Download Abstract Preventing Caries and Periodontal Disease on a High Risk

Abstract
Preventing Caries and Periodontal Disease on a High Risk Patient. A. MURPHY*, A. CARLTON, P. RETTIG
(Indiana University School of Dentistry).
OBJECTIVE: The objective of this clinical case presentation is the implementation and evaluation of
preventive measures by a dental hygiene student on a patient who presents with high caries risk and
localized periodontitis. BACKGROUND: A 54 year old Caucasian male patient presented as a 3 month
prophylaxis recall with a chief complaint of “sensitivity in one tooth in the upper right quadrant.” His
medical history was positive for hyperlipidemia, hypertension, diabetes mellitus type II, prior head and
neck radiation, and anxiety and depression. He takes multiple medications which may induce
xerostomia, taste disorder, and gingival hyperplasia. The patient presented with generalized healthy
radiographic bone levels measuring 1-2mm from the CEJ to the alveolar crest. The patient presented
with generalized moderate plaque-induced marginal and papillary gingivitis as evidenced by red,
bulbous and rolled gingiva which is spongy in consistency. The patient also presented with generalized
healthy periodontium as evidenced by 1-3mm CAL, with localized areas of 4-6mm CAL. The patient’s
plaque score at the last recall visit was 28%, which was an improvement by 36% from our first
appointment. The patient presents with numerous modifying factors and a fair adherence to protective
modifying factors. DH CARE PLAN: Patient will be placed on a 3 month recall interval as an adult
prophylaxis patient, which includes debridement, oral hygiene review, nutritional counseling, 5% NaF
varnish application, and evaluation for the need of prescription fluoride. EVALUATION: The patient’s
plaque score and gingival health have continually improved over his course of treatments in the dental
hygiene clinic. The patient was receptive to the information provided during his dietary analysis session,
and he understands the correlation between his systemic and oral health. Probing depths and areas of
demineralization are not progressing at this time. CONCLUSIONS: Positive results have occurred from
the preventive treatment plan. It is critical to continue monitoring the patient’s systemic health, caries
risk, and periodontal conditions to evaluate the long-term success of the preventive measures applied,
but short-term results have shown continued improvement.