CLINICAL REPORT: Caries, Root, and Fracture Risk Assessment
Prepared By		Prepared For
Dr. William Sheffield 123 Main St. Seattle, WA 98101,   Phone: 555-555-1234, Fax: 555-555-6789 Exam Date: 2007-04-09		Mary Anderson Age: 46 Risk Assessment ID: fec00940-2566-455a-9c4a-da6526c11704 Patient PreViser ID: f73dfd87-8853-4404-86bb-43485afbf935

Background Information: Permanent premolars and molars Early decalcification or carious Root surfaces Restored Months Patient has been Caries-free 12 - 23 Root Surface Erosion/Abrasion/Abfraction No A tooth has been fractured (non-traumatic) No A tooth that is present has root canal fillings and is not restored with a crown No Oral Hygiene Acceptable Fluoride products used (fluoridated water, supplements, toothpaste, rinses, or gels) Yes Has fixed orthodontic appliance No Experiences dry mouth Yes Bruxes, grinds, or clenches -OR- Symptoms of habits like occlusal or incisal wear, tooth facets, or cervical wear exist Yes Has pierced tongue or oral habit (eating ice, playing musical instrument with a mouthpiece, opening bottles) placing excessive stress on teeth No Has had a major change in health (heart attack, stroke, etc.) during the past 12 months No Times per day snacks or beverages containing sugar are consumed between meals 5 or more

Risk Scores Caries Risk Score: 2 - Moderate Fracture Risk Score: 2 - Moderate Root Surface Risk Score: 1 - Low

Prevention - Active Intervention Prevention is based on risk and risk factors. This is treatment before disease is observed. Repair of the effects of disease rarely results in a condition as good as the original health state. Preventing disease eliminates tooth loss and reparative treatment. Fluoride Therapeutic oral rinses Occlusal Adjustment Bite guard Crown for at risk tooth    Communication Dental treatment cannot keep you healthy. Your participation is very important. The most common patient behaviors that influence health and treatment success are oral hygiene, nutrition, and smoking. You may receive advice, including resources for you to change to health-promoting behaviors. Oral hygiene Instruction Nutritional Counseling    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. 2 x year 3 x year 1 x year 4 or more per year Generally most effective May be effective Less likely to be effective

Oral Hygiene
	Oral Hygiene is of particular importance to you. You should learn improved methods of maintaining your teeth and gums. You can ask us to explain or show you oral hygiene hints online. We can show cleaning methods that you may not have tried before. These methods are easy, quick, not painful, and they can be a big contributor to improving your overall oral health.