Case Study 27

Patient Profile: Patient is a 28 year-old White Caucasian female who is interested in having a prophylactic appointment.

Chief Complaint: I have several lumps on the roof of my mouth that are sometimes painful and my gums bleed every time I brush my teeth."

Dental History: The patient has not seen a dentist for over 10 years.

Medical History: The patient is five months pregnant and diagnosed with gestational diabetes. She is currently taking prenatal vitamins and daily insulin injections. Vital signs recorded: Blood Pressure: 142/92; Pulse: 59 BPM; Respiration: 24 Breaths/Minute.

Extraoral Examination:

  • Assessment reported within normal limits.

Supplemental Information:

  • Smokes 1-3 cigarettes daily.
  • Eats only fast food throughout the day and drinks carbonated soft drinks daily.

Health Behaviors:

  • Patient brushes twice daily with a manual toothbrush.
  • Patient rinses with a phenol mouthrinse several times daily.
  • Patient does not floss.

Gingival Description: Generalized marginal and papillary erythema and edema. Generalized bleeding upon probing.

Bleeding Index: 70%

Plaque Free Score: 30%

Social History: The patient works the nightshift at a gas station. She lives at home with her unemployed mother and unemployed boyfriend. She has two younger brothers who she cares for.

PERIODONTAL CHARTING

Case Study 27 Pictorial Chart

Intraoral Images

Right Side Right Side
Right Palatal Right Palatal

QUESTIONS

Your Faculty has access to the answers in this case study. Please ask them to look in the Faculty Corner for the answers to this case.
  1. The mandibular anterior incisal edges demonstrate what abnormality?
  1. Based on the patient's pregnancy, she requires all of the following treatment considerations except one. What is the EXCEPTION?
  1. A dental hygiene care plan specific for this patient will include all of the following except one. What is the EXCEPTION?
  1. The BEST explanation for the bleeding index to be elevated is attributed to:
  1. Due to the patient's condition, she needs to avoid or limit the use of dental procedures requiring:
  1. In order to alleviate discomfort from the palatal region, the patient must strictly avoid using all of the following EXCEPT:
  1. The lesions in the maxillary right palatal intraoral image MOST likely exist and are inflamed due to responses from all of the following EXCEPT:
  1. Pregnancy-associated gingivitis is often accompanied by increased levels of what gram-negative organism?
  1. The BEST dental hygiene care plan for the patient should start with:
  1. All of the following will directly impact the success of the patient's dental hygiene care plan except one. What is the EXCEPTION?