Patient M.D. 41 yrs old, caucasian, non- smoker(quit 2 yrs ago). EO/IO- Within normal limitations. Red gingiva with moderate marginal inflammation. Bulbous, spongy tissue interproximally mainly on the mandibular anteriors. Generalized recession of 3-4 mm. Probing depths of 2-3 mm also generalized. Moderate bleeding upon probing. Medium calculus deposit sub and supragingivally. Patient states he brushes twice a day with a medium bristle toothbrush and does not floss or use mouth rinse.
Patient complains of sensitivity when brushing and even though my mirror kept sticking to his buccal mucosa, patient states he does not suffer from dry mouth. For home care switched patient to a soft bristle toothbrush and gave him samples of Sensodyne. Toothbrushing technique taught was the Stillman’s method. On this first visit I only worked on UR and LR quadrants. Patient returned 4 weeks later to finish his cleaning. Reevaluation of both quadrants previously scaled was positive. Pink gingiva with very mild gingival inflammation. No bleeding upon exploring. My favorite part was showing Mr. D a mirror comparing both sides. He was very happy to see the improvement and receive my praises. Now I tried to introduce flossing in this final visit. It didn’t go well. Mr. D told me he has never flossed and wasn’t about to start. So I had to go around trying to teach him and just help him understand the importance. So I went back to praising him because of his toothbrushing technique improving. Before i began his cleaning I asked him to show me how he brushes when he was done I took out the floss and made him hold the mirror. I flossed the previously scaled quadrant(LR). Showed him what he had left behind even though his brushing was excellently done. He laughed and said I was tough. I laughed and said I know where the enemy hides and now so do you. I finished his cleaning that day and at the end of the visit he told me he wasn’t going to promise me anything but that he was willing to try!