The patient under examination was a 78-year-old Caucasian woman who presented to our facility seeking dental care. As I began by recording her blood pressure, which was 121/88, accompanied by a pulse of 77, indicating hypertension stage 1 (dental treatment is still allowed). She had come in seeking regular dental maintenance. While reviewing her medical history, she mentioned two medications she was taking: Atorvastatin 20 mg for high cholesterol and Valacyclovir 500 mg for occasional herpes outbreaks.
During the comprehensive oral exam, she disclosed experiencing dry mouth, a condition known as xerostomia, which is likely a side effect of the medication Atorvastatin. Knowing that she experiences dry mouth, I recommended to use Biotin oral rinse which aids in immediate dry mouth symptom relief. Taking note of her oral home care routine, I learned that she uses an electric toothbrush with Prevident 5,000 toothpaste exclusively. Upon a detailed dental overview, I observed mild inflammation, attrition, class II embrasure spaces, and severe generalized recession. The periodontal evaluation which measures the gums depths, revealed generalized probing depths ranging from 1 to 3 mm ( which is okay and indicates no suspicion for possible bone loss); localized 4 mm pockets, localized furcation ( which visually you see the “normal” gum line exposing the root of the tooth); and moderate to severe bleeding upon probing ( which indicates there being bacteria and tarter build up inside of her gums).
Upon further oral assessments, I was not able to obtain her plaque score since she had multiple veneers but based on my findings, it became imperative to make specific modifications to her oral hygiene regimen. I took the time to thoroughly explain to the patient the importance of using a soft-bristled brush, considering the severity of her recession and to incorporate the Biotene oral rinse to reduce the feeling of having a dry mouth.
The patient expressed gratitude for the information provided, as it shed light on how she could optimize her oral hygiene practices. Moreover, she expressed satisfaction with the thoroughness of her dental cleaning which I was able to complete within the one visit. It was rewarding to see her leave with a sense of empowerment and a renewed commitment to maintaining her oral health.
