Mr. G is a 53-year-old Hispanic male that came into the clinic in 10/2022.

Initial visit (10/2022): Mr. G’s vitals revealed BP: 144/104, P: 123. The second reading done 25 minutes later revealed BP: 161/107, P: 117. His last physical examination was in 2017. He was advised that he needed to get an examination done ASAP to make sure his health was okay and to obtain a medical clearanctoto continue with dental treatment. It was explained to him that the #1 cause of death is cardiovascular disease; “the silent killer.” He was also encouraged to visit his physician yearly.

Re-visit (11/2022): The patient was diagnosed with pre-diabetes and high cholesterol. Every night, he has to take one pill from each medication; Metformin, Atorvastatin, and Atenolol/Chlorthalidone.  His vitals on that day read BP: 129/94, P:97. Mr. G was unaware of his health conditions and even said that he never would have gone to the doctor until he saw his vitals on the initial visit. This shows why it is very important to take every patient’s blood pressure at every dental visit.

Dental history: Mr. G’s last dental cleaning was in 2006. He had never been exposed to dental radiographs until his visit to NYCCT.  Intraoral findings revealed mandibular tori and maxillary torus. He had severe generalized attrition, fractures on teeth #3, 4, 12, 19, 21-28, and cupping of the cusps. #7-#10 lingual enamel wall appeared worn down. He also presented with generalized recession.

Generalized probing depths ranged from 1 to 4mm, with localized 5-6mm pockets in the posterior teeth. Underprobing due to heavy calculus.

Based on generalized heavy supragingival and subgingival calculus, he was a heavy calculus case value.

Based on radiographic evidence of <15% crestal bone loss, he was a Periodontitis Stage 2, Grade B case.

Treatment plan:

Mr. G planned to come back to the clinic for 3 additional visits after the initial visit. The importance of flossing was reinforced. A comparison was made to when we wash our hands, we wash in between our fingers. Why not do the same in between our teeth?

Unfortunately, the patient denied to take before and after pictures. I was very happy with the results and so was he! All of the calculus was gone and he explained to me that when moving his tongue around his teeth, it was very smooth!

Consent was given to use his dental radiographs and periodontal exam for this post.