Classic Periodontal Disease after COVID with Brenda Sullivan RDH

Challenge: Patients are avoiding routine dental visits due to fear of contracting COVID. This patient had missed several hygiene appointments during the pandemic. Our goal was to re-establish health and increase homecare to help this patient’s general immunity.

Background: This case study involves an 84-year-old male with a history of scaling and root planing, who before this assessment was in good periodontal health. His blood pressure was 114/72 and his pulse 83. He has a history of cancer, high cholesterol controlled with medication and arthritis. The stress of the pandemic impacted him in a negative way. He decreased brushing and increased sweets (carbohydrates) into his diet. Thankfully, he knew he needed his teeth cleaned and finally made an appointment. The clinical assessment revealed #11 had gross recurrent decay and #13 had broken at the gumline. There were several other areas of decay. The periodontal assessment showed moderate bleeding with advancing probe depths, mobility, and furcation involvement. He was diagnosed with adult chronic generalized moderate periodontal disease with localized severe periodontal disease.

Solution: The specimen for MyPerioPath® testing was collected following the periodontal assessment and the patient was educated that the disease process is now active. The results were reported on 12/14/2020. A treatment plan of 4 quadrants of scaling and root planing to reduce bacteria was completed. In addition, the systemic antibiotic of Amoxicillin 500 mg tid and Metronidazole 500 mg bid for 10 days was prescribed along with homecare instructions of brushing 2x/day with a Sonicare™ electric toothbrush, Waterpik™ daily and use of Oracare medicated rinse 2x/day and oral probiotics. #11 and #13 were extracted and a removable partial denture supported by existing implant #12 was fabricated. My patient was allowed to heal and practice the homecare instructions. He reappointed to the office on 4/19/2021 when a post specimen was collected. The post-therapy results were reported on 4/27/2021 with an 84% reduction in bacteria levels.

Resolution: This pandemic has taken a toll on several of our patients. I am grateful when they return for care even if I expect most to need our help to become healthier. This case study is an example of what can be achieved with the partnership of the patient to provide appropriate home care and personalized periodontal therapy based on clinical lab results from OralDNA® Labs.

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Brenda Sullivan RDH
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