perio status
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What is your Perio Status?Patient
Primary purpose is to provide quality
dental hygiene care to all patients,
while recognizing and respecting the
dignity of each individual.
To provide oral health care needs in
today’s ever changing world.
Blood Pressure Readings
Date:Blood Pressure:Date:Blood Pressure:Date:Blood Pressure:Date:Blood Pressure:Date:Blood Pressure:Date:Blood Pressure:
Oral Hygiene Instruction & Specific Adjunct
Brushing 2x day for 2-3 minutes
Manual ToothbrushDepartment Stores - $1-
$15
Electric ToothbrushDepartment Stores/Online - $20-$300
Flossing 2x day
Floss & Floss Picks
Department Stores
Laser*Done at Dental Office
Chemotherapeutic Considerations
Toothpaste
Over the counter
toothpasteDepartment Stores - $5-$20
Rx
MouthwashOver the counter mouthwashDepartment Stores - $10-$20
Rx MouthwashDentist will show a need for this mouthwash
Spry Moisturizing SprayStreu’s Pharmacy635 Main St.Green Bay, 920-437-0206
Recare Intervals Prophy – Pts. have healthy,
gingivitis and/or maintained home self-care. Pts. are asked to come every 6 months for oral hygiene appt.
Periodontal Maintenance –