DH 355 Santa Monica Relationship Between Diabetes and Periodontal Diseases Questions

Please read each patient scenario and plan an oral hygiene home instruction: 

For each section include the rationale for the selection.

If there is no recommendation, state “no recommendation”.

Include the following:

1) Disease Concept Education

2) Tooth brushing: 

a. Technique

b. Product recommendations

3) Interproximal aids

4) Mouth rinse products

5) Fluoride therapy

6) Any other recommendations or referrals

I. Patient Profile: Patient is a 79-year old African-American female, 5’7” and weighs 160 lbs. Patient reports she has not had a dental check-up for several years.

Chief Complaint: “My teeth have not been cleaned in a long time and are in bad shape.”

Dental History: The patient had the mandibular right first molar extracted one year ago and has received no dental treatment since.

Medical History: The patient had a hysterectomy at age 62. She suffered a mild stroke four years ago, relies solely on a cane in order to walk and occasionally suffers with shortness of breath upon exertion. She recently underwent laser surgery on the retina in her right eye. Daily medications include: 81 mg aspirin, (Omeprazole) Prilosec®, (Lovastatin) Mevacor®, and (Clopidogrel bisulfate) Plavix® 

Supplemental Information:

• Patient is curious about a power brush since her hands are weak.

• She questions whether a mouth rinse will reduce her bleeding.

Health Behaviors:

• Patient reports she brushes with a fairly hard manual toothbrush.

• She does not floss and is uncertain whether she uses fluoridated toothpaste.

Bleeding Index: 55%

Plaque Free Score: 35%

II. Patient Profile: Patient is a 61-year old White Caucasian male. The patient is a retired banker and remains active in the community in several volunteer organizations.

Chief Complaint: The patient has no chief complaint other than palatal irritation due to an ill-fitting maxillary partial denture. Patient is aware that a new partial will need to be fabricated since his visits to the dental school for adjustments have been unsuccessful.

Dental History: The patient has received dental care throughout his life.

Medical History: The patient’s blood pressure was recorded at 124/78. He had double by-pass surgery in 1992 and has encountered no complications since. He is currently taking (Metoprolol succinate) Toprol® and (Pravastatin sodium) Pravachol®. His only allergy is to bee and wasp stings.

Extra oral Examination:

• Assessment reported all within normal limits.

Supplemental Information:

• Patient uses a phenol mouth rinse for 60 seconds prior to bedtime and soaks his partial in the same mouth rinse.

Health Behaviors:

• Patient brushes twice daily.