone levels, and
evaluate them to look at patient’s periodontal case. Start head and neck and Periodontal assessment. Do
initial plaque score and bleeding score. Gave the patient education on brushing and flossing techniques,
and briefly identify periodontal disease. Learning Level: unaware. The patient has never heard of
periodontal disease. We discussed that not flossing was a factor in the development of periodontal
disease.

App't 2:
Review medical/dental health history and pre- rinse. Finish head and neck exam, intra oral exam,
and periodontal assessment. Do dental charting and periodontal charting. Complete risk assessment and
informed consent. Acquire plaque score. Patient education: relationship between flossing and
periodontal disease. How gingivitis progressed to periodontitis.

App't 3:
Update medical/dental health history and pre-rinse. Explain procedure to patient, apply topical
anesthesia if needed and begin ultrasonic and fine scaling the upper right quadrant. I will also full perio
chart the UR quadrant and calculate a new bleeding score.
For the upcoming patient education sessions, I will lay out short and long-term goals that are attainable
for the patient to gain optimum oral health.

Discuss First Long-term goal:

 Patient will reduce the plaque score to 1.6 by last appointment
Discuss Short-term goals:
 Define plaque.
 Demonstrate proper brushing technique the bass method.
 Lower the plaque score by .3 each appointment.

Discuss Second Long-term goal:

 Patient will halt further progression of disease and decrease bleeding by the last appointment
Discuss short-term goals
 Decrease the bleeding score.
 Proper flossing technique: finger wrap and C-shape motion.
 The patient will floss at least once every 2 weeks, since the patient does not floss

Discuss Third long term goal:

 The patient will quit smoking
Discuss short term goals:
  Define oral cancer
 Show/teach patient home oral screenings
 Reduce number of cigarettes smoked per day.

I will then begin patient education session 1. I will ask the patient if she knows what plaque is, and
how she brushes her teeth. I will then explain to the patient what plaque is and how to control it. I will
show her the bass method and explain briefly how her periodontitis was accumulated by plaque and
gingivitis. I will tell her how we can attain the goal of lowering the plaque score by showing her
brushing and rinsing properly.
I will conclude the session by stating that this is a team work effort and that if she does her part, I
will do mine. Then I will review what we have talked about that day, and will briefly explain what we
will be talking about in the next session: Periodontitis and flossing.

App't 4:
Update medical/dental health history and pre-rinse. Take plaque score. Apply topical anesthesia if
needed and begin ultrasonic and fine scaling the upper left quadrant. I will also get a net bleeding score,
and full perio chart UL quadrant.

Patient Education session 2:

Ask patient what plaque is and what brushing method is used. I will review plaque and brushing with
the patient. I will then explain how not flossing has been a major factor in the development of her
periodontal disease. I will then begin reviewing the second Long-term goal.

Discuss Second Long-term goal:

 Patient will halt further progression of disease and decrease bleeding by the last appointment
Discuss short-term goals
 Decrease the bleeding score.
 Proper flossing technique: finger wrap and C-shape motion.
 The patient will floss at least once every 2 weeks, since the patient does not floss
I will briefly explain what our next session will be over: Smoking.

App't 5:
Update medical/dental health history and pre-rinse. Take plaque score. Apply topical anesthesia if
needed and begin ultrasonic and fine scaling the lower right quadrant. I will also get a new bleeding
score and full perio chart LR quadrant.

Patient Education Session 3:

I will ask the patient what periodontitis is and ask her to show me the proper way to floss.
Then, I will ask the patient if she knows that smoking was a major contribution to developing
periodontal disease. I will explain the Third Long-Term goal.

Discuss Third long term goal:

 The patient will quit smoking
Discuss short term goals:
 Define oral cancer
 Show/teach patient home oral screenings
 Reduce number of cigarettes smoked per day.

I will conclude our third and final patient education session by reviewing everything we have learned
and the goals we have established. I will send her with my best wishes and hope that she will remember
to work at her goals to achieve optimum oral health.

App't 6:
Update medical/dental health history and pre-rinse. Take plaque score. Apply topical anesthesia if
needed and begin ultrasonic and fine scaling the lower left quadrant. While finishing up the patient I
will do chairside patient education by reviewing skills of brushing, flossing, smoking and goals
associated. I will also get a new bleeding score and full perio chart the LL quadrant.

App’t 7:
Update medical/dental health history, pre- rinse and do final plaque and bleeding score. Asses
gingiva, periodontal pockets, and gingival index. Acquire final periodontal charting, post calculus, and
Arestin. Compare pocket depths and explain to patient my findings. Do plaque free, and apply fluoride.
Refer patient to DDS to have third molars removed. Assign a recall visit of 3 months. List final gingival
statement.

7. Radiographic Findings: (crown root ratio, root form, condition of interproximal bony crests,
thickened lamina dura, calculus, and root resorption)
She has generalized moderate horizontal bone loss in the posterior of the upper right, left as well as
the lower left and lower anterior region. This shows that there is disease process in the periodontal
tissues. She has some loss of crestal lamina dura and widened PDL space in the upper and lower
anterior. This also reflects periodontal disease. Another contributing factor is the patient has generalized
subgingival calculus that is visible in x-rays throughout the whole mouth.

