Case 1

This case presents a 28 year old occasional smoker patient with latex and iodine allergy and is not taking any medications. Patient’s last date of oral hygiene service was sometime in 2006, more than 8 years ago. Patient presented with gingival recession, halitosis, severe gingivitis and was a type II, localized type III perio case. Gingiva was erythematous with bulbous interdental papilla. There were no significant findings extra-orally nor intra-orally. Patient management was moderately difficult because patient seems to be a highly functioning autistic individual with attention deficit who was also very sensitive in and out of his oral cavity. Patient did not like the saliva ejector, continually sat up to expectorate, and was easily alarmed by his surrounding during treatment. The quantity and quality of this patient’s calculus was beyond heavy and patient’s level of oral hygiene was very poor. Patient had no restorations. Probe readings measured from 2mm-9mm with deeper readings localized in the maxillary 1st to 2nd molar regions with severe bleeding upon probing. Full mouth debridement , four quadrants scaling and root planing, referral was given, and oral hygiene instructions were given during second appointment. Recall frequency was 3 months.

Full mouth series of radiographs taken on a 28 year old Asian Male patient. Patient presents with bone loss on the mandibular incisor regions as well as the posterior regions of the maxillary and mandibular arches. Patient also presented with generalized radiographic calculus. 

Facial aspect of the mandibular incisors before scaling and polishing

Facial aspect of the mandibular incisor after scaling and polishing 

Lingual aspect of the mandibular incisors prior to scaling and polishing

Lingual aspect of the mandibular incisors after scaling and polishing

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Case 2 

This case presents a 32 year old hispanic marijuana user and cigarette smoker male with iodine and shellfish allergy. Patient was diagnosed with asthma since he was teenager and is currently on albuterol in the form of an inhaler. Patient has dental anxiety and the last date of oral examination was for the extraction of tooth #3. Last date of oral hygiene services is unknown. There were no significant findings both extra-orally and intra-orally. Patient is a mouth breather, had no restorations, has recession in most premolar regions and was missing #3. Gingiva was erythematous and flaccid upon blowing with air with bulbous interdental papilla. Probing depths were 2mm-6mm with deeper readings in the posterior regions and severe bleeding upon probing. Patient had halitosis and very poor oral hygiene with generalized heavy material alba and heavy subgingival calculus. Patient had severe gingivitis and was a type I perio case. Oral hygiene instructions were given, full mouth debridement and four quadrants scaling and root planing was done in two visit. Recall frequency is 3 months.

Facial aspect of patient’s teeth prior to scaling and polishing

Facial aspect of patients teeth after scaling and polishing

Lingual aspect of the mandibular incisors prior to scaling and polishing

Lingual aspect of the mandibular incisors after scaling and polishing

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Case 3

This case presents a 17 year old female patient with anemia. Patient was a light case with healthy perio and superior oral hygiene. Patient had minimal restoration confined to the occlusal surfaces of two molars. She was a qualifying patient for sealant placement. Oral hygiene instructions were given. Perio charting rendered probing depths of no more than 3mm with no bleeding upon probing. Full mouth debridement and four quadrant scaling was done in the first visit along with sealant placement on #18 and #19. Recall frequency is 6 months.

Successful sealant placement with cotton roll isolation on a 17 year old female patient.