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e ese Dental Charting | coin. Competency Examination [wea | Clinic | | Product a ee el Student Name: THUOTOR LVL [Grade //PaS8__~FAL Team omrden Wea apaatiaanamihe eee ai aeroas toa | 4. Assembleamirorand exlorer Glvlo 2. Uted ig miner cmretad a andraogagne a alt xarihaion Nino 3. Recorded caries 7 {fri ulo ulo e 5 Recorded coclusion correctly is ulo 6 Mattanedefecon conto standards {alulo | ironman * (aloe Dental Charting Competency Examination : Sacks 1. oN orpisns, Periodontal Assessment ¢ [7¥, Gouitce Competency Examination aloe — Clinic | or Ill Product Circle the Pationte Oral Health Statue Below: Oral Healn States | Gingivils Periodontitis | Gereraied Localized | Aci Chronic ieatny © sion | Madera Severo 40 arse fe tt Se Raa ‘asiicatons of pedertal dsease nein paints who exit modento tosovereporedarialdeesee ‘Standard 4 [1 ceternned ie event ofan and acs resent Rue] wa 2 Asura dseibed he gga hve 2. res exis eestn of mn mths Cd afule @. Resarasobianed and recorded sx (6) readhgs per tooth epaaaring he >] yo _* feeeaneacue ain SI eons an docunenies inal Bedna (elo 6._ ene nd docunentad oth mobi and emia alele 7. Keni an docunentetucaioninvotenentofGissiiorgeater | A U|o _Wainioiedinecton one stanade a] ue [wa Alulo &Wainiined Professbnaism ata tes ik annem = T (ere Oe’. | Evaluating Faculty Signature: — ~~ Periadontal Assessment Compotoney Examination ee Selective Polish, Floss, Fluoride Soke inti couse Competency Examination “Dental Hygiene — Clinic 1 Process, Paton ore EL —— [ooie OUT Student Name: (OAK) LIRW. Grade: PASS) FAL RoR Reset a ae a Ral SRE A OH foam feaeeel Its psn cpio tooo ote manterminniaing rend eptnzig 7 glared we poor ee let v _Piabed saby gases on ten Glu 3._Inperentdcore ecngue cach plan nabod aaah v rrr aces no eiopronma an csv auras ePeGh@y w ._ User sspapte nein olny ese aclu 8 Ud avon posh on renies v TL Resed ough and martonedpeter riba iste 3 Seeaieaareore rg oss Tate Ped tse arouse mae far oToah Tard uv Sid oss wand down toh surface, while hong fous fry agar te prorat wane ‘anced Tos 0 pew -sed portn ore pale to he nae se Disciosed and rectecked fr any remsining plaque andr stain ard remioved Infred iter 9 fueise process elolofofefelelofalalelolelelele Apsied tise varin sacoctet Tnebuced stent experate as tauaht aitaineerfesionalan atl ies Evaluating Faculty Signatur: Selective Polish, Floss Fluoride Eonjpetency Examination

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