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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 –