A 74 year-old male patient presented with controlled high blood pressure, high cholesterol, and diabetes. The patient stated that he takes takes (medications) as prescribed for 20+ years. He also smokes 10+ cigarettes a day for 40+ years.
Patient was informed about his increased risk for oral cancer, xerostomia and periodontal disease due to smoking and his medications. He said that he is aware but does not feel any dry mouth and does not feel that his periodontal disease is advancing. Upon assessments bilateral white leukoplakia on the gingiva of the mandibular posterior teeth was found. Patient also requested FMX radiographs in which more bone loss compared to his last radiographs were shown and this also translated in his periodontal readings in which pockets got deeper by 1-2mm . Patient also presented with a broken crown on #17D. All findings were explained to patient and appropriate referrals were given to the patient for evaluation of lesions and restorations.
Scaling and root planning was done focusing on removing the stains, since that was the patient’s chief complaint during this visit. The stains were removed without the use of engine polishing and patient left satisfied with the results.
Patient was also advised about smoking cessation due to his increased risk for oral cancer. Patient explained that he is not interested in quitting since he has been smoking for so many years and nothing has happened to him. I still gave him some resources he can use for support if he changed his mind about quitting. I explained to him that he not only would his risk for oral cancer would decrease but also the rate of which his periodontal disease advances would decrease as well.
