Case # SW – Stace Weet is your first morning patient. She ha…

Case # SW – Stace Weet is your first morning patient. She has diabetes and is insulin-dependent. Stace’s VS were BP 104/72, P 82, R – unable to detect or assess. You confirm that she took her insulin this morning. Assessment reveals generalized recession throughout with pockets of 5 and 6 mm generalized throughout. Current radiographs show generalized bone loss. She has several small amalgams on posterior occlusal surfaces. Biofilm control on the crowns is good, but there is a lot of biofilm subgingivally noted during probing and exploring. You commence scaling. Stace is complaining of a headache and that her stomach is “rumbly”. She seems unusually grumpy with you and starts ignoring your direction as the appointment progresses.QUESTION: You should initially respond to this situation by:

Case # AL -Addie Lessent is a 14 year-old female. She has co…

Case # AL -Addie Lessent is a 14 year-old female. She has come in for her six-month recall appointment. Medical history indicates seasonal allergies and mild exercise-induced asthma. She is taking Zyrtec (antihistamine) daily and uses her inhaler only before strenuous physical activity. VS are BP 112/76, P 78, R 16. EIE reveals mild enamel hypoplasia of the permanent first molars and a composite restoration in the mesial pit of the occlusal of #14. She has orthodontic brackets on #4 – #13, orthodontic bands on #3 and #14 with an arch wire on the facials. There is generalized erythema and edema of the free gingival margin and heavy plaque on the cervical thirds of all teeth and surrounding the bands and brackets. Probe readings on permanent first molars and permanent incisors range from 1-3 mm with generalized bleeding and localized hemorrhaging. Moderate supragingival calculus is present on the lower anterior lingual surfaces. Permanent molars have deep fissures; #19 has a gray shadow underneath the enamel on the mesial aspect. Bitewing radiographs reveal decay on the mesial of #19. The dentist recommends dental sealants be done at this visit on all permanent molars except #19.QUESTION: What home care oral hygiene techniques and aids would be most appropriate for her for total plaque control and disease prevention?

Case # DW -Damon Weals is a 41-year-old male, and author of…

Case # DW -Damon Weals is a 41-year-old male, and author of several popular ‘mystery’ books. He has cerebral palsy (CP) and a seizure disorder. He is in a wheelchair and has moderate to severe muscular contractures of the hands, wrists and elbows. He takes Dilantin (phenytoin) daily to control seizures. Damon is verbal, but difficult to understand since his speech is affected by his CP. He has been going to dentists regularly throughout his life, but this is his first time in your dental practice. He is unable to perform self-care and has a home health aide who does all of his oral hygiene care on a daily basis. Intraoral assessment shows moderate attrition of all occlusal and incisal surfaces; accumulation of material alba throughout the mouth and retained food particles in the vestibular folds; moderate gingival hyperplasia; and heavy plaque on the cervical third of all teeth. Calculus accumulation is generalized with small spicules scattered subgingivally throughout the mouth and heavy supragingival calculus on mandibular anterior linguals and maxillary posterior facials. Damon is trying to give you some information about his medical history but you cannot understand him.QUESTION:  You want to move Damon from his wheelchair to the dental chair. What is the first step?