Challenge: Patient experiencing recent vision impairment presented as Stage III Grade B, active generalized periodontal disease with localized severe periodontal disease in the maxillary anterior area.
- Age: 36
- Sex: M
- Medical History: Patient reports recent vision impairment with the right eye. Under the care of the ophthalmologist, a diagnosis has not been found. No other systemic diseases or conditions reported.
- Last Dental Exam: Within 3 years
- Chief Complaint: Loose anterior tooth with mild discomfort.
- Clinical Assessment: Class III Mobility on teeth 8 and 10, no clinical findings of decay. Patient reports no history of trauma to head or neck.
- Periodontal Assessment: Generalized 3-5mm probing depth with localized 9+ probing depths on teeth 7 and 8. Generalized bleeding in all 4 quadrants. Suppuration from teeth 8 and 10.
Additional Comments: Patient states he noticed loosening of teeth around same time as vision impairment. This occurred approximately 3 months prior to the dental exam.
- Date of MyPerioPath® Collection: 12/21/2020
- Periodontal Therapy:
- Full mouth scaling and root planning, irrigation, and bacterial decontamination.
- Systemic Antibiotic used: Metronidazole 500mg 10 days.
- 6 weeks post SRP: Consult with Periodontist and extract teeth 8 and 10.
- Perform MyPerioProgress® Collection: 02/18/2021
- 3 months post extract; cone beam computed tomography (CBCT) and evaluation for implants by periodontist. Areas of teeth 8 and 10 showed not enough bone for implant placement. Permanent bridge was recommended and completed for patient.
Additional comments: During the full course of therapy, the patient discontinued the use of medication for his ophthalmic problems and reported a stabilization on vision loss. The patient’s ophthalmologist requested copies of our salivary diagnostics results to investigate further.
Results: There was generalized improvement in all 4 quadrants resulting in 1-3mm probing depths with no bleeding. The microbiological reduction of 67% resulted in his periodontal health. The patient has been able to maintain this periodontal health for one year and counting. The patient has been consistent with our recommendation of a 3-month hygiene care where a periodontal maintenance, irrigation and bacterial decontamination is performed each time.
Although the patient was unable to have implants to replace missing teeth 8 and 10, the fixed bridge #6-#11, along with stabilization of his vision has restored his self-confidence. This case has taught me to be confident with our treatment protocols. Even though, this case had a twist–the vision impairment and the recognition of the loose anterior teeth—our treatment protocol had a positive correlation. This case supports the information we currently know about the Mouth Body Connection™ is just the tip of the iceberg.
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- Periodontal Disease with a Patient Experiencing Vision Impairment - March 11, 2022