2. 28 year old male
Good health
Recently had arthroscopic knee surgery
Iraq war veteran
Calculus Classification: 3b
Takes muscle relaxants and Ibuprofen
BP was within normal limits each appointment
3. Last NSPT: 2008
Generalized gingivitis
Heavy bleeding
Moderate plaque levels
Missing teeth: #1, 2, 15, 16, 17, 18, 31, 32
Malopposed teeth
Fillings out
Brushes 2x/day, Flosses 1x/day
PSE: Generalized 4’s and 5’s posterior, 3’s and 4’s
Anterior
6. Fluoridated toothpaste
Drinks a lot of orange juice and coffee (ACIDIC!!)
DOES NOT HAVE AN ESTABLISHED DENTAL HOME!
Clinical Conditions:
1 or 2 new caries lesions/restorations in last 36 months
Visible plaque
Unusual tooth morphology
2 interproximal restorations
Exposed root surface on #27 (1mm recession)
Open margin on the gold crown on #3
MODERATE RISK FOR CARIES!!!
7. Susceptible tooth structure: rotated teeth and
unsound dentition
Inadequate fluoride intake (No professional
applications)
Poor oral hygiene: Attributed to accumulation of
marginal plaque
Viscous saliva: reduced cleansing ability
Thick plaque reduces buffering ability of saliva
Muscle relaxants may cause dry mouth
8. From 8/2011
What’s evident:
Open margin on mesial of #3
Caries on distal of #4
#6 blown out
Possible supernumerary tooth above #9 and #10
Calculus visible distal of #30, and mandibular anteriors
9. Taught patient proper brushing technique since he was
completely missing the gumline
On his final appointment, plaque levels had decreased
Explained he’s at moderate risk for caries and that frequent
cleanings and good home care are essential
Emphasized importance of getting unsound dentition fixed
What I learned:
How big of a role saliva plays in caries prevention
Just because people “claim” to brush and floss on a regular
basis, doesn’t mean they’ll have good oral health
Can’t always believe patients: he thought he had an implant
on #8 when it’s really just a crown with a post
10. Sroda, Rebecca. (2010) Nutrition for a Healthy Mouth.
Baltimore, Maryland. WoltersKluwer Health/
Lippincott Williams and Wilkins
http://www.rxlist.com/flexeril-drug/patient-images-
side-effects.htm