Challenge: Patient with extremely limited history of dental care presents seeking dental wellness. Although patient is anxious, she is highly motivated to create a healthier dental foundation.
Background: A 33-year-old woman with history of acid reflux, seasonal allergies and anemia is seeking to better her dental care. The patient has limited recollection of any dental care in her life, even childhood. The patient’s home care consists of manual tooth brushing 1-2 times per day with the occasional flossing. Upon periodontal assessment, a diagnosis of AAP Case Type II with localized 1-2 mm of recession was noted. Bleeding on probing was categorized as moderate with localized heavy bleeding sites. The presence of subgingival plaque prohibited a full mouth probe recording prior to scaling and root planing. Patient is motivated to achieve better dental health to compliment her physically active lifestyle of running and hiking.
Solution: A pre-therapy MyPerioPath® was obtained 1/8/2019. When placing the order, the therapeutic threshold line removal option was selected. Two visits of periodontal therapy were applied (1/8/2019 and 1/31/2019) and consisted of scaling and root planing with ultrasonic scaler, handscaling, diamond files and laser assisted periodontal therapy. The systemic antibiotic option was considered but not administered. Oral hygiene instruction was provided at both visits and included the Tell-Show-Do learning approach to review C-shape flossing technique, modified Bass brushing technique for generalized areas, and the Stillman technique for areas of recession.
On 4/4/2019, a post-therapy MyPerioPath® was obtained and additional therapy of laser bacterial reduction was applied. Oral home care evaluation revealed patient is currently flossing every day and is utilizing an electric toothbrush 2 times per day.
Resolution: It was rewarding the see the patient come in for the second half of her gingival therapy, as she was very motivated to maintain her overall oral health. She continues to be diligent in her efforts to make it to her dental visits. Scaling with the ultrasonic system went very well and the patient did not experience any sensitivity in the areas of recession. This patient’s case study was very rewarding. These pre- and post-treatment lab reports allowed me to better assess and evaluate the treatment we provided during the patient’s gum therapy in January 2019.
During the patient’s definitive therapy visit in April, it was rewarding to see that the patient had gained some clinical attachment with a decrease in her probing depths of 5 mm to 4 mm as well as a decrease in areas of bleeding on probing. She is very motivated and has made a strong attempt to implement routine oral care.
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