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PERIODONTAL CHART PATIENT NAME Pre-treatment FILE NO. Re-evaluation DATE Recall maintenance Diagnosis CAL BOP PD PI Calc CEJ-GM FACIAL Mobility LINGUAL GM- Gingival Margin. CAL- Clinical Attachment Loss. CEJ- Cementoenamel Junction* PD- Probing Depth Pl- Plaque if presents put. Calc- Calculus if presents put. BOP- Bleeding on probing if presents put red Plaque Index Bleeding Index Periodontal Diagnosis Supervisor s Signature. CEJ- Cementoenamel Junction* PD- Probing Depth Pl- Plaque if...
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How to fill out perio charting form

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How to Fill Out Perio Charting Form:

01
Begin by identifying the patient's personal information, such as their name, date of birth, and contact details.
02
Record the date of the perio charting and indicate any relevant notes or observations about the patient's dental health.
03
Start with the upper right quadrant of the patient's mouth and carefully examine each tooth. Use the charting form to mark the presence of dental conditions, such as recession, bleeding, mobility, furcation involvement, and any dental restorations.
04
Move systematically through each quadrant of the mouth, documenting any abnormalities or conditions on the charting form.
05
Use appropriate symbols or abbreviations to represent different conditions, such as "B" for bleeding upon probing, "PD" for pocket depth, and "CAL" for clinical attachment loss.
06
Pay attention to the specific measurements required by the charting form, including pocket depths, gingival recession, and clinical attachment levels.
07
Ensure that all information is accurately recorded and legible on the perio charting form.
08
Once the charting is complete, review the form to ensure all necessary information has been documented and there are no errors or omissions.

Who Needs Perio Charting Form?

01
Dentists and Periodontists: Perio charting forms are essential for dental professionals to accurately assess and monitor the periodontal health of their patients. This information enables them to create appropriate treatment plans and track progress over time.
02
Dental Hygienists: Hygienists often perform perio charting during routine dental exams or periodontal therapy appointments. The charting forms help them identify areas of concern, develop personalized oral hygiene plans, and educate patients on the importance of periodontal health.
03
Dental Students and Trainees: Perio charting is an important skill for dental students and trainees to learn as part of their dental education. By practicing charting, they can enhance their diagnostic abilities and gain a better understanding of periodontal conditions.

Video instructions and help with filling out and completing perio charting form

Instructions and Help about periodontal charting form

Welcome to the University of Michigan dentistry podcast series promoting oral health care worldwide the symbols used for charting are shown at the top of Pagan chart there are symbols for missing teeth food impaction open contacts mobility bridges drifted or extruded teeth beginning for kitchens exposed for kitchens and periapical areas' mobility of the teeth is recorded in the squares both here and at the base of the chart the buccal and lingual aspects of the teeth are labeled on the chart this is the buccal of the maxillary teeth and the lingual of the maxillary teeth the chart is divided into millimeter markings which are an aid to marking the depth of periodontal pockets on the chart and the cementoenamel junction the reference point from which the measurements are made is indicated in these areas now let me see if I can demonstrate the use of the symbols for charting on this chart let's assume that we are missing tooth number one and tooth number five that there is an area of food impaction between 2 and 3 sometimes you may have an area of food impaction even though the contact point is not open particularly if there is a plunger cusp there's an open contact however between 2 camp; 3 & 3 & 4 the mobility of the teeth is number two has a mobility of one three has a mobility of two and eight has a mobility of one there is a bridge replacing tooth number 5 with 4 and 6 as abutments tooth number four has drifted medially the buckle of tooth number two has a beginning for fashion involvement as the for occasion involvements are marked right at the percussion the buckle of tooth number three has an exposed for occasion it means we can insert the periodontal probe all the way into the bifurcation area the mesial-lingual of tooth number three has an exposed for cushion it's wide open tooth number eight as a periapical area recording these symbols for charting I would then begin by recording the pocket depth in excess of three millimeters and if you are calling these out to an assistant we would begin on the distal buccal of the last tooth which is number two, and we begin like this 4 5 4 3 7 6 4 3 3 3 2 3 3 3 4 3 2 3 after you have recorded the buccal pocket depth I would then proceed to the lingual beginning on the distal lingual of tooth number 2 again and recording only those pocket depths the next s of 3 millimeters 4 5 5 5 8 8 4 3 3 2 to 3 3 to 4 3 to 3 once the recording of the pocket beds has been accomplished I would then proceed to record the level of the free gingival margin in relationship to the cementoenamel junction on those teeth with pockets or those teeth with gingival recession and the teeth would qualify in that category would be any tooth that has a gingival margin apical to the cementoenamel junction I would begin on the first tooth here that has pocket depth recorded and on measuring from the distal of tooth number 2 we the first measurement is 2 millimeters the PRE gingival margin is 2 millimeters from the cementoenamel...

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Perio charting forms must be completed by a dental healthcare professional, such as a dentist, dental hygienist, or dental assistant.
1. Begin by noting the patient's name at the top of the form. 2. Using the numbered chart, locate and mark each of the patient's teeth with a "T" for tooth and a number corresponding to the tooth number. 3. Fill in the chart by noting the current condition of each tooth. For each tooth, you will need to record the pocket depth, furcation, and the presence or absence of bleeding, calculus, and recession. 4. Fill in the box marked "Other" for any other abnormalities or conditions that should be noted. 5. Once you have completed the form, review it to ensure that all teeth have been marked and that all information is accurate and complete.
Perio charting forms are used to help dental hygienists document the health of a patient's gums, teeth, and other structures of the mouth. They are used to track the depth of periodontal pockets, monitor the progression of periodontal disease, and assess overall oral hygiene.
The deadline to file perio charting form in 2023 will depend on the guidelines of your local dental board. Please contact your local dental board for specific information.
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