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ELAINE
JESSE GROSSMAN
DH 222
CLINICAL DENTAL HYGIENE
medication.)
A1C was 7.5 2 months before evaluation appointment. (Patient sees physician every 3
months.)
Patient has high cholesterol. (Controlled with medication.)
appointments.
Trazadone- SSRI Antidepressant (sleep aid)
Considerations: Patient may experience xerostomia. Use vasoconstrictors with caution.
# 28 fractured
Recommended for full crown. *(MODBL composite.)
# 13 recurrent decay
Recommended for MOD amalgam.
* Dentist ended up restoring #12 and #28 because patient said she would rather have them extracted
than pay for a crown because she could not afford it.
lingual of #31.
Contour- Generalized slight moderate blunting of papilla.
Consistency- Generalized slight moderate edematous.
Bleeding- Generalized spontaneous upon probing. 24 teeth/144 sites
Clinical Assessment Markers- Furcations, mobility, recession, IAG.
Recession
Generalized moderate bone loss (Case type III)
Furcations
IAG
husband.
Interventions:
Patient was educated on proper home care.
Patient will start brushing at least one time per day.
Patient will start scheduling regular dental visits. It is recommended once every 4 months.
Expected Outcomes:
Patient will develop the motivation to starting taking better care of her teeth.
Patient will hopefully start brushing daily and visiting the dentist regularly, as recommended.
Restorative Recommendations
microscope, Oraqix
Patient was too sensitive to perio chart, even with the Oraqix, so we made the decision
she had a diabetic incident. Dr. W and staff treated as though she had low blood sugar
(hypoglycemia), but it turned out that her blood sugar was very high. This was a great
learning experience because we learned that during diabetic incidents it is better to
assume that the person has low blood sugar because it will not harm a hyperglycemic
patient to give them more sugar, however if you fail to treat someone with low blood
sugar they can go into a diabetic coma.
visits.
OHI- work longer in the posterior and angle water flosser
05/12/16 Restorative, LA
#12 MODBL with pins
placed (composite)
#13 MOD (amalgam)
Statement of Inflammation- Generalized normal with localized inflammation around #24 and #25
Microscope- risk factor B, spirochetes, vibrio, cocci (not too many to count).
Before
After
Restorative Recommendations
She had reported brushing 1-2 x per week at most. She saw an ad in the newspaper and knew
she should come into the clinic. Her motivation was the fact that her gums were bleeding
when brushing, her husband complaining of her bad breath, and the fact that her husband had
all of his teeth extracted a few years prior (which she was trying to avoid).
After treating Elaine, I realize that she is someone who loses her motivation quickly. I
recommended her to be seen for 3 month perio maintenance appointments with a dentist of
her choice. At this point, Elaine is doing a good job with home care and definitely has the tools
she needs to stay healthy, but it will ultimately be up to her.
Elaine is concerned with her type II diabetes and knows that having active periodontal disease
intensifies the systemic effects. She also knows the effects diabetes can have one her
periodontal disease and this was a big motivator for her.
crazy on OHI and she is now using an interproximal cleaner and electric toothbrush. Although
I explained to her what I learned in a textbook during my Periodontology class: The most
important thing she can possibly do would be to come into the dentist every 3 months or as
often as she can. My guess is that she is not someone who will ever be diligent about brushing
and flossing. If we can keep her coming back we can re-motivate her so she will keep up on her
daily home care and regular dental visits.
Periodontist consultation would be highly beneficial if patient was willing to go!
I feel like there is not a lot I would change with the treatment of this patient, however, I would
hope that she would find the internal motivation to make good choices for herself that will
sustain a healthy life.