Scribd Logo
Upload

Welcome to Scribd!

  • 100 views

    Periodontal Case Study by Mae Viray

    Uploaded by

    api-610791922
    This patient presented with high risk factors for oral disease due to a history of smoking, poor homecare, and lack of dental visits. The treatment plan focused on non-surgical periodontal therapy, oral hygiene instruction, smoking cessation counseling, and restorative work. The goals were to improve periodontal health, reduce risk factors, and establish regular preventive care. At follow-up appointments the patient showed less inflammation and plaque, had responded well to treatment, and was motivated to maintain good oral hygiene habits. The dentist recommended ongoing periodontal maintenance to sustain progress.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Periodontal Case Study by Mae Viray

    Uploaded by

    api-610791922
    100 views27 pages
    This patient presented with high risk factors for oral disease due to a history of smoking, poor homecare, and lack of dental visits. The treatment plan focused on non-surgical periodontal therapy, oral hygiene instruction, smoking cessation counseling, and restorative work. The goals were to improve periodontal health, reduce risk factors, and establish regular preventive care. At follow-up appointments the patient showed less inflammation and plaque, had responded well to treatment, and was motivated to maintain good oral hygiene habits. The dentist recommended ongoing periodontal maintenance to sustain progress.

    Original Title

    periodontal case study by mae viray

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    This patient presented with high risk factors for oral disease due to a history of smoking, poor homecare, and lack of dental visits. The treatment plan focused on non-surgical periodontal therapy, oral hygiene instruction, smoking cessation counseling, and restorative work. The goals were to improve periodontal health, reduce risk factors, and establish regular preventive care. At follow-up appointments the patient showed less inflammation and plaque, had responded well to treatment, and was motivated to maintain good oral hygiene habits. The dentist recommended ongoing periodontal maintenance to sustain progress.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    100 views27 pages

    Periodontal Case Study by Mae Viray

    Uploaded by

    api-610791922
    This patient presented with high risk factors for oral disease due to a history of smoking, poor homecare, and lack of dental visits. The treatment plan focused on non-surgical periodontal therapy, oral hygiene instruction, smoking cessation counseling, and restorative work. The goals were to improve periodontal health, reduce risk factors, and establish regular preventive care. At follow-up appointments the patient showed less inflammation and plaque, had responded well to treatment, and was motivated to maintain good oral hygiene habits. The dentist recommended ongoing periodontal maintenance to sustain progress.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    You are on page 1of 27

    AGE:43

    Construction worker

    HH: 1-2 packs of cigarettes per day for 30 years,


    social drinker (3 alcoholic drinks per wk)
    LAST RDH VISIT: 14 years ago
    CC: bad breathe, sensitivity, chipped tooth, dry mouth
    HC ROUTINE: brushes 1-2 times per day, never flossed
    INSURANCE: first time insurance holder
    DIET: Fast Foods
    HC: 1-2 times daily, floss - 0 times

    IO: Leukoplakia on labial & buccal mucosa, white coated tongue, inflamed tonsils & uvula,
    nicotine stomatitis (hard palate).

    GD: Gen mod pigmented gingiva, rolled margins. Loc fibrosis, recession, & cyanosis.

    Hard Tissues: Gen radiographic calculus & Bone Loss, impacted 3rd molars. Attritions,
    abfractions, existing amalgam & composite fillings.

    Perio Assessment: Gen 3-4mm, Loc 5-6mm PDs, Class I-II Furc, class I MOB, 2mm MAG , gen
    3-4mm& 5-6mm CAL, 1-2mm GM, MOD calculus, Class III-IV perio classif, AAPIII-B, gen BOP.

    Plaque Index: 33%

    Caries Risk: HIGH Periodontal Risk: HIGH Oral Cancer Risk: HIGH

    Low Dental IQ/Motivation due to years of no established care (Insurance related)


    oh, hello
    there!
    Rationale for case
    selection:
    This patient was classified as a
    MOD-III , II-B. Periodontal
    findings include gen 4mm
    pocket depths w loc 5-6, BOP,
    class I-II furc involvement,
    recessions, MAG/NAG, and
    mobility. He has been smoking
    cigarette for the last 30 years
    and his last cleaning was 14
    years ago.
    1 • Demo Modified Bass , c-wrap
    TREATMENT PLAN: flossing
    • Recommend e-toothbrush, H2o
    floss
    • Talk about Periodontitis
    OHI + Perio Education
    Ef conc 2 • 4% Articaine w/epi (1:200,000)
    Pain Mgt+ NSPT+ antimicrobials
    • D4341 UR
    Diet/Nutrition & Smoke • D4341 LR + Arestin
    Cessation Counseling • D4341 UL + Arestin
    Restorations/Referrals • D4341 LL + Arestin

    🧐Re-eval Appointment 3 • Cariogenic VS Cariostatic Foods


    🦷PM • Talk about Oral Cancer
    • NRTs (patches, lozenges, gums,
    inhaler, Bupropione medication)

    4 • Class IV Composite #6 #8 #9 due


    A to fracture
    D0170 4-6 weeks post SRP + NaF varnish • Refer pt for buildup & crown #19
    5 #3 due to decay
    + xylitol & Fluoride Rx +NG
    D4910 every 3 months for a year, and then • Refer for extraction of impacted #1
    6 #16 #17 #32
    every 6 months thereafter
    DESIRED OUTCOME:

