Patient Pain Management

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A 42 year old patient, heavy case/type III perio presented with excessive hypersensitivity. This patient appeared to have generalized root exposures, which is the main contributing factor of having hypersensitivity. Due to this condition, I advised the patient to start using a fluoridated rinse; 20ml, twice a day in accordance with using Pronamel toothpaste twice a day. Pronamel has been shown to have the most fluoride availability to incorporate its fluoride ions within the tooth structure. During our assessments, the patient requested to get anesthesia for every quadrant of scaling. In order to get the most effective and comfortable patient pain management, I informed the patient that this altered treatment plan would prolong our treatment completion. On the first visit, I scaled the lower left quadrant using 2 carpules of 2% Lidocaine HCLwith epinephrine 1:100,000, 1.7cc each – one left mental and buccal infiltration and one mandibular left alveolar block. I began with the infiltrations first, however the anesthetics seemed to take a while before they diffused, in which case we then proceeded to giving the inferior alveolar block. The patient had a great experience once the anesthetics took effect. On our second visit, we proceeded with scaling the lower right and upper right quadrants using 4 carpules of 2% Lidocaine HCLwith epinephrine 1:100,000, 1.7cc each – two of which were given for the inferior right alveolar blocks along with the right buccal and mental infiltrations. The remaining 2 carpules were used for the upper right quadrant. The patient had a right posterior superior alveolar injection along with the middle palatine and anterior apical facial infiltrations. On our last visit, I scaled the upper left using 2 carpules of 2% Lidocaine HCLwith epinephrine 1:100,000, 1.7cc each, I injected the left posterior superior alveolar, the middle palatine and local anterior apical facial infiltrations. The patient was very satisfied with the patient pain management and concluding our treatment plan comfortably.

Pediatric Patient Assessment 

An 8 year old, pediatric patient presented with a classic oral manifestation of having a thumb sucking habit. This patient appeared to have an extreme high palatal vault in accordance with having an excessive open bite occlusion. During the assessments, I immediately recognized these symptoms and asked the patient if they are sucking on their thumb. The patient raised their right hand and stated that she was using her right thumb for her sucking habit. It was a very interesting experience to conclude that this patient manifests a habit through these targeted symptoms.