CLINICAL REPORT: Periodontal Risk and Disease Assessment
Prepared By		Prepared For
Dr. John Martin 20849 Cascade Ridge Drive, Mount Vernon,, Washington, 98274,   Phone 360.941.4715 Email carlf@previser.com Exam Date  8/21/2007		Sally Adams Age 53 Risk Assessment ID 8c80f6d2-0bdb-4e41-afa5-a5bfe0485eca PreViser Patient ID 8c2fb32a-b376-4b40-bdc4-a105fda2d0ab

Patient History Dental Care Never/First Visit Smoking History Never smoked Diabetic Not diabetic Dental History Perio Surgery For Pockets No Bleeding On Probing Yes Furcation Involvements Yes Subgingival Restorations No Vertical Bone Lesion Yes Calculus On Radiographs Below Gingival Margin Yes Oral Hygiene Acceptable

Pocket Depths 5-7mm <5mm <5mm     Bleeding       <5mm <5mm <5mm		Radiographic Bone Height 2-4mm <2mm <2mm <2mm No X-ray <2mm

Risk Score 4 Disease State 21 Localized moderate periodontitis

What Changed  What Changed?

Disease State Severe Gum Disease Moderate Gum Disease Mild Gum Disease Gingivitis Healthy Perio Risk   Very High Risk High Risk Moderate Risk Low Risk Very Low Risk    Disease State    Perio Risk 35 25 21 4 4 4

Active Intervention Generally Most Effective May be Most Effective Less Likely to be Most Effective

Reduce Pockets <5mm
		Pockets that are less than 5 mm deep can be thoroughly cleaned of bacteria and calculus most easily. However, all deep pockets were at one time less than 5 mm, so one should always watch for advancing disease. The optimal pocket depth is 3 mm or less. Prophy or maintenance Host modulators

Reduce Pockets 5-7mm
		Pockets in the 5 to 7 mm depth range cannot be cleaned with a toothbrush and floss, and professional tooth cleaning tools don't always reach the bottom of the pocket. Incomplete removal of plaque and calculus results in deeper pockets and tooth loss. SRP with adjunctive therapy as indicated Surgery when SRP with adjunctive therapy as indicated is not effective - Bone surgery - Flap surgery - Regenerative Therapy (Special Circumstances) Extraction (Special Circumstances) Prophy or maintenance without SRP or surgery Medicaments alone (Special Circumstances) - Locally Applied Anti-microbials - Systemic Antibiotics - Host modulators

Furcation Involvements
		Furcations are the junctions of roots in multi-rooted teeth (molars). The term "furcation involvement" describes loss of the bone filling these junctions. They are more challenging to clean than deep pockets, which means bacteria and calculus are not completely removed. Furcation lesions generally worsen until the tooth is lost. Surgery when SRP and/or adjunctive therapies are not effective - Regenerative Therapy - Molar root removal - Bone surgery Extraction Surgery when SRP and/or adjunctive therapies are not effective - Flap surgery SRP with adjunctive therapy as indicated Locally applied anti-microbials alone

Vertical Bone Erosion (Vertical Bone Lesion)
		Vertical bone lesions are deep holes in the bone and are associated with deep pockets. This condition will worsen until the tooth is lost. Repair of the bone lesion will decrease pocket depth, improving its cleansability. Surgery when SRP and/or adjunctive therapies are not effective - Regenerative Therapy - Bone surgery Extraction Surgery when SRP and/or adjunctive therapies are not effective - Flap surgery SRP to bone crest with adjunctive therapy as indicated Orthodontics (Special Circumstances) SRP with adjunctive therapy as indicated Locally applied anti-microbials alone

Subgingival Calculus
		Below gumline calculus (tartar) is a breeding surface for disease-causing bacteria. Complete calculus removal is essential to successful treatment. Calculus, a hard, rock-like material resists toothbrushing, requiring special dental instruments for removal. Total removal is increasingly difficult as pockets deepen past 5mm. SRP Gingival Flap Surgery (Special Circumstances)

Prevention And Maintenance

Visit The Dentist
		Symptoms are warning signs that frequently appear too late in the disease process for the simplest, most predictable, least costly treatment. Regular visits to detect disease in the early stages can prevent more complex and expensive treatment. Better still are regular visits for preventive care targeted to your risk factors. Every 3 months Every 4 months Every 2 months

Oral Hygiene
		Oral Hygiene is of particular importance to you. You should learn improved methods of maintaining your teeth and gums.