    Adequate Anesthesia/ Pain Management

    Great Healing post NSPT

    Smoke-Free

    Wisdom Teeth Extraction

    Regular RDH visit (3-month recall)


    DESIRED OUTCOME:

    Manage Perio Disease and Restore Periodontal Health


    ⬜decreased inflammation, BOP & PDs
    ⬜remove calculus buildup
    ⬜increased salivary flow
    ⬜improve plaque score
    ⬜arrest decay/restore teeth
    ⬜kill bacteria
    ⬜ Stop further wear (attrition, abfraction)
    ⬜Improved HOMECARE ⬜stable CAL
    NSPT: UR/LR/UL/LL SRP with
    Articaine 4% (1:200,000)

    Composite fillings w/ LA
    INITIAL
    THERAPEUTIC
    STRATEGY Nicotine Replacement
    Therapies

    PREVENTION EDUCATION STRATEGY:


    at 3rd & 4th SRP
    at 1st and 2nd SRP appointment due to bad
    appointments due breath caused by bacteria,
    to gen IP plaque buildup (white coated tongue)
    at 4-6 wk re-eval
    appointment,
    due to gen plaque
    buildup from
    ineffective brushing
    technique
    INSTRUMENTATION STRATEGY:
    MANDIBLE
    Cavitron ultrasonic all surfaces
    orban files- tenacious calculus D of 3rd molars
    17/18 distal of 3rd molars or terminal molars
    13/14- distals of post teeth
    7/8 for the buccal & lingual of posterior teeth.
    11/12 for the mesials of posterior teeth and F, D & M of anteriors.
    ½ gracey & Sickle scaler – anteriors.
    furcations

    MAXILLARY
    Cavitron ultrasonic all surfaces
    orban files- tenacious calculus D of 3rd molars
    BH 6/7 – all posterior surfaces
    7/8 for the buccal & lingual of posterior teeth.
    ½ gracey & Sickle scaler – anteriors.
    furcations
    Consent Forms signed prior to TXT..
    11/11/21 1/20/21 2/14/22 2/28/22 5/9/22
    Svs/TX Initial HH, HH, C-NPE, OHI, Reassessed LR, OHI, OHI, UR C-4341
    Ts NPEs, RAD, Pt Class, LR D4341 UR D4341 w/LA w/LA
    Comple DDS Exam, w/LA
    ted OHI,
    counseling.
    TXT No revisions No GG did not work due to Too many errors upon No revisions
    revision revisions positive aspirations, scale checkout,
    s contacting too early. planned on calc map &
    & (due to pt anatomy rescaling of UR on
    justifica and technique error). next appointment
    tion Gave IABL instead.

    Pt care Pt glad to Pt Pt responded very well Pt’s teeth “look n feel Pt responded well
    & have oral motivated to txt, expressed great”. LR tissue to txt.
    feedbac cancer to . Will interest in coming back healed well. Pt “have
    k screening try quit-line for next SRP . He got been flossing @ least
    done for the service, numb. NAR. once daily.
    first time. NRT.
    Pt Discussed the Discussed OHI on c-wrap flossing Pt showed Recommended
    progress importance of importance due to gen plaque improvement in E-toothbrush
    & knowing oral of XRAYs in buildup IP. flossing technique and bec of gen plaque
    preventi
    ve
    cancer risks/ diagnosing. plaque index score. buildup, 👎 pt
    measure S&S. compliance &
    s lifestyle.
    Expectations:
    HH: currently using nicotine patch and lozenges and Replacement Therapy

    EO: WNL

    IO: white coating on tongue and nicotine stomatitis have disappeared

    GD: Gen pink, pointed, knife-edged, stippled gingiva.

    Plaque score: <20%.

    FPA: Gen 3mm, no BOP, stable furcations & recessions.

    OHC Outcomes: Pt twice daily w/ e-toothbrush , once daily, and more effectively with the absence
    of plaque buildup IP & all over the gumlines. (improved plaque score, PDs, GD, and lesser BOP)
    Therapeutic Outcomes: Tissues looking great and healed well. Pt satisfied, and looking forward
    to his PM appointments .

    Future Care Recommendations: 3month recall for a year or until stable, and then 6 months
    interval thereafter . Will schedule fillings to be done on Sem 6, & follow up other referrals.
    .
    SUMMATIVE EVALUATION OF THERAPEUTIC & PREVENTIVE OUTCOMES

    I learned that patients are motivated by results and by realizing that there is
    actually a problem that needs to be addressed.

    E.g pointing out problem areas using a mirror or radiograph. perio education
    using layman’s term.

    For this pt who is a smoker, educating him about the adverse health outcomes
    related to smoking and how the changes in his mouth (IO exam) can be
    determining factors for oral cancer is impt. Also educating him about the many
    resources available to help him quit like counseling, quit-line services, and
    NRTs are great! I hope that he will be successful in his journey to quitting. I
    hope to see him in his upcoming SRP appointments, and in restorative clinic.
    Hoping to see him on his re-evaluation appointment to also follow up referral
    for crown, and extractions.

    You might also like