Gingival Hyperplasia with bone loss and Anorexia Nervosa

Challenge: A 15-year-old patient with multiple years of periodontal concerns being co-managed with a periodontist without resolution. Background:  A 15-year-old female has been presenting for care at our practice since age 4.  From an early age the patient displayed behavioral concerns and chronic poor home care.  The dental history is early eruption of #19, three month recall due to levels of supra and sub gingival calculus, and mild bone loss resulting in a referral to the periodontist ...
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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,...
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Patient with Dental Pain, Periodontal Disease & High Blood Pressure

Challenge: To address the dental concerns to resolve patient’s dental pain. To educate the patient on the connection between dental health and overall health. Background: The patient is a 37-year-old male who presented with a dental pain emergency. The home care is poor and patient has history of only seeking dental care for emergencies. Medically, the patient has hypothyroidism, hypertension, high cholesterol and significant difficulty breathing while asleep. The blood pressure reading o...
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The Co-management of an Esophageal Cancer Survivor

  Background: The patient is a 75-year-old female with a history of esophageal cancer in 2013. The origin of the cancer was determined to be lichen planus. Surgical removal of the lesion occurred and no reconstructive surgery was needed. However, post-surgery to present date, the patient experiences severe acid reflux and sleeps with her head elevated. She has great home dental care and follows a 3-month periodontal maintenance. During the head and neck exam, no significant findings ...
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Case Study: Dental Hygienist with Type II Diabetes

Background: This patient is a 38-year-old female, who works as a dental hygienist. She was recently diagnosed with Type II Diabetes. In agreement with her medical doctor, she has committed to diet and lifestyle changes to control her diabetes before the consideration of medication. These lifestyle changes include regular exercise and eliminating sugar. When this hygienist presented in my chair, her chief complaint was “When it comes to my diabetes, I know what to do, I just need to do it! As...
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Exchanging Spit and What Else?

Recently, I had a patient who presented with generalized gingivitis. Her husband was also recently diagnosed and treated for generalized chronic periodontitis. She asked the familiar question “How did I get gingivitis? I brush and floss every day.” These questions opened the door for an interesting discussion about her risk factors. She has two children under the age of 4 and she works full time as a nurse. Both of these contribute to her disrupted and inadequate sleep patterns. She is overw...
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Case Study: Class II Periodontitis

Background: The patient is a 54 year old female who presented with the chief complaint “My gums bleed when I brush, there are possible cavities and I don’t like the tooth crowding.” Her last dental visit was about 6 years ago. There is a family history of diabetes, cardiovascular disease, stroke and cancer. The home care consisted of manual tooth brushing 1-2 times per day with occasional antibacterial mouth rinse. During the clinical assessment, it was discovered that several amalgam restor...
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A Higher Standard of Care

For many years now, research has shown that there is a mouth body connection. In other words, what is happening in the mouth can impact what is happening with the body! In order for someone to have good health, they need to have good oral health. Unfortunately, periodontal disease is silent, as it does not hurt until it is severe. The minimal pain factor, as periodontal disease develops, may be why 80% of the United States population is suffering from periodontal disease. In the next paragra...
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Case Study: Pregnancy and Periodontal Pathogens

Background: Patient is a 31 year old female, who presented with the chief complaint "My gums are swollen and painful." The last dental visit with exam was about 6 months ago. The radiographic examination including bitewings revealed horizontal bone loss and heavy amounts of generalized subgingival calculus. The patient's gums were erythematous with probe depths between 5-9 mm. Patient was diagnosed with generalized severe chronic periodontal disease. The additional challenge was that the patie...
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Periodontist Turned Patient

  As a periodontist, I pride myself on healthy gums. I admit to only getting a prophylaxis when the schedule permitted. My home care most likely resembles what most dental professional do, brush twice daily with an electric toothbrush and flossing most days. In grad school, it was discovered I had a few 4mm periodontal pockets. However, my professors were not concerned and I was never diagnosed with periodontal disease. Now fast forward several years. At age 37, after surviving an...
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