Dental Health Report
Dental Health Report
![](https://assets.topworksheets.com/3c373852-c35e-4805-91d9-e4d9553684d9/image/9536f45a-37ac-40fc-9f9a-97582a264544.jpeg)
Patient’s name
Age
The following treatment was completed today
Complete Exam
Periodontal Exam
Cleaning / Fluoride
X-ray
Cavity restoration
Oral hygiene findings
Plaque
Tartar/calculus
Bleeding gum
Inflamed gums
Your Grade
Hygiene recommendations