Patient Name 7. CA (F) Age 3¢ File # Date of Evaluation ATTITUDE & DISEASE STATUS ATTITUDE (Patient Self Assessment) willing to change the way you care for your oral health? DISEASE STATUS MAYBE=B = NO=C€ x DISEASE STATUS (Clinician Assessment) 1 No current disease “ATTUDE CD = Nepterpa mtrans Active disease SALIVA RESTING SALIVA STIMULATED SALIVA 47 Sees 2.4 HYDRATION viscosiry pi Quanity pH reser JQ sity isviny OQ 9 O® an@® «O@ nee IQ tommy MQ os TQ | rnsmKQ of OQ ane OQ acer OQ os IO soni @ 4.306 24 urFeRNG oss O®@ spo onme B® 10 pte PLAQUE BACTERIA , DIET é ot exposure in between meats PLAQUE pH 'S. MUTANS Coury SUGAR ‘ACID ois @ > 200.000 cis |@ my < AAA Fede % os noe ~O®@ «k® +42 zives 1@ = Z@ 2009 GC ASIA DENTAL PTE LTD Modified with permission from Preservation & Restoration of Tooth Structure 2 edition