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BACTIFENSE for the WARFIGHTER

Daily Oral Care Routine Tracking

BACTIFENSE FRESH START PROGRAM TRACKER

Date*

Month

Day

Year

Participant # (Create 4 digit code here) *

My Oral Health Professional Sponsor:*

Please Select Your BACTIFENSE Program Category*

5- Day Refresh Program

10-Day Fresh Start Program

14-Day Pro-Care Program

Please check off the day of the program you are on below:*

Day 1

Day 2

Day 3

Day 4

Day 5 (5-Day Refresh Plan)

Day 6

Day 7

Day 8

Day 9

Day 10 (10-Day Fresh Start Plan)

Day 11-

Day 12-

Day 13-

Day 14- (2 Week Pro-Care Plan)

MORNING SWISH COMPLETED

YES

NO

AFTERNOON SWISH COMPLETED

YES

NO

EVENING IRRIGATION AND SWISH

YES

NO

Add Daily Report Comments Here:

Please read over the below list and check off the box that most closely describes your current gum health condition, (1-10).*

1. Severe Bleeding: Frequent bleeding, extreme tenderness, visible gum damage.

2. Significant Bleeding: Moderate bleeding during brushing or swishing.

3. Mild Bleeding: Light bleeding, occasional discomfort.

4. Inflamed Gums: Red, swollen gums with no bleeding.

5. Tender Gums: Mild tenderness, improved color and texture.

6. Improving Recovery: Minimal redness, occasional sensitivity.

7. Stable Recovery: Pink gums, firm texture, no tenderness.

8. Healthy Appearance: Fully healed, no sensitivity, good gumline.

9. Optimized Health: Strong gums, improved circulation.

10. Ideal Health: Perfectly healthy gums with no symptoms.

Please read over the below list and check off the box that most closely describes your current Breath Freshness Level, (1-10).*

1. Severe Odor: Persistent bad breath, noticeable to others.

2. Strong Odor: Frequent bad breath, reduced freshness.

3. Moderate Odor: Noticeable by self, slight improvement.

4. Occasional Odor: Mild improvement in freshness.

5. Neutral: Average freshness, no bad odor.

6. Freshening: Moderate improvement, pleasant taste.

7. Mildly Fresh: Fresh for several hours after swishing.

8. Mostly Fresh: Breath stays pleasant most of the day.

9. Very Fresh: Consistently fresh breath.

10. Ultimate Freshness: Breath remains odorless and clean all day.

Please read over the below list and check off the box that most closely describes your current Tenderness/Pain Level, (1-10).*

1. Extreme Pain: Severe discomfort interfering with eating or speaking.

2. Strong Pain: Persistent soreness, worsens with brushing.

3. Moderate Pain: Frequent discomfort, manageable.

4. Mild Pain: Occasional discomfort, improving.

5. Minimal Pain: Barely noticeable tenderness.

6. Slight Sensitivity: Gums feel better but slightly tender.

7. Recovering: No noticeable pain, mild sensitivity.

8. Pain-Free: Comfortable gums.

9. Strong & Comfortable: No pain, completely normal.

10. Optimal Health: Perfectly healthy gums, no tenderness.

Please read over the below list and check off the box that most closely describes your current Level of Concern About Oral Health, (1-10).*

1. Extreme Concern: Fear of significant dental issues.

2. Very High Concern: Constant worry about oral health.

3. High Concern: Awareness of potential problems.

4. Moderate Concern: Somewhat worried but improving.

5. Neutral: Balanced perspective, taking action.

6. Slight Concern: Improvement reducing anxiety.

7. Low Concern: Positive outlook on progress.

8. Very Low Concern: Confident in gum/teeth health.

9. Minimal Concern: Almost no worries.

10. No Concern: Complete confidence in oral health.

Please read over the below list and check off the box that most closely describes your current Program Satisfaction Level, (1-10).

1. Very Dissatisfied: Unhappy with results and experience.

2. Dissatisfied: Below expectations.

3. Somewhat Dissatisfied: Minor improvements noticed.

4. Neutral: Acceptable but not extraordinary.

5. Somewhat Satisfied: Decent progress.

6. Satisfied: Clear improvements, positive outlook.

7. Very Satisfied: Meeting expectations with good results.

8. Highly Satisfied: Great results, very pleased.

9. Exceptional Satisfaction: Beyond expectations.

10. Perfect Satisfaction: Outstanding results, highly recommended.

Breath Freshness Estimator

Gum Health Estimator

Tenderness/Pain Estimator

Oral Health Concerns

Daily Routine Completion

Day # of Program

ROME GUM ESTIMATOR.png

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Program Satisfaction

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BACTIFENSE

support@bactifense.com

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