Printable periodontal chart
A blank perio chart for all 32 adult teeth, laid out the way most dentists here record it: mobility and furcation for each tooth, then bleeding on probing, plaque, gingival margin and probing depth at three sites on the buccal side and three on the palatal or lingual side. FDI numbering, A4 landscape.
Add the clinic and patient below if you like, or leave them blank and write by hand. Then print it or save it as a PDF.
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| Buccal | ||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Mobility | ||||||||||||||||||||||||||||||||||||||||||||||||
| Furcation | ||||||||||||||||||||||||||||||||||||||||||||||||
| BOP | ||||||||||||||||||||||||||||||||||||||||||||||||
| Plaque | ||||||||||||||||||||||||||||||||||||||||||||||||
| Ging. margin | ||||||||||||||||||||||||||||||||||||||||||||||||
| Prob. depth | ||||||||||||||||||||||||||||||||||||||||||||||||
| Tooth | 18 | 17 | 16 | 15 | 14 | 13 | 12 | 11 | 21 | 22 | 23 | 24 | 25 | 26 | 27 | 28 | ||||||||||||||||||||||||||||||||
| Palatal | ||||||||||||||||||||||||||||||||||||||||||||||||
| Prob. depth | ||||||||||||||||||||||||||||||||||||||||||||||||
| Ging. margin | ||||||||||||||||||||||||||||||||||||||||||||||||
| Plaque | ||||||||||||||||||||||||||||||||||||||||||||||||
| BOP | ||||||||||||||||||||||||||||||||||||||||||||||||
| Furcation | ||||||||||||||||||||||||||||||||||||||||||||||||
| Lingual | ||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Mobility | ||||||||||||||||||||||||||||||||||||||||||||||||
| Furcation | ||||||||||||||||||||||||||||||||||||||||||||||||
| BOP | ||||||||||||||||||||||||||||||||||||||||||||||||
| Plaque | ||||||||||||||||||||||||||||||||||||||||||||||||
| Ging. margin | ||||||||||||||||||||||||||||||||||||||||||||||||
| Prob. depth | ||||||||||||||||||||||||||||||||||||||||||||||||
| Tooth | 48 | 47 | 46 | 45 | 44 | 43 | 42 | 41 | 31 | 32 | 33 | 34 | 35 | 36 | 37 | 38 | ||||||||||||||||||||||||||||||||
| Buccal | ||||||||||||||||||||||||||||||||||||||||||||||||
| Prob. depth | ||||||||||||||||||||||||||||||||||||||||||||||||
| Ging. margin | ||||||||||||||||||||||||||||||||||||||||||||||||
| Plaque | ||||||||||||||||||||||||||||||||||||||||||||||||
| BOP | ||||||||||||||||||||||||||||||||||||||||||||||||
| Furcation | ||||||||||||||||||||||||||||||||||||||||||||||||
How to fill it in
Probe six sites per tooth: mesial, middle and distal on the buccal side, and the same three on the palatal or lingual side. Write the probing depth and the gingival margin in millimetres, tick the bleeding and plaque boxes for the sites that bleed or carry plaque, and note mobility and furcation per tooth. The grey furcation boxes are for teeth that aren't molars.
Probing depths of 1 to 3 mm are usually healthy; 4 mm and deeper are pockets to watch, and the sites that bleed tell you where inflammation is active. For the summary at the bottom, BOP % is the number of bleeding sites divided by the number of sites you probed.
Making paper charts less painful
Have the assistant write while you probe and call out the numbers, tooth by tooth in the same order every time. Chart the upper buccal row first, then palatal, then lower lingual and buccal. Keep the chart in the patient's file and date it, so you can compare the re-evaluation with the initial exam.
The same chart, without the paper
FindClinica has this chart built in, with the same rows. Click a site and pick the number; deeper pockets are coloured so they stand out. Each chart is saved as an Initial Exam, Re-evaluation or Maintenance, the app works out the mean probing depth, and you can print it as an A4 PDF for the patient. More about the perio chart.

Common questions
Does it include primary teeth?
No. Periodontal charting is for the 32 permanent teeth; for children, use the printable dental chart, which has the milk teeth.
Can I print it on A4 portrait?
It's designed for landscape so all 16 teeth of an arch fit across the page. The print button sets landscape for you.
Why are some furcation boxes grey?
Furcation is recorded on molars. The grey boxes are for incisors, canines and premolars, so there is nothing to write there.
Read next
- Printable dental chart
- How to use the perio chart in FindClinica
- Dental clinic software in Pakistan
- All free tools and templates
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Free tools and templates
Chart perio in half the time
Tap a site, pick a number, and FindClinica keeps every chart on the patient's file. Free plan, unlimited patients.