A 46-year-old African American female patient presented with asthma, seasonal allergies and allergies to nuts, apples and furry fruits. Patient reported that she takes loratadine for her allergies and carries her albuterol inhaler with her wherever she goes. As soon as the patient sat down on the dental chair, she stated that she was embarrassed because she has “let herself go” and hasn’t been doing a great job keeping up with her oral hygiene. The patient seemed to have difficulty opening her mouth due to being embarrassed. Because many patients present with various levels of severity in their oral health, I re-assured the patient that I’ve seen many patients with different levels of severity and that she is taking the right step forward by being in our clinic. I also told her that no one was here to judge her and that we are only here to look and do our best to help to the best of our abilities.
Upon completing assessments for the patient, she was diagnosed as a periodontitis Stage 1, Grade B patient with generalized heavy calculus on the interproximal areas of the molars and localized subgingival calculus on the anterior lingual calculus with a bridge of calculus buildup supragingival in that same area. After taking vertical bitewings, there were areas of localized horizontal bone loss observed. The patient was informed of the findings and the diagnosis was explained to the patient. Though the patient seemed distraught at first, she understood that completing treatment would benefit her oral health immensely. She was grateful that we had showed her the images and explained very thoroughly whilst answering all her questions.
While engaging in conversation about the patient’s lifestyle, it was revealed that she had children and she was working two jobs. She lived a very busy lifestyle and seemingly had no time to take care of herself. While she took good care of her daughter’s flossing on a daily routine, she hasn’t flossed for herself in months. Noting her busy lifestyle, I wanted to complete her case in the least amount of visits, but I treatment planned for two additional visits, but assured her that I would try my best to get as much done as I can during each visit. Usually, most patients would receive a fluoride varnish treatment following the cleaning procedure, but due to precautionary measures, the fluoride varnish treatment was omitted. Instead, more time was spend emphasizing the cruciality of good oral hygiene for herself, as well as, for her children.
During each visit, only one method of OHI was revealed and taught in order to reduce the burden and track the progress of the patient’s compliance. The patient revealed that though she has not been flossing daily, she was definitely trying to be more conscious of it. I re-emphasized the importance and pushed her to floss and make it a habit without judging her. By the end of the final visit, the patient was very thankful for the change I made in her life and the considerable amount of care that the faculty and I have put in to help her. She appreciated how thorough the evaluations were, as well as, how patient we were with answering her questions.
