Case study#1-Diabetes
Periodontitis Stage II Grade B – Type- 2 Diabetes
Periodontitis is a severe gum infection that can lead to tooth loss and other serious health complications. If it’s not treated it can lead to bone destruction which supports the teeth. Periodontitis and diabetes has a bi-directional relationship, if one can be controlled it improves the other condition automatically. Diabetes is a chronic condition that result in too much sugar in the blood. A 51 years old asian female, Medical history- type 2 diabetic, ASA-2 presents to the clinic, most recent HBA1c-6.5, patient is taking metformin 1000 mg for diabetes, patient has a history of betel nut chewing for 5 times a day for last 30 years. During intra-oral assessment localized inflamed, erythematous, spongy gingiva, localized blunted papilla and localized bleeding on posterior teeth of both upper and lower quadrants upon probing, generalized moderate to severe attrition present, generalized extrinsic and intrinsic dark red staining present on both facial and lingual surfaces of teeth with moderate sub-gingival calculus, caries present on teeth#1M, 2D, 20M, 21D, 29D, 30D, class-1 mobility present on teeth#23,24,25,26 due to bone loss extending to more than 1/3rd of the root, confirmed with radiographs.
For treatment plan patient was advised to discontinue the consumption of betel nut, brush , floss properly and use
before picture
Before picture
After picture
After picture
hydrogen peroxide containing mouthwash, performed debridement and engine polishing for removal of dark stain.
Case study #2-
Periodontitis Stage II Grade-B
patient’s radiograph
Periodontitis is a severe gum infection that can lead to tooth loss and other serious health complications. If it’s not treated it can lead to bone destruction which supports the teeth. A 41 years old asian female, medical history- healthy, ASA-1, Patient is taking vitamin D 500mg twice daily and biotin capsule 1000mg once daily. During intra-oral assessment localized flaccid spongy gingiva present on posterior lower right and left quadrants, localized bulbous inflamed gingiva present on lower anterior sextant, 2mm recession present on teeth#20F, 21F, 28F, 29F; attrition present on teeth#7,8,9 and erosion present on teeth#8L, 9L, 10L, 19O, 30O ; suspicion of carious lesion on teeth#14D, 15M ; generalized moderate bleeding upon probing with heavy sub-gingival and supra-gingival calculus and generalized horizontal 15-30% bone loss.
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For treatment plan patient was advised and demonstrated proper method of brushing , flossing, rinse with antiseptic mouthwash, performed debridement and engine polishing .
Case study#3- Cancer
Cancer is the disease when cellular changes cause the uncontrolled growth and division of cells. A 29 years old asian female, medical history- thyroid cancer-complete surgical removal of thyroid gland followed by radiation treatment for a week, patient is taking levothyroxine 112 mcg once daily , vitamin D 2000 IU once daily. Patient presented with generalized erythematous gingiva, localized soft gingiva, attrition present on teeth# 23-26 with heavy calculus and moderate bleeding mostly on upper anterior and posterior teeth upon probing, with less than 5-10% bone loss radiographs confirming her gingivitis case. Patient present with very mild xerostemia due to radiation treatment. For treatment plan, recommended xylimelts( containing 500mg xylitol ) that will stimulate her salivary gland, demonstrated proper method of brushing and flossing, performed debridement, engine polishing and applied fluoride varnish.
