Demographics:

Patient M.H, 24 years old, Heavy Type II

 

Assessment:

Patient has no significations in medical history to report. His vital signs were within normal limits Blood pressure: 118/66 and pulse 60.
Patient is non-smoker
No premedication’s required.
No systemic conditions.
No medicines are currently prescribed or being taken.

 

Oral Pathology:

Extra-oral and Intra-oral patient has no significant findings. He has submandibular tori.

 

Dentition:

Patient has class I occlusion, 0mm overjet, and 0% overbite. Anterior teeth are edge to edge. Teeth #22 and 10 have a cross bite.

No missing teeth and no restorations

Patient had no suspicious lesions.

 

Periodontal:

Patient has generalized areas of red moderate inflammation around the teeth.

Case type II, had 3-5mm Probing depths, moderate bleeding upon probing, no recession was present.

 

Oral Hygiene:

Patients initial Plaque score was good .6
Patient had generalized subgingival calculus and supragingival calculus on mandibular anterior’s.
In session one I taught him tooth brushing using a soft manual toothbrush. We discussed the Modified Bass Method. In session two, he showed success with his brushing technique. I showed him flossing with regular floss.

 

Radiographs:

Yes the patient is required to take full mouth series radiographs because the patient had never taken any radiographs before.

Not relevant because no radiographs were taken

 

Treatment Management:

In the first visit I finished all assessments and scaled 3 teeth in the lower right quad using hand scaler. Second visit we went over oral hygiene instructions and scaled lower right, upper right, and lower left quadrant using the ultrasonic and hand scalers. Third visit I scaled upper left quadrant, polished and did the fluoride 4-minute tray system treatment.

No medical, social or psychological factors that impacted the treatment.

For home care the first aid recommended was using a soft toothbrush and using the modified stillman method because the patient hasn’t been brushing properly and was skipping the lingual areas.

I felt my strength was being able to scale away that tenacious calculus that was underneath his tight contacts, when the professor saw that I was able to take it all out she was very proud of me and had told me that I did an excellent job.

I had trouble teaching my patient how to floss because he had very tight contacts and he had calculus stuck in between the contacts so the professor had said I should scale first and then teach him how to clean that interproximal area.

No referral was needed.

 

Evaluation:

At first when teaching the patient the importance of oral care he was laughing at the thought of it, he didn’t seem to think it was serious, but as I kept explaining to him, and showing him the possible outcomes of diseases he started to understand better and comply with me more.

His gingiva was red and inflamed he had moderate bleeding, by the third visit his gingiva became less inflamed and he had less bleeding and his tissues were firm and resilient.

 

 

 

 

Reflection:

I think everything went well and I wouldn’t have changed any part of it.

Yes I accomplished everything I had planned educationally and mechanically.

 

Demographics:

Patient N.K., 44 years old, Medium Type II

 

Assessment:

Patient has no significations in medical history to report. Her vital signs were within normal limits Blood pressure: 102/64 and pulse 74.
Patient is non-smoker
No premedication’s required.
No systemic conditions.
No medicines are currently prescribed or being taken.

 

Oral Pathology:

Extra-oral and Intra-oral patient has no significant findings. Patient has a bilaterally scalloped tongue due to grinding.

 

Dentition:

Patient has class I occlusion, 1mm overjet, and 10% overbite.

Missing teeth #1,2,5,13,15-17,29,30,32, multiple occlusal composite restorations, and multiple Porcelain fused to metal crowns and bridges #3-6, 12-14, 20, 28-31.

Has general attrition

Patient had suspicious lesions on mesial of #7,19

 

Periodontal:

Patient has generalized areas of moderate inflammation around the teeth and margin apical to CEJ, rounded edges, fibrotic tissue. Bulbous papilla localized on mandibular anterior’s.

Case type I, had 4-5mm Probing depths, moderate bleeding upon probing, had generalized 1mm gingival recession.

 

Oral Hygiene:

Patients initial Plaque score was good.
Patient had localized subgingival calculus and supragingival calculus on mandibular anterior’s.
In session one I taught her tooth brushing using a soft manual toothbrush. We discussed the Modified Bass Method. In session two, she showed success with her brushing technique. I showed her flossing with tuft floss because she had a lot of spaces and interproximal plaque also for under the bridges.

 

Radiographs:

No the patient doesn’t require to take radiographs.

Not relevant because no radiographs were taken

 

Treatment Management:

In the first visit I was doing assessments and got up till probing. Second visit I took the Calculus detection exam and finished the assessments. Third visit went over oral hygiene instructions, scaled upper right quadrant using hand scalers. Fourth visit had to rescale upper right quadrant and scaled lower right quad using hand scalers. Fifth visit took the clinical skills exam. Scaled upper left and lower left quadrant using the ultrasonic and polished.

No medical, social or psychological factors that impacted the treatment.

For home care the first aid recommended was using a soft toothbrush and using the modified stillman method. The patient had been using a hard toothbrush with horizontal force, which caused generalized recession. It was difficult for her to learn the technique at first but then she got the hang of it.

I felt my strength was introducing the tuft floss, because my patient had bridges and she never knew that you clean underneath it. My faculty showed it to me first and I did the rest with no problem.

I had trouble teaching my patient how to brush correctly, she kept doing it wrong, and my professor had to re show it to her.

She was referred to the dentist for a dental exam because the last time she went was over 3 years ago.

 

Evaluation:

She was motivated to learn and changed her habits quickly.

Yes the patient got more interested throughout the progress, and she started to ask a lot more questions.

Patient has generalized areas of moderate inflammation around the teeth and margin apical to CEJ, rounded edges, fibrotic tissue. Bulbous papilla localized on mandibular anterior’s. After completion she had less gingival inflammation it was more of a pink color rather then red, it was more firm and resilient, and her papilla was still bulbous around her anteriors

At the beginning the patient was very sensitive but as treatment progressed she didn’t feel irritable anymore.

 

 

Reflection:

The only thing I would’ve changed during this treatment plan if I was able to would be to use an ultrasonic for all quadrants so that way it would’ve been quicker and the patient wouldn’t have had to come in so many times.

Yes I accomplished everything I had planned for the patient; it was very educational the patient learnt a lot out of it and so did I.