Case Studies


B.W. 60 yr old ASA II patient. A history of asthma, hypertension, hyperlipidemia and dust in lungs. Taking 7 different medications; Atrovastin 20mg and Valsartan 160 mg for hyperlipidemia. Montelukast SOD 10mg once daily at bedtime and Proair HFA 90mcg spray for asthma. Advair 250-50 Diskus to prevent asthma attack. Benedryll 50mg when needed for allergies.Patient is allergic to Codeine, penicillin, shell fish, certain nuts, and latex gloves.

Patient presented with heavy stain and moderate calculus. Since the patient had asthma and dust in lungs, prophy jet was contraindicated for this patient. Using utlrasonic scaler and hand instruments, complete removal of both stain and calculus was achieved. Due to elevated blood pressure, I had to wait until the patient’s BP stabilized. The first BP reading was extremely high; 170/110 and the pulse was 112. The second attempt 174/96 P:106. The third attempt 170/94 P:109. the fourth attempt 168/97 P:104.

This patient had moderate periodontitis with generalized recession. Slightly boulbous and inflamed marginal gingival with minimal bleeding upon probing. This patient was encouraged using electric toothbrush instead of manual TB.

V1 included URQ scaling using ultrasonic and hand instruments.

V2 included re-evaluation of URQ and completion of rest of the mouth. Polished with coarse paste and 5% fluoride varnish was applied.


T.B. 48 years old ASA I patient. Patient had no systemic condition and non-smoker. Patient presented with generalized heavy calculus deposits and light stain. This patient had moderate periodontitis with localized recession. Oral hygiene instruction indicated flossing technique and modified stillman’s TB method.

V1 included URQ and LRQ scaling using ultrasonic and hand instruments.

V2 included re-evaluation of URQ and LRQ and completion of ULQ and LLQ. Polished with fine paste. Applied 5% fluoride varnish.

  1. Sealant placement using rubber dam
  2. Observation of geographic tongue