eee » student__[wua fui Faure _ vate Q-12-1S- acer re PN cor Legare “io ) GRADING CRITERIA: A score of 1 will be given if no significant errors are identified. A score of % will be given if 1-3 significant errors are identified. A score of 0 will be given if required information is missing of deemed inaccurate by the instructor. _L 1. Patient information is present. LL 2. medicat History findings are present. 1 3, medical History sks are identified. a sociat and Dental history findings are present. 1.5. Social and Dental history risks are identified. bs. Dental Examinations findings are present. 7. Dental Examination risks are present. 8. Plaque score calculated correctly. Isl 9. Bleeding score calculated correctly. _ 10. Periodontal information assessed correctly. pelertut fe feu 111. dental hygiene diagnosis problems stated correctly 112. Dental hygiene diagnosis risk factors or etiology stated. _L13. Planned intervention education stated clearly for each clinical finding _L14, planned intervention oral hygiene is appropriate fr each cnc finding. = 15. LTG 1 stated clearly. 16.STG 3 goals stated appropriate for LTG 1 4 17. LTG 2 stated clearly Vie STG 3 goals stated appropriate for LTG 2 _1 19. 116 3 stated clearly. ' 50 st@ 3 goals stated appropriate for LTG 3.1, Prognosis } 22. Prognosis explanation, £23. Appointment - planned treatment _! 24. appointment plan education, counseling or OHI 25. Referrals listed if necessary. 26. Recall Interval. hn Aawore of toy. Turned in on time. 20s ose () Possible points (27) 92-100-A 83-91-B 75-82 -C 74 and below F