Case Study 5

Patient Profile: Patient is a 48-year old White Caucasian female, 5’2” and weighs 110 lbs.

Chief Complaint: “My teeth are really sensitive and my gums bleed when I brush my teeth.”

Dental History: She does not receive annual dental examinations and the last dental hygiene appointment was 9 months ago.

Medical History: She reports having frequent kidney infections as a young woman. She has a family history of diabetes, high blood pressure, osteoarthritis and osteoporosis. Her daily medications include: 81 mg aspirin, (Hydrochlorothiazide) Microzide®, OTC antihistamines, 1000 mg calcium citrate and 2000 IU’s Vitamin D.

Extraoral Examination:

  • Submandibular, submental and preauricular nodes were palpable and tender.
  • All other assessments reported within normal limits.

Supplemental Information:

  • Localized bleeding upon probing.
  • Food catches easily between teeth.
  • Teeth are sensitive to all drinks, especially high energy drinks.

Health Behaviors:

  • Patient brushes with a hard bristled toothbrush and has not changed it since her last hygiene appointment.
  • She has trouble with flossing and gives up quickly.
  • She uses a nightly phenol rinse to see if it will decrease her bleeding.

Bleeding Index: 55%

Plaque Free Score: 30%

PERIODONTAL CHARTING

Case Study 5

STUDY MODEL

Mandibular Anterior Lingual/Maxillary Palatal Mandibular Anterior Lingual/Maxillary Palatal
Full Direct Full Direct
Right Side Right Side
Left Side Left Side

RADIOGRAPHIC IMAGES

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L

Mandibular Anterior Lingual Sextant Mandibular Anterior Lingual Sextant
Maxillary Palatal Maxillary Palatal
Maxillary Left Palatal Maxillary Left Palatal
Full Direct Full Direct

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. According to Angle’s classification of malocclusion, what BEST describes the patient’s canine relationship?
  1. What are the technique errors in the mandibular left canine periapical radiograph?
  1. What BEST describes the furcation involvement on tooth #19?
  1. Which extraoral examination method was used to determine swollen, tender and enlarged submandibular and submental nodes on this patient?
  1. According to G.V. Black’s classification of restorations, what BEST describes tooth #28?
  1. The mandibular anterior lingual sextant requires scaling and root planning, which instrument(s) would serve as the BEST to adequately remove deposits?
  1. Which of the following gingival characteristics BEST describes the interdental papillae around teeth #26, #27?
  1. Which of the following is the LEAST effective home care device to reduce plaque on the interproximal surfaces in the lower anterior sextant?
  1. What is the BEST criterion to evaluate success from scaling, root planning, debridement and oral hygiene instructions after a series of dental hygiene appointments?
  1. Based on the patient's medical history findings, Vitamin D and calcium citrate are indicated to assist in treating what medical condition represented?