8. Journal Notes: (Record in detail the treatment provided, oral hygiene education, patient response,
Complications, improvements, diet recommendations, learning level, progress towards short and long term goals,
expectations, etc.) The progress notes should be written by appointment date.

Appt 1: September 19, 2017:

Reviewed medical/ dental health history, pre-rinse, FMX survey to view patients bone levels, and
evaluate them to look at patient’s periodontal case. Completed head and neck and intra oral exam. I
started the periodontal assessment on the patient. Patient showed a plaque score of 2.16 fair, and a
bleeding score of 5.8%. I then gave chairside patient education about what plaque is and we talked
about brushing techniques. The brushing technique we talked about was the bass method and the patient
was unaware, but eager to learn. We also briefly discussed periodontal disease and how gingivitis
progressed to periodontitis. We discussed then that not flossing was a factor in the development of
periodontal disease.
Appt 2: September 26, 2017:
Updated medical/dental health history, and took a few retakes so I could see the bone levels and
structures needed. I then finished the periodontal assessment and radiographic findings. I then
completed the dental charting with x-rays, and Dr. Wiggins checked over my work and went over the
findings with my patient. There were no referrals, but he did advise patient to remove 3rd molars if they
became a bother. Next I completed the risk assessment and informed consent treatment plan. For
chairside patient education we talked about how gingivitis progressed to periodontitis and reviewed
what plaque is.

Appt 3: October 12, 2017

Updated medical and dental health history, pre rinsed, and took a plaque score. The plaque score was
2.0 fair and the bleeding score was 1%. I then did a gingival index and the total was 48. Next I used
ultrasonic instrumentation and fine scaling to clean the maxillary right quadrant. During ultrasonic
instrumentation my patient experienced sensitivity so I administered topical Benzocaine 20%. The
tissues were extremely sensitive and inflamed, so I advised the patient to swish with warm salt water
and take Ibuprophen. I ended the appointment with our formal patient education session 1. We talked
about all of the long and short term goals I have set, but we focused on the first short term goal. I talked
to my patient about what plaque is, and how to remove plaque. I demonstrated the bass method and she
practiced the motion. The patient seemed interested and eager to learn proper home care. I explained
that if she would do her part by going home and working on the bass method removing the plaque, that
I would do my part at each appointment educating, and cleaning her teeth to my best ability. We agreed
that it was a team work effort. I then reviewed what we talked about, and briefly explained what we
would talk about next session: flossing and periodontitis.

Appt 4: October 19, 2017

Updated the medical and dental health history, pre- rinsed and took a plaque and bleeding score. The
plaque score was 2.3 fair, and the bleeding score was 1.6%. Then Dr. Wiggins administered Lidocaine
2% and I used my ultrasonic on the maxillary left. I then full periodontal charted all of the pocket
depths for the maxillary. There was 4mm pockets in the posteriors on the facial and lingual. There was
a generalized CAL of 2-3mm in the maxillary. I then fine scaled the maxillary left getting residual
calculus pieces left. I ended the treatment with patient education session 2: Periodontitis and flossing. I
began by reviewing what we talked about last session which was gingivitis and brushing, then went
over our long and short term goals. I then explained what periodontitis is, and how to halt the
progression of the disease by flossing. We focused on our goal of halting the disease, by starting to floss
at least once a week. I demonstrated the proper flossing technique: the “C” shaped motion. The patient
seemed interested and eager to learn proper home care. I explained that if she would do her part by
going home and working on flossing, that I would do my part at each appointment educating, and
cleaning her teeth to my best ability. We agreed that it was a team work effort. I then reviewed what we
talked about, and briefly explained what we would talk about next session: Tobacco and oral cancer.

Appt 5: October 26, 2017

Updated the medical and dental health history, pre- rinsed and took a plaque and bleeding score. The
plaque score was 1.5 good, and the bleeding score was 2.1%. Then Dr. Wiggins administered Lidocaine
2% and I used my ultrasonic on the mandibular right. I then full periodontal charted all of the pocket
depths for mandibular right and started fine scaling in this area. I ended the appointment with patient
education session 3: tobacco and oral cancer. I began the session by reviewing over what we talked
about last time: periodontitis and flossing and went over all of our short and long term goals. We then
focused on our main goal to stop smoking tobacco and to reach that goal we talked about reducing the
number of cigarettes smoked per day. I then taught my patient how to self-oral screen her mouth to look
for signs of oral cancer. I taught her how to look on the sides of her tongue, underneath and at the back
of her throat. I showed her what oral cancer looked like and what to look for when screening. She then
practiced the screening guidelines. The patient seemed interested and eager to eventually stop smoking.
I explained that if she would do her part by taking steps towards tobacco cessation, that I would do my
part at each appointment educating, and cleaning her teeth to my best ability. We agreed that it was a
team work effort. I then reviewed what we talked about, and briefly explained what we would talk
about next session: Review of what we learned in each session.

