Case Study #3: Your first patient in clinic is a healthy 24…

Case Study #3: Your first patient in clinic is a healthy 24 year old with probe depths 1-3mm and tight, resilient tissue. They report that they do not floss and have not had a dental visit in 6 years. They have generalized calculus interproximal and you are using the sickle scalers to access the calculus.  You notice that you don’t have a sharpening card in your cassette, so you begin scaling without sharpening. While you are scaling, you place the instrument at the proper location on each tooth and use light, sweeping, supragingival strokes using your fingers. When your clinic instructor checks your scaling progress, they indicate that you have missed several areas of calculus in the middle of the proximals and have burnished other areas of calculus. In summary, you have not made much progress with your scaling. Use this information to answer the following questions. QUESTION: What portion of the sickle scaler adapts to the tooth structure to effectively remove calculus?

CASE STUDY #3: You are seeing a patient for a  4 month perio…

CASE STUDY #3: You are seeing a patient for a  4 month periodontal maintenance appointment.  She had full periodontal charting 10 months ago and bitewing radiographs taken then.  She reports that she was diagnosed with diabetes and she’s having a hard time managing it so far.  When you look in the mouth to begin your charting, you see that there has been some gingival changes and that her probe depths are deeper than at her last appointment.  You also take some photos and show the patient the changes that you are seeing. Use this information to answer the next 5 questions.  QUESTION: What type of exam would you choose on your periodontal chart?

CASE #4: Your new patient presents with a chief complaint of…

CASE #4: Your new patient presents with a chief complaint of “I want to get established as a patient and I think I may have some gum issues going on”. During the health history and dental history, the patient reports high blood pressure and diabetes that he takes medications for and that he is a current daily cigarette and e-cigarette/vaping user.  He used to have regular dental hygiene appointments, but has not been in a dental office since the COVID pandemic started in 2020. During the head and neck exam you identify that they have a white and yellow lesion on their side of their tongue, 3 teeth that appear to have decay and gingiva that is swollen, red, and blunted. When you ask about the tongue, the patient says that it has been there for about a month and has not healed. During the periodontal and clinical examination you detect 4-6mm probe depths on all of the posterior teeth, furcation involvement on several molars and generalized bleeding. Use this information to answer the following questions: QUESTION: When you ask follow up questions about his health history and complete vitals, which set of numbers would indicate a need for a medical consult before we should treat him?