Periodontal Treatment Plan Template

• Does the template use 2017 AAP staging and grading?

  Yes. Staging (I–IV) and grading (A–C) are structured fields tied to your charting, so classification stays consistent case-to-case.

• Can I record full-mouth pocket depths and bleeding sites?

  Yes. Six-point pocket depths, bleeding on probing, recession, and mobility are captured per tooth and roll into the diagnosis.

• Does it handle SRP, surgical, and regenerative therapy in phases?

  Yes. Phase I (SRP), phase II (surgical / regenerative), and maintenance each have their own sequenced fields and consent block.

• How do I plan periodontal re-evaluation?

  Re-eval fields capture updated pocket depths, bleeding, mobility, and the decision to move to surgery or maintenance.

• Does it work for peri-implant maintenance and mucositis?

  Yes. Peri-implant probing, bleeding, and biofilm management protocols sit alongside natural tooth records.

• Can I schedule perio maintenance intervals from the plan?

  Yes. Set 3-, 4-, or 6-month intervals with next-appointment protocol and recall triggers linked to risk level.

• How is the plan shared with the referring GP or hygienist?

  Send a branded PDF, PIN-protected link, or email — GP, hygienist, and patient all see the same staging, plan, and cadence.

Frequently Asked Questions

• Interactive dental chart with Universal and FDI notation

• Phased periodontal sequencing tuned for staging and grading

• Itemized fees per appointment with insurance estimate fields

• Informed-consent blocks for risks, benefits, and alternatives

• Clinic branding with logo, address, and clinician details on every page

• Assigned tags and progress so clinic members can track case status

• Editable online, downloadable as DOCX or PDF, or sent via email or PIN-protected link

• Multi-language output for patients who prefer their native language

• Take a full perio history

  Capture smoking, diabetes control, medications, and prior perio treatment — the risk factors that drive grading and prognosis.

• Chart six sites per tooth

  Probing depths, recession, BOP, mobility, and furcation. Baseline the whole mouth before you plan therapy.

• Set AAP stage and grade

  Assign stage I–IV based on severity and complexity, grade A–C based on rate of progression, and a per-tooth prognosis.

• Sequence therapy in phases

  Phase 1 non-surgical, re-evaluation at 6–8 weeks, Phase 2 surgical if needed, then periodontal maintenance.

• Present risks, fees, and recall plan

  Explain why periodontal maintenance is not the same as a routine cleaning, itemize fees, and capture consent.

From Full-Mouth Probing to Signed Perio Plan in 5 Moves

Built for Perio & Hygiene-Driven Practices

• Full-mouth perio charting

  Pocket depths, recession, bleeding, mobility, and furcation on every tooth — six sites per tooth.

• AAP staging and grading

  Set stage I–IV and grade A–C once, and it prints on every version of the plan.

• Phased perio therapy

  Non-surgical, re-evaluation, surgical if needed, and periodontal maintenance sequenced with clear endpoints.

• Measurable recall

  Log baseline probing depths and BOP percentage so the patient sees progress at each maintenance visit.

Why Periodontists & Hygiene Teams Use This Template

• Periodontists

  A go-to workflow for structured periodontal treatment planning cases, from diagnosis through consent.

• Hygienists leading non-surgical therapy

  Keep case presentation consistent across periodontal cases without forcing one clinical style.

• General dentists managing periodontal cases

  Learn (or teach) case presentation with a template that mirrors real periodontal workflows.

• Multi-clinician practices standardizing perio recall

  Standardize how periodontal plans look across locations, so every clinic sends the same clean document.

Free Periodontal Dental Treatment Plan Template

• Non-surgical therapy

  Full-mouth SRP by quadrant, oral-hygiene coaching, and adjunctive antimicrobials with a re-evaluation date.

• Surgical periodontics

  Access flap, resective surgery, or regenerative procedures with materials and expected healing timeline.

• Periodontal maintenance

  3, 4, or 6-month recall with probing, re-charting, and risk-based prophy vs SRP decision.

• Perio–restorative coordination

  Crown-lengthening, biologic-width, and restorative sequencing when perio and restorative work overlap.

<p>Quick answers to what periodontists and hygienists ask about this template.</p>

Every perio case reads the same here: charting, staging, therapy, re-eval, maintenance.

The Anatomy of a Periodontal Case Plan

<p>Reviewed by periodontists and hygiene teams who run structured perio programs.</p>

• No credit card required

Plan SRP, periodontal surgery, maintenance, and peri-implant cases with structured pocket charting, staging & grading, and phased therapy — editable online and shareable as PDF, DOCX, or PIN-protected link.

What's Inside the Periodontal Template

Turn Every Perio Diagnosis Into a Signed Therapy Sequence

Periodontal Case Types It Handles

Periodontal Treatment Plan, Ready in Seconds

This Template vs a Standalone Perio Chart

Start free, then pay per credit with volume discounts — or unlock lifetime access to all features with a one-time payment.

<p>Free to try — no card, no install. Draft a phased perio plan in the browser.</p>

Non-surgical through regenerative — plus peri-implant maintenance in the same template.

Where a pocket depth chart ends and a real phased perio plan begins.