Case study #1
A 35 year old Philippine male, ASA 2
Patient reports not taking medication or no known allergies. Patient reports smoking THC with nicotine every day and takes psychedelic mushrooms once a month. His oral hygiene consists on brushing and flossing once a day and does not use mouth rinses. Patient presents with nicotine stomatitis , hyper-keratinized palate and sloughing of the buccal mucosa upon the intra oral exam. The patients probing depths were generalized 2-7mm with bleeding upon probing. The gingiva was spongy and red with mild inflammation. The papillae was generally bulbous. Severe supra gingival and sub gingival calculus was present in all aspects. Based on “AAP periodontal classification” he was a Stage lll Grade B.
I exposed an FMS which revealed no suspected carious lesions or no periodical pathology. There was radiographic calculus in every aspect. There was generalized 15-33% bone loss.
For OHI – I advised my patient to brush 2x/day using bass method . A water pic was recommended to flush out the flaccid gingiva after the cleaning. I also recommend to use alcohol free mouth rinses. I emphasized that due to his constant dry mouth bacteria easily adheres to his teeth. He needs to constantly keep his mouth moist with water or xylitol containing products such as gum and biotin.
After a the ultrasonic and hand scaling prophylaxis , engine polish and fluoride varnish 5% was provided! His re-care was set to 3 months.
