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Browsing by Author "Rettig, Pamela"
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ItemDental Anxiety: The Effects on Oral Health and Dental Treatment.(4/13/2015) Cobb, Mandi; Rettig, Pamela; Cobb, Mandi; Rettig, Pamela; Dental HygieneObjective: The objective of this case presentation is to educate the dental professional on the management of a patient with dental anxiety. Assessment: A 20 year old Caucasian male presented to the dental hygiene clinic for a cleaning at the request of his grandmother. The patient reported a negative medical history with the exception of anxiety to dental care. Due to this anxiety, consent was obtained from the patient to speak with the grandmother in regards to his medical history. At this time, the grandmother disclosed that the patient had a traumatic dental experience as a child and has not been to the dentist since that event occurred. Clinically, the patient presented with generalized severe gingivitis as evidenced by red, rolled, spongy tissue with bleeding upon probing due to the presence of heavy calculus. Despite the inflammation present, bones levels are healthy. The patient reported never brushing his teeth due to pain and fear of causing pain to himself. DH Care plan: Patient received full mouth debridement, modified adult prophylaxis, and extensive oral hygiene instruction. Treatment: Experimental techniques were utilized throughout the course of treatment in order to ease anxiety while providing effective treatment. Results: Experimental methods that were used throughout treatment proved effective for the completion of full mouth debridement and adult prophylaxis. Conclusions: The patient presented with extensive gingivitis and heavy calculus deposits. For optimal success in the future, a short recall is necessary for the patient to receive continued extensive dental hygiene therapy. ItemThe Effects of Dilantin on the Oral Cavity Over Time.(2015-04-13) Ames, Rachel; Rettig, Pamela; Ames, Rachel; Rettig, Pamela; Dental HygieneThe objective of this case presentation is to discuss the long-term effects of Dilantin in causing gingival hyperplasia as seen in a patient. Assessment: A 54 year old African American male patient presented to the Dental Hygiene Clinic at Indiana University School of Dentistry (IUSD) with a chief complaint of “I need to get my teeth cleaned for my three month appointment.” The patient was referred to our clinic from the IUSD Graduate Periodontal clinic for his three month periodontal maintenance appointment. Medical history indicates he suffers from epilepsy and has been taking Dilantin for over forty years. An intraoral examination revealed advanced localized periodontal disease in the lower right quadrant with probing depths ranging from 1-10mm and clinical attachment levels ranging from 1-8mm. Patient also presented with generalized healthy gingiva as evidenced by coral, firm, and stippled tissue. The intraoral radiographs reveal generalized mild bone loss as evidenced by 3-4mm from crest of bone to CEJ. The patient’s oral hygiene habits include: brushing twice a day, flossing once a day, and using an antimicrobial mouth rinse once a day. DH Care Plan: periodontal maintenance, topical fluoride varnish, review of oral hygiene, and review of the use of a water irrigator. Evaluation: The patient was referred to the Graduate Periodontal department for further evaluation due to the increase of gingival overgrowth on #31 distal and the presence of exudate. The dentist who performed the last dental exam in the Dental Hygiene Clinic feels the patient will need another gingivectomy. Conclusions: From the review of the evidence-based literature, the Dilantin is the cause of the gingival hyperplasia that this specific patient has been experiencing over the years and his need for continuous periodontal surgery. ItemThe Effects of Poor Dental Knowledge on Oral Health.(04/13/15) Ison, Kayla; Helwig, Melissa; Rettig, Pamela; Helwig, Melissa; Rettig, Pamela; Dental HygieneObjective: The objective of this clinical case report is to evaluate the effects of low dental knowledge and low socioeconomic status on the oral health of an individual. Background: A 32 year old Hispanic male presented to the dental hygiene clinic as a new patient with a negative medical history with the exception of untreated hypertension diagnosed at his last physical examination 5 years earlier. Patient reported smoking 2 to 3 cigarettes per day. Patient had received a prophylaxis 5 years ago in Mexico at a free clinic, but he has never been able to receive regular dental care due to his low socioeconomic status. Patient had limited oral health education prior to his visit to the dental hygiene clinic. Assessment: Patient presented with generalized moderate to severe plaque induced marginal gingivitis as evidenced by red, spongy, rolled gingiva, and a bleeding score of 74%. The periodontal description revealed generalized mild chronic periodontitis as evidenced by 4-5mm CAL and localized moderate chronic periodontitis as evidenced by 6-7mm CAL on #1, #4, #5, #11, #13, #14, and #18. Patient also presented with generalized mild horizontal bone loss on radiographs as evidenced by 2.6mm to 3.5mm measurements from crest of alveolar bone to the CEJ. The patient’s plaque score ranged from 18% to 26% and generalized moderate to heavy supragingival and subgingival calculus was detected. Active decay was found on #2, #16, #17, #28, and #30. Dental Hygiene Care Plan: Patient received scaling and root planing in all four quadrants, a tissue re-evaluation and extensive oral hygiene instruction. Results: At the tissue re-evaluation, the patient’s gingival health and probing depths were improved. Conclusion: The patient’s positive response to treatment is the result of the thorough scaling and root planning therapy, extensive patient education, and patient compliance. ItemMaintaining Oral Health with Parkinson’s disease and Arthritis.