Patient with Chronic Gingivitis & Oral Candida

Challenge: Patient presented with chronic gingivitis and oral Candida symptoms

Background: A 64-year-old female sought treatment from a medical doctor for a “thrush-like” infection. The medical doctor then referred the patient to an ENT. However, this patient was already of our record and decided to start with our office. The chief complaint is a “thrush-like” infection in the mouth, throat and lips. The clinical assessment confirmed generalized white patches. Upon periodontal assessment, generalized recession with scattered 5 mm probe depths were detected. The patient has arthritis, osteoporosis, heart disease and history of vaginal yeast infections. The patient takes a probiotic. Recently, the patient has been experiencing episodes of loss of balance.

Solution: A pre-therapy MyPerioPath® and OraRisk® Candida was performed 2-15-2018 to assist in identifying the cause of the gingival inflammation and white patches. A prophylaxis was performed and a recall of 3 months was recommended. The systemic antibiotic option per the MyPerioPath® results and a Mycelex Troche solution rinse were administered and instructed to use both for 10 days with their respective doses. The home care instructions included daily flossing, a pre-rinse with CloSYS™, brushing for a two full minutes with a basic toothpaste, then followed by ACT® anti-cavity fluoride mouthwash. Exposure to xylitol 6-10 grams per day was also recommended. A post therapy MyPerioPath® and OraRisk® Candida was performed 5-24-2018.

Results: The chronic gingivitis resolved resulting in healthy tissue. The white patches also resolved and is confirmed with the post results. The patient is extremely happy. Following therapy, the patient fractured her hip and there is concern the patient may have to postpone continued therapy, resulting in relapse. If this occurs, we will be ready.

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Kathleen Nichols, DDS
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