Heavy Calculus Removal and Arestin Placement

The post treatment probing measurements are four weeks after initial placement of Arestin.




Medical History

This patient’s last dental cleaning was in July of 2015 and his chief complaint was “Here for a dental cleaning and to figure out why I have a lingering odor in my mouth” He is a 23 year old male from Bangladesh. He does not take any medication, does not have any allergic reactions to medications, states that he breaks out in hives when in contact with sea food, does not drink, but smokes hookah one to two times per week.

Head and Neck Cancer Screening

When assessing his head and neck examination, patient had 10 small petechiae in the back of his throat on the soft palate. Everything else was within normal limits.

Gingival Statement

His gingiva was generally red, enlarged, and soft. He had type two embrasure spaces in his anterior teeth and type one in his posterior teeth. Bleeding upon probing and exploration was severe.

Home Care

He was using a medium bristled tooth brush twice a day so I instructed him to use a soft bristled tooth brush and demonstrated the modified bass toothbrushing technique. In his second visit, we reviewed flossing with waxed floss. For his third visit, we reviewed the use of rinse containing fluoride. For his last visit, we went over the use of an electric toothbrush.

Summary of Hard Tissue

His class of occlusion was one bilaterally, overjet was 3mm and overbite was 30% Patient was exposed to a full set of radiographs and plaque covered 100% of his teeth. According to the radiographs, all of his third molars are impacted.

Classification of Patient

He was a Heavy/ Type II active periodontitis patient. He has a high risk of caries and complained of xerostomia upon waking up, through out the day and especially when playing sports.


He was given a referral to the oral surgeon for evaluation of his impacted wisdom teeth and a referral to the periodontist for evaluation of his periodontal health.

Last visit and Recare Appointment
On his forth and final debriding visit, I used an engine polisher with fine paste and applied 5% Sodium Fluoride varnish. His recare appointment was scheduled for 3 months later since he had very heavy calculus and was periodontally involved.
This patient was extremely satisfied with his visits with me in the City Tech Dental Hygiene Clinic. Unfortunately he was running late to a funeral on his fifth and final visit and I was not able to take pictures of his gingiva during his post treatment evaluation. He may come back one more time before the end of the semester so that I can take pictures post evaluation. I will post them here in the near future. Scroll down below to read what he had to say about his visit!
This picture is before placing Arestin but after debriding his entire oral cavity:
Dental chart: 
Perio chart: 
“My time at the dental clinic in City Tech was great. They took good care of me, handled with proper care, looked after me. I haven’t been to the dentist for any check up for a very long time due to several reasons but when I found out about Jenan, an excellent dental hygienist and hopefully one of the best ones to graduate from there as a dental hygienist, took it upon herself to treat me as one of her patients. She was very kind, helpful, gentle with my teeth and would ask if I’m ok or not. This was a really great amazing experience for me and offered their best hospitality while being there. I’m glad I came across with her and the institute and from now on I will be happy to make appointments there.”