Case Study 32

Patient Profile: Patient is a 33-year old White Caucasian male.

Chief Complaint: “I have a bad taste in my mouth.”

Dental History: The patient has not seen a dentist in 3 years.

Medical History: The patient is unaware when he last saw his physician. He reports frequent migraines and was diagnosed with Hepatitis A several years ago. He has a family history of diabetes, hypertension and alcohol abuse. Vital signs recorded: Blood Pressure (RAS): 135/88; Pulse: 100 BPM; Respiration: 18 Breaths/Minute

Extraoral Examination:

  • Assessment reported within normal limits.

Supplemental Information:

  • Patient presented with generalized heavy plaque, and generalized moderate bleeding upon probing with localized heavy bleeding in the maxillary anterior sextant, and mandibular lower right quadrant.

Health Behaviors:

  • Patient is unaware of his toothbrush design or type of dentifrice he uses.
  • Patient does not floss.
  • Patient uses a phenol mouthrinse several times daily.
  • Consumes lemonade and high power energy drinks throughout the day.

Bleeding Index: 75%

Plaque Free Score: 10%

Social History: He reports no history of smoking or alcohol use.


Case 32 - Periodontal Chart


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Case 32 radiographic images

Full Direct Case 32-Full direct


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. What is the BEST index to determine the extent of plaque at the gingival margin?
  1. How will the clinician correct the error in the maxillary anterior periapical radiograph?
  1. The patient’s blood pressure recording represents what category?
  1. What best describes the radiographic root appearance on tooth #13?
  1. The patient requires local anesthesia in order to successfully scale, root plane and debride the upper right quadrant. He reports experiencing a fast heartbeat, headache and restlessness from previous local injections. What course of action should the hygienist take?
  1. Which of the following suggests the best course of action for the clinician based on the patient’s blood pressure recording?
  1. The patient’s chief complaint can be associated with:
  1. What is the first course of action for this patient’s dental care plan?
  1. All of the following will improve the patient’s gingival health EXCEPT one. What is the EXCEPTION?
  1. After reviewing the radiographs, which teeth require dental treatment?