My frist Patient at New York City College of Technology
1. Demographics: S.J. 27 years old, black female, heavy/type I.
2. Assessment: Pt has a history of pancreatitis due to gallbladder. Gall stones removed on 9/11. BP 113/69 RA. P 91. Pt smokes 6 x days x 8 years. No systemic condition present, No prescription medication/ no OTC.
3. Oral Pathology: EOIO- NSF
4. Dentition: NO tooth anomalies. Caries active on tooth number 1-O and 17-O. I gave the patient referral to see dentist.
5. Periodontal: Buccal mucosa and LR retromolar pad keratinized. Generalized moderate BUP, localized anterior marginal bulbous, pigmented gingiva, localized interproximal areas slightly rolled. Generalized 2-3mm depts with localized areas of 4-5mm on tooth number 1, 16, and 32 distal aspect which are pseudopockets.
6. Initial plaque score was 1.1; On the third visit another plaque score was taken and the result showed a decrease to 0.6. I was pleased that the Pt listen to my advice and the result was positive, a cleaner oral cavity . The main areas of calculus are subgingival in the interproximal area. I planned to teach the Pt flossing which will aid in the removal of the interproximal plaque and help to reduce the buildup of calculus. I was able to teach the Pt flossing on the initial visit. On the second visit I taught the Pt the modified bass TB method. The Pt was able to demonstrate the corrected method and I believe that is why her plaque score decreased from 1.1 to 0.6
7. Radiographs: The Pt last radiograph was taken in 2010 for an emergency visit and at that time the dentist only took one PA. Pt needs a FMS. The Pt can’t remember if she ever had a FMS. She stated that the last couple of times she went to the dentist it was for emergency.
8. Other Findings: Pt smoking is a risk indicator which may lead to oral health problems in the future. Pt is trying to stop so I gave her information to NYC smoking quit line and I also gave Pt educational literature.
9. Treatment Management: The Pt had sensitivity during probing assessment, I discussed this with the professor and she recommends topical gel and oriqix for the next visits.
Visit 1: Scaled UR with hand instruments used topical gel and oriqix1 carpule. Introduce flossing. The Pt was still sensitive so the next visit Pt will need lidocain with epinephrine 1; 100, 00 2%.
Visit 2: Scaled LR with hand instruments and ultra sonic. I used topical gel and lidocain with epinephrine 1:100, 00 2 %( infiltrations) 1 carpule. PI/OHI. Re-eval UR, flossing. Introduce modified bass TB method. The Pt demonstrated the flossing method exactly as I thought her from the previous visit. Pt tolerated anesthesia well.
Visit 3: Scale UL and LL with hand instruments and ultra sonic. I used topical gel and lidocain with epinephrine 1:100, 00 2% (infiltrations) 1carpules per quadrant. PI/OHI. Re-eval UR, LR, flossing, modified bass TB method. The Pt is demonstrated the flossing and the modified bass TB method correctly. Polished and applied fluoride varnish 5%. Pt tolerated anesthesia well.
The original treatment plan was for four visits but I was able to finish the UL and LL on the same visit so my treatment plan was modified to three visits.
A 34 year old Indian male present to dental clinic for a cleaning and as we discuss he’s medical history he states that he chews tobacco 1-2x a day for the last 10 years. During the oral examination he had a lesion 5mm x 3mm on the left buccal mucosa. He stated that’s the side he chews his tobacco. The heavy staining from the tobacco covered the entire dentition. Carious lesions were also present on tooth number 3(o), and 18(o). Patient had no systemic condition. The Treatment consists of scaling of all four quadrants, air polish for heavy staining, application of fluoride varnish 5% and education on smoking cessation. A referral was given for a biopsy of the lesion and for active caries.
Arestin Patient
Gum disease is a bacterial infection that can lead to damage to the gums, tissue, and bone around your teeth. The destruction of tissue and bone causes pockets to form around teeth. Arestinwith scaling and root planning can help address the symptoms of gum disease.Aretin is a prescription antibiotic approved by the Food and Drug Administration (FDA). It is used with scaling and root planning (SRP) procedures and is placed by a dentist or dental hygienist for the treatment of periodontal (gum) disease.Arestin contains 1mg(powder) microspheres—tiny particles—that are smaller than grains of sand and are not visible to the eye. The microspheres are filled with the antibiotic minocycline hydrochloride. These microspheres release the antibiotic over time, killing the bacteria that cause periodontal disease. Using arestin along with SRP give optimal results.
A 55 year old black male presented to the clinic for a cleaning. Bp 117/79 P87. Medical history, EOIO was reviewed, NSF. Radiographs (FMS) was recommended and taken on the first visit since he haven’t been to the dentist for ten years. A radiolucency under tooth number 19 so the patient can see a was seen and a pan was also taken. A referral was given for evaluation for tooth number 19. After the examination he was considered a heavy/type II. The treatment was for two visits for SPR. Two quadrants per visit. On the last visit I placed arestin in four sites on tooth number 1MB, 2DB, 2MB, 3DB. The patient was given post treatment instructions and asked to return for re-evaluation in 8 weeks. On the re-evaluation there was a decrease in pocket depth from 6mm to 3mm on tooth number 1 and 2. On tooth number 3 the pocket depth reduced from 6mm to 4mm pocket depth. The patient also went to the dentist and got number 19 extracted. This was my first placement of arestin and I was so pleased to see clinical changes. The patient was given a recall appointment for 4months.
