Case study 2 : High blood pressure
Med HX:59 year old Asian female BP 135.87(Hypertension stage 1) ASA 3.Patient reported she has high cholesterol with a CAC score of 172. Pt has high blood pressure and is not taking any medication for it. Patient prefers to manage her blood pressure with diet habits.
Den HX: Her last cleaning was in our clinic in September and 4HBWS were exposed at the time.Patient brushes twice a day with an electric toothbrush.
SOC HX: non drinker and non smoker
Oral examination : During the intraoral assessments the patient presented with bilateral mandibular tori and palatal tori. During dental charting the patient has a 10 % overbite, overjet 4mm and bilateral class 1 occlusion. Her periodontal status presented as generalized 2 to 3 mm pockets with localized 5mm in the molar areas, also localized recession of 1mm in the premolar areas. Generalized heavy subgingival calculus with localized supra on the mandibular anterior teeth. Her previous radiographs of vertical bitewings demonstrated generalized horizontal bone loss up to 10% with no carious lesions present and calculus in the premolar areas.
Treatment implementation: The patient was diagnosed with a heavy Stage 1 Grade B periodontal case. Due to her heavy buildup I decided to have her come back for two appointments for each side of the mouth . During each visit I ensured I was always taking her blood pressure before and after the appointment. I also made sure this patient was relaxed and talked to her during each procedure I was doing to reduce any anxiety. I also provided the patient with nutritional consulting since she manages her blood pressure through diet. I recommended her healthy foods like vegetables, fruits and whole wheat items. As most of her buildup was interproximal, I decided to have her homecare targeted in flossing methods. I recommended the patient a water flosser as it can be used for deeper pockets and reduce inflammation and bleeding. It is also easier to use for the patient as she prefers a more simple way to floss. Each appointment I taught her how to use the water flosser correctly so she can remove food debris. I also recommended a normal string floss as well using the c shape method. The patient was very satisfied with the treatment I provided and she should have less buildup in her next recall if she follows the homecare I provided .
