This patient, an 81-year-old Asian American male, presented with a complex medical and dental history, including hypertension, hyperlipidemia, benign prostatic hyperplasia, and a history of coronary stents. He is currently taking multiple medications with known oral side effects, including xerostomia, gingival hyperplasia, and increased gingival bleeding. Clinical and radiographic evaluations led to a diagnosis of Stage III, Grade B generalized periodontitis, characterized by generalized probing depths of 4–6 mm, >5 mm clinical attachment loss, furcation involvement on #14 and #19, and over 33% horizontal bone loss. Heavy subgingival and supragingival calculus, moderate marginal inflammation, and TMJ crepitus were noted. Oral hygiene challenges were attributed to the patient’s dexterity limitations, for which modified techniques and adaptive aids such as a water flosser were recommended. Treatment included full-mouth debridement and quadrant scaling with topical anesthetic, radiographs, and fluoride application. The patient was educated on the connection between oral and systemic health, the potential impact of medication on gingival tissues, and the importance of strict 3-month periodontal maintenance to manage disease progression.
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