It's titer.
I probably am not a good one to answer this because I think 1 visit with a vet that you don't like is enough. I would switch.
Titers are good to see immunity and he is probably wanting to see if her antibodies are going up but titers are a bit controversial to start with. You don't have to do them with puppy shots. I would probably do three sets 3-4 weeks apart starting after 8-9 weeks and preferrably after 12 weeks. If you start after 16 weeks, you only need to give 2 sets. I am into the whole vaccine/titer/immunity thing and I don't think I'd want to pay for them when your vet is still going to give just as many vaccines.
The periodontal shot is new and underreasearched. I have heard 1 bad report about it so far. There may be a place for this shot in older animals where the owners can't brush their teeth and the dog can't have a dental but I would use caution. Brush her teeth everyday and do dentals when they are necessary in my opinion. Yorkies do have teeth and gum issues and this shot could help but why shove more vaccines into them?
You can ask for an estimate before anything is done and make him tell you what he is giving. Ellie's vet knows how I am
, so she would never give anything without me agreeing.
Ellie saw four vets that just weren't what I was looking for before I found on that is more than awesome. Ellie's back-up vet is great too.
Don't just settle because if a major medical issue or emergency comes up, you need to be able to trust them and know that your pups are safe.
And please never let him give the rabies on the same day as another vaccine again. Rabies is responsible for quite a few reactions and it is better to separate vaccines. The most I'd consider giving at once is DHPP.