Class II Periodontitis

By: Sue Baughman, RDH

December 12, 2017

The Challenge:

The patient has Class II periodontitis with a lack of home care and recall. Through periodontal therapy, our goal is to establish a remission of the disease and establish a healthier bacterial load to reduce oral/systemic complications. Through education, our goal is to establish home care habits to assist patient’s remission and stress the need for recall not just for health of periodontium but overall health.

The Background:

  • Age: 54
  • Sex: F
  • Medical History: High Blood Pressure & Allergy to Penicillin
  • Family Medical History: Diabetes, Cardiovascular disease, Stroke & Cancer
  • Last Dental Visit: 6 years
  • Home Care: Manual toothbrush 1-2x per day with occasional antibacterial mouth rinse and tongue brushing
  • Nutrition: Diet soda daily, tea with honey
  • Patient Chief Complaint: “Bleeding gums when brushing, possible cavities and tooth crowding.”
  • Clinical Assessment: Deteriorating margins of amalgam restoration, recurrent decay diagnosed by exam and radiographs. Generalized plaque with moderate calculus.
  • Periodontal Assessment: Class II periodontitis. 110 out of 168 points of bleeding, all 28 teeth with generalize 4 mm probe depths with localized 5mm probe depths. Bone loss of 1-10% including both horizontal and vertical throughout.

The Solution:

  • MyPerioPath® Pre results June 15, 2017
  • 4 quadrants scaling & root planning
  • Systemic antibiotics Ciprofloxacin & Metronidazole per MyPerioPath ® treatment considerations
  • Chlorhexidine rinse at home 2 x daily
  • Doxcycline subgingivally in all areas
  • MyPerioPath® Post results October 5, 2017

The Result:

On October 5, 2017, patient was seen for a 6 week tissue check. Patient has been using an electric toothbrush 1-2x per day, flossing a couple times per week, utilizing a tongue scraper, and using the chlorhexidine mouthrinse. Patient discontinued the rinse after 2 weeks due to increasing sensitivity. Post-therapy periodontal charting was completed with 1 localized 4mm residual pocketing and 12 out of 168 bleeding on probing. OralDNA® MyPerioPath® saliva sample was collected. A prophy, polishing, flossing was also completed. Patient will be seen every 3 months for periodontal maintenance. On October 10, 2017 MyPerioPath® results showed reduced periodontal pathogens. The pre-test showed 7 pathogens above threshold and the post MyPerioPath® showed 0 pathogens above threshold. Patient was called and results were reviewed, she then received a copy to give to her medical doctor.

About the Author:

Sue Baughman RDH graduated Cum Laude in 1993 from University of Northwestern Ohio Associates of Applied Business with majors in Business Administration and Marketing. She received her Associates of Applied Science in Dental Hygiene from Rhodes State College in 2001. She has been practicing in a complete health dental practice, Whole Health Dentistry for 10 years. In 2014, she received the Next Level Practice award “Hygienist of the Year” for overall outstanding patient care. She enjoys life as a hygienist in addition to being a wife for 20 years and mother of two wonderful children.