Agenesis
S.A., 23 years old, Asian, Female. Medium calculus case value/Type I-localized II Perio.
Patient’s chief complaint is “I have spaces in the front of my teeth and I haven’t had a cleaning in a long, long time”. Patient’s last dental cleaning and x-rays are in 2010. Patient reports she brushes twice daily, flosses with traditional floss 3x/week, and does not use an oral rinse.
Patient presents with Class I occlusion bilaterally, 25% overbite, and 4mm overjet. Localized moderate attrition is found on anteriors of both arches. Tooth #1, #16, #17, #22, #27, #32 are clinically missing and patient reports she does not recall of any extractions. Tooth #2-O, #15-O, #16-O clinically show suspicious caries and referral was given to patient. Gingival presents with generalized moderate inflammation with lack of stippling, resiliency, and overall redness. Localized moderate rolled margins are found on B of posteriors and L of mandibular anteriors.
Patient is a full-time graduate student and teacher. She reports she has dental insurance and a dental home however does not have the perceived need to visit the dentist because she is not in discomfort. She reports she is an occasional teeth grinder due to stress and there are often times she eats cariogenic foods at late nights without brushing her teeth.
For intervention, I introduced the patient to a powered toothbrush (she is using a manual, medium bristled toothbrush) because most plaque was found on the posterior and hard-to-reach areas. I recommended the Colgate Total dentifrice and a daily Fluoride rinse to protect the enamel from future caries. A panoramic was exposed due to to clinically missing teeth and radiographic evidence shows that patient is congenitally missing #1, #16, #17, #22, #27, #32.
Treatment Plan:
V1- Perform assessments. Expose PAN and discuss findings with patient. Full mouth debridement with ultrasonic and hand scalers. Engine polishe with fine paste and apply 5% NaF varnish with micro brush. Provided post-op instructions of no eating abrasive/hot foods and no brushing/flossing for 4-6 hours. Recall 6 months.
