Post on 17-Mar-2018
109110
108
107
105106
406405
408
407
209210
208
207
205206
104 204
409
410411
404
306305
308
307
309
310311
304
103 203102 202
101 201
403 303402 302
401 301
canine
canine
1st premolar
1st premolar
2nd premolar
2nd premolar
3rd premolar
3rd premolar
4th premolar
4th premolar
1st molar
1st molar
2nd molar
2nd molar
3rd molar
1st incisor
1st incisor
2nd incisor
2nd incisor
3rd incisor
3rd incisor
client namepatient name
date
#
Right maxillary Left maxillary
Right mandibular Left mandibular
Canine Dental Chart
© Veterinary Information Network / design by Tamara Rees
109 209110 210108 208107 207106 206105 205104 204103 102 101 201 202 203
409410411 408 406407 404405 306305304 307 309308 311310403 402 401 301 302 303
professional teeth scaling/polishing
Procedures and Treatments
plaque barrier gelplaque barrier sealantlocal antimicrobial application
endodontics
restorations
extractions
oral surgery
orthodontics
periodontics
Exam and Findingspresenting complaint
periodontal disease test strip
perio pockets
gingivitis Index plaque Index calculus Index occlusion class
gingival recession
osseous recession
mobile teeth
missing teeth
fractured teeth
radiographs taken
other pathology / findings
0 1 2 30 1 2 30 1 2 30 1 2 3 4
0 1 2 3 4 5
future treatment plan
recommended home care products