(04/13/15) Jones, Lindsey; Minett, C; Rettig, Pamela; Jones, Lindsey; Rettig, Pamela; Dental HygieneObjective: The objective of this case presentation is to discuss the modifications of dental care for a patient with Parkinson’s disease. Background: A 72 year old Caucasian male presented to the dental hygiene clinic for a periodontal maintenance appointment. Significant findings in the medical history include current treatment of Parkinson’s disease, arthritis in the hands and feet, and medications Omeprazole, Fluoxetine, Gemfibrozil, Gabapentin, Levodopa, and Clonazepam. Assessment: Patient presents with generalized moderate plaque induced gingivitis evidenced by reddish-pink gingiva, 60% BOP, bulbous, spongy papillae. Clinically the patient presented with generalized 4-8mm clinical attachment levels. Radiographically, the patient presented with generalized mild to moderate bone loss evidenced by 3-5mm from the CEJ. The primary contributing factor to the gingival inflammation was the plaque score of 97%. The patient struggles with oral hygiene due to his Parkinson’s disease and arthritis in hands. DH Care Plan: patient received full mouth debridement, instruction on a modified floss holder with clay, product recommendations of xylitol gum and toothpaste to reduce xerostomia. Results: Oral health indicators from previous appointments showed minimal or no improvements due to the patient’s medical condition. Conclusions: Since last recall a few sites had improved including probing depths by 1-2mm. Patient was referred to a comprehensive care clinic for extraction of tooth number four, and an implant is treatment planned for replacement. It is recommended that the patient continue on 3 month intervals to monitor his oral health status and identify dental disease early ItemModification of Dental Hygiene Care in a Breast Cancer Patient.(04/13/15) Stanton, Erica; Gudgel, S; Rettig, Pamela; Stanton, Erica; Rettig, Pamela; Dental HygieneObjective: The objective of this clinical case presentation is to evaluate the treatment of a patient undergoing chemotherapy for breast cancer and identify necessary modifications throughout the dental hygiene appointment. Background Information: A 72-year old, Caucasian female patient presented to the dental hygiene clinic with the chief complaint of “I want to get my teeth cleaned.” The patient also reported symptoms of xerostomia and burning sensation of the gingiva. The patient receives regular periodontal maintenance care every three months at a private practice. The medical history revealed breast cancer, hypertension and history of myocardial infarction. The patient’s breast cancer is currently being treated with chemotherapy and radiation. Clinical Examination: The patient presented clinically with generalized mild plaque-induced marginal papillary gingivitis as evidenced by red, rolled, spongy gingiva with bleeding on probing and generalized moderate chronic periodontitis as evidenced by 4-5mm clinical attachment levels. Radiographically, the patient presented with localized mild horizontal bone loss as evidenced by 3-4mm measured from the cementoenamel junction to the crest of the alveolar bone around teeth numbers 4 (distal), 15 (mesial), 19, 27, 29 and 31. Oral hygiene habits consist of patient brushing at least once per day, but seldom flossing or using mouthwash. The patient is at high risk for dental caries due to active decay, medication-induced xerostomia and inadequate home care. DH Care Plan: Periodontal maintenance with extensive oral hygiene instructions were performed. Toothpaste and mouth rinse for dry mouth were recommended at the initial appointment. Evaluation: This patient will return for periodontal maintenance in March 2015. At that time oral hygiene and caries risk will be evaluated. Conclusion: In this case report, the complaints of a patient with a history of breast cancer, xerostomia, and burning of the gingiva were addressed. ItemRecognition and Treatment of Amlodipine (Norvasc) Induced Gingival Hyperplasia.(04/13/15) Silcox, Darci; Thompson, N; Rackley, R. Hunter; Silcox, Darci; Rettig, Pamela; Dental HygieneObjective: The objective of this clinical case presentation is to help dental hygienist recognize and understand the treatment of gingival hyperplasia. Assessment: A 56 year old Caucasian male presented to the dental hygiene clinic with the chief complaint, “I want my teeth cleaned.” The patient’s last cleaning was in 2011 at Indiana University School of Dentistry (IUSD). The patient’s medical history revealed that he smokes one pack of cigarettes a day and has been taking the calcium channel blocker amlodipine for approximately two months for hypertension. The patient’s gum tissue presented clinically as pink, stippled, rolled, and bulbous with a hyperplastic appearance. The mandibular attached gingiva in particular, was firm and had an enlarged clinical appearance. Amlodipine is known to cause gingival hyperplasia. Drug-induced gingival hyperplasia was reclassified in 1999 by the APP as a dental plaque-induced gingival disease. Amlodipine is a commonly prescribed drug with the prevalence of gingival hyperplasia being reported as high as 33.3%. Gingival hyperplasia can manifest from mild to severe depending on modifying factors including the patient’s ability to remove plaque biofilm and the length of time the patient is on amlodipine. DH Care Plan: Treatment for this patient at the IUSD hygiene clinic includes scaling and root planing on the maxilla, with full mouth debridement, and a tissue re-evaluation 4-6 weeks after treatment. Each case of gingival hyperplasia should be treated based on the individual’s needs; this can include non-surgical therapy, surgical procedures, or a combination of both. Evaluation: Due to time constraints associated with this presentation, this patient has yet to be re-evaluated after treatment at IUSD. Conclusion: Hygienist must stress the importance of plaque control and spend quality time on oral hygiene instructions. If a patient is on a medication known to cause gingival hyperplasia it is important to note any changes at each visit.