Bright Hollow Family Dental

Gentle care for every smile
2140 Maplewood Avenue, Suite 3
Burlington, VT 05401
(802) 555-0173
brighthollowdental.example
Personalized Treatment Plan
Chart No.
BH-4821
Plan Date
March 4, 2026
Next Visit
March 18, 2026
Patient
Elena VargasDOB 06/12/1988 · Patient since 2019
Treating Dentist
Dr. Priya Nadkarni, DDSWith hygienist Tomás Vela, RDH
Care Window
3 visits · ~6 weeksHygiene → restorative → review
What we foundExam · 03/04/2026

A thorough exam and full-mouth X-rays show <b>moderate (Stage II) periodontitis</b> — gum inflammation with early bone loss, most active in the back teeth. Two older teeth also have decay beneath the gumline that needs restoring before it reaches the nerve.

The good news: caught at this stage, periodontitis is very manageable. With a deep cleaning and a steady home routine, we expect the gums to firm up and the bleeding to stop within weeks.

#14
Upper-left molar — <b>deep filling needed</b> (decay below an old restoration)
Restore
#19
Lower-left molar — <b>decay reaching dentin</b>, composite filling
Restore
Gen.
Generalized <b>4–5mm pockets</b> with bleeding on probing, posterior sextants
Treat
Gum Health · Pocket Depth
4.6
Now (mm)Avg. pocket depth today
3.0
Goal (mm)Healthy target · 6 wks
Our goals togetherMeasurable · Time-bound
1
Stop the gum bleeding and inflammation
Reduce bleeding-on-probing to under 10% of sites and bring average pocket depth from 4.6mm to 3.0mm.
By 6 weeks
2
Restore teeth #14 and #19
Place two composite fillings to remove decay and protect the nerve, restoring full chewing function with no sensitivity.
By visit 2
3
Build a lasting home routine
Establish twice-daily brushing and daily interdental cleaning so gum health holds between visits and at the 3-month recall.
Ongoing
The plan, step by stepFrequency
01
Visit 1
Scaling & root planing (deep cleaning)
Remove plaque and tartar above and below the gumline across all four quadrants under local anesthetic, then polish and apply fluoride.
1 session
~75 min
02
Visit 2
Composite restorations · #14 & #19
Remove decay and place two tooth-colored composite fillings, checking the bite and finishing for comfort.
1 session
~60 min
03
Home
Daily home-care protocol
Brush 2× daily with a soft brush, clean between teeth daily, and rinse as directed — we'll send you home with a personalized kit.
Daily
Ongoing
04
Visit 3
Re-evaluation & 3-month recall
Re-measure pockets, confirm bleeding has resolved, and set your maintenance hygiene interval.
1 session
~45 min
Your appointment schedule3 visits
Mar 18
Visit 1
Deep cleaning · upper & lower left
Apr 1
Visit 2
Fillings #14 & #19 · upper & lower right cleaning
Apr 15
Visit 3
Re-evaluation & recall planning

Estimated investment

Scaling & root planing (per quadrant ×4)$880
Composite restorations (×2)$420
Re-evaluation & fluoride$140
Total before insurance$1,440

Consent to treatment

I've reviewed this plan with my dental team, understand the recommended care, and consent to proceed. A copy of this plan is mine to keep.

Patient signature
Dr. Priya Nadkarni, DDS · Date
Bright Hollow Family Dental · 2140 Maplewood Avenue, Suite 3, Burlington, VT 05401 · (802) 555-0173 · brighthollowdental.example
Questions before your next visit? Call us any weekday — we're happy to walk through anything on this plan.