Appt 6: November 7, 2017

Updated the medical and dental health history, pre- rinsed and took a plaque and bleeding score. The
plaque score was .13 excellent, and the bleeding score was 2.0%. I then finished scaling the mandibular
right. Next Dr. Wiggins administered Septocaine and I used my ultrasonic on the mandibular left. I then
did chairside patient education and we discussed the development of calculus, the learning level was
unaware.

Appt 7: November 13, 2017

Updated the medical and dental health history, pre- rinsed and took a plaque and bleeding score. The
plaque score was .83 excellent, and the bleeding score was 2.0%. I then finished scaling the mandibular
left and full periodontal charted the pockets in this area. I then did chairside patient education and we
discussed plaque versus calculus, the learning level was unaware.

Appt 8: December 7, 2017

Updated the medical and dental health history, pre-rinsed and took a plaque and bleeding score. The
plaque score was 2.0 fair and the bleeding score was 8.3%. I then took a new gingival index that was
1.25 fair. This score has improved but still reflects her periodontal disease. I then did patient ed. Session
#4. We reviewed plaque and the bass method. We reviewed periodontal disease, and flossing with the
“C” shaped motion. We also reviewed oral cancer and oral screening. The learning level was aware.
After, I hand scaled and full perio charted the UR, UL, LR, and LL quadrants. There was very little
residual calculus to remove, and I saw reduction in some of the periodontal pockets in the anterior and
posterior. Next I did plaque free and polishing. I then placed Arestin on teeth # 1, 2, 15, and 31 distal
surfaces and discussed how it works for reducing the pocket depths. Next I did fluoride varnish 5% and
finished up our appointment.

9. Prognosis: (Based on attitude, age, number of teeth, systemic background, malocclusion, tooth morphology,
periodontal examination, recare availability)
Overall Prognosis: Good.
I rate my patient a good prognosis because she does not have any systemic factors influencing her
periodontal disease. She does however have modifiable risk factors such as smoking. She is currently
trying to work on the number of cigarettes smoked per day. I believe in this patient because she has the
best attitude and truly wants her teeth to be in the healthiest state. She seems eager about the treatment
and wants to work to obtain optimum oral health. Her plaque score did fluctuate but she is still working
on that as well as flossing. She is 34 years old and has 30 well-functioning teeth. However on #1 and
#16 these teeth have a poor prognosis, because the patient has a hard time keeping these areas clean.
There is also greater pocket depths in these areas contributing to her periodontal disease. She is
currently unemployed so this makes it easy to schedule a recall appointment.
10. Supportive Therapy: Suggestions to patient regarding re-evaluation, referral, and recall schedule. (Note:
Include date of recall appointment below.)
I explained to her all of my clinical findings, the improvements (plaque score and probe depths) and
also discussed the areas that still need work (3rd molars, flossing, and smoking.) I praised the patient for
overall improvement of her oral health, and encouraged her to keep up the good work. I recommended
that she work on flossing at least once a week, and go from there. There were no referrals, but she was
put on a 3 month recall to better maintain her periodontal disease. She is committed to coming again in
March of 2018 for a cleaning.

11. Assessment of Changes: (including plaque control, bleeding tendency, gingival health, probing depths)
Plaque control- over all the patients plaque score fluctuated. There were times of success and areas that
needed improvement. We went over the bass method at each patient education session.
Bleeding tendency- Over all the patients bleeding score fluctuated as well. She stated from the
beginning that she never flosses. She is currently trying to remember to floss at least once a week to halt
the progression of her periodontal disease.
Gingival health- This is the area of most improvement. Over all she showed tremendous improvement
in the color, pocket depths and inflammation of her gingiva.
Probing Depths- This was also an area of improvement because over all the patients pockets decreased
by about 1-2 mm throughout the whole mouth.
Overall, my patient has improved greatly in areas of probe depths and gingival health. If my patient
continues the proper home care, the halt of her disease can be reached. This is our ultimate goal in her
periodontitis, which is halting the disease progression.

12. Patient Attitudes and Cooperation:

My patient’s attitude and cooperation was very positive and eager. She was always very interested at
every patient education session, and tried to reach every goal we set. Her attitude made this learning
experience one to remember. The reason why I predicted her prognosis as good is because of her
eagerness to learn, and strive to better her health.

13. Personal Evaluation/Reaction to Experience:

This whole experience was a big eye opener for me. I have learned so many things about periodontal
disease, prevention, and my patient than I ever though imaginable. I learned new things at each
appointment and it was truly rewarding to see my patients reaction to treatment. She was always happy
and willing to do anything necessary to obtain proper oral care. She was part of the reason that made
this learning experience so much fun. I can’t wait to see her next semester to see how far she has come
with her treatment.
 GINGIVAL INDEX
PERIODONTAL CARE PLAN

Initial date: _10-12-17___

Gingival Area

M F D L

3 2 2 2 2

9 2 1 2 2

12 2 1 2 2

19 2 2 2 3

25 2 3 2 2

28 2 2 2 2

TOTAL __2.0 poor___

Final date _12-7-17__________________

Gingival Area

M F D L

3 1 1 2 1

9 1 1 1 1

12 2 1 2 1

19 1 1 1 1

25 1 1 1 1

28 2 1 2 2

TOTAL_1.25 fair_____________