Get Periodontal Risk Assessment Form

Filling out the Periodontal Risk Assessment Form online is a crucial step for both dental professionals and patients to assess periodontal health risks. This guide offers clear, step-by-step instructions to help users complete the form accurately and efficiently.

Follow the steps to fill out the Periodontal Risk Assessment Form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the patient's name and the current date at the top of the form.
3. In the patient interview section, list the chief concern and any relevant habits. Indicate if the patient is a smoker or chewer, a bruxer or clencher, or if there are other habits that should be noted.
4. Next, outline any treatment concerns or expectations the patient may have regarding their periodontal care.
5. Review the patient's dental history, including the frequency of visits, recent hygiene practices, and history of periodontal surgery or dentistry.
6. Check for any diagnoses of periodontal disease and document pertinent details about orthodontic history and family history of periodontal disease.
7. Assess and note any gum recession or sensitivity in teeth and gums.
8. Review the patient's medical history, documenting existing systemic conditions, medications, and history of alcohol or drug abuse. Include information about artificial joints, chemotherapy, autoimmune disorders, allergies, and other relevant medical details.
9. Move on to the diagnostics section. Record findings related to soft tissue health, mobility or percussion results, probing depths, calculus buildup, alveolar bone loss, tooth vitality, osseous defects, presence of bleeding or exudate, and occlusal assessment.
10. Indicate the furcation involvement and any signs of inflammation or infection.
11. Classify the periodontal case type based on the American Academy of Periodontology categories, ensuring to select the appropriate type from acute to severe cases.
12. In the general treatment plan, outline any genetic testing, antimicrobial treatments, and specify whether the treatment will take place with a hygienist or dentist.
13. Detail specific procedures such as adult prophylaxis, laser-assisted treatments, debridement, and occlusal adjustments.
14. Determine the recare interval and provide any additional comments necessary for clarification.
15. Finally, ensure you enter the dentist's name and the date of the assessment. Review the entire form for accuracy before completion.
16. After filling out the form, users can save their changes, download, print, or share the completed document.

Start filling out your Periodontal Risk Assessment Form online today.