iorwen
Uploaded by
16 SLIDES
331 VIEWS
170LIKES

Comprehensive Care Plan for 62-Year-Old Male with Multiple Health Concerns

DESCRIPTION

This case study outlines the comprehensive dental management of a 62-year-old Hispanic male patient with a complex medical history, including hypertension, HIV, and coarctation of the aorta. The treatment plan integrates preventative measures against periodontal disease, including personalized oral hygiene instructions, nutritional counseling, and necessary premethods. By addressing existing dental issues, including generalized gingival recession and periodontitis, the plan aims to improve the patient’s overall health while considering his specific medical needs and lifestyle. Regular re-evaluation is recommended to monitor progress.

1 / 16

Download Presentation

Comprehensive Care Plan for 62-Year-Old Male with Multiple Health Concerns

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. P3 Project Gerardo Viadas, RDAEF

  2. Personal History Personal: • 62 year old • Male • Hispanic • Single • Retired Medical: • Hypertension • HIV • Coarctation of the aorta • Periodontitis • Seasonal Allergies • Herpes Simplex II

  3. Medical History Continued • BP 144/56 P 54 R 18 • BP 120/60 P 70 R 18 • BP 150/60 P 86 R 20 • ASAIII • Premedication required for coarctation of the aorta. • EpivirAntiviral HIV Drug • Viramune Antiviral HIV • Acyclovir Antiretroviral HSVII • Hydrochlothorizide Diuretic Hypotension • Proklor Potassium supplement uptake • Clarinex Seasonal Allergies (Antihistamine)

  4. Review of Symptoms • Neurological: None • Psychological: None • Functional : None • Respiratory: None • Cardiovascular: Coarctation of the aorta • Dermatological: None • Gastrointestinal: None • Hematological: None • Endocrine: None • Immunological: HIV Dental History • BW’s: 6/2006 • FMX: 6/2006 • Latest exam: 7/2008 • Latest dental prophylaxis: 6/08

  5. Dental History Continued Patient presents w/ restorations on teeth #’s 2MO, 3O, 8RCT, 14PFG, 15MOD, 18OB, 19DO, 28O, 29O, 30O, 31MO Missing teeth: #1,12,13,16,17,23,24,25,26,& 32. Patient present w/ generalized 3 mm recessions on all teeth. Abrasions and abfractions are not present.

  6. Clinical Examination: First Visit • Extraoral exam: WNL (max. opening 45mm) • Intraoral exam: Hard tissues WNL, soft tissue WNL except for generalized 2-3mm gingival recessions on existing teeth, salivary flow WNL. • Patients presents with a lower partial denture replacing teeth #’s 23,24,25, &26 (lower anterior incisors), and an upper partial denture replacing teeth #’s 12 and 13.

  7. Clinical Examination Continued • Occlusal relationship: Class I • Facial profile: mesognatic • Overbite: 5mm • Overjet: 3mm • Mobility: WNL • Furcation: WNL • Generalized 2-3mm probings w/ localized 4-5mm probings. • Gingival description: Maxillary attached gingiva: pink, firm, and stippled. • Maxillary free gingiva: pink, firm and smooth. • Mandibular attached gingiva: pink, firm, and stippled. • Mandibular free gingiva: pink, smooth with localized rolled borders. • Initial PI: 65% PFI:35% • Initial BOP: 1% • Calculus description: Light 2 supra and slight subgingival. 25% interproximally. • Radiographic interpretation: Consistent horizontal bone loss. • Periodontal classification:Generalized severe periodontitis.

  8. Pre-operative Images

  9. Treatment Plan • OHI: Modified Bass technique • Flossing instructions: using the “C” method of wrapping the floss around each tooth. • Interdental Aids: Proxybrush for open contacts. • Tongue scraper: Coated tongue. • Flouridetx: 2% sodium fluoride for 4 minutes. • Full–mouth scale • Re-Evaluation 3-4 weeks, to reassess the OH, to assess improvement, and new problems, and to evaluate the frequency of follow-up with dental hygiene appointment.

  10. Nutritional Recommendations • PT should exercise 30 minutes (suggestion). • PT should drink more water instead of coffee and bottled coffee flavored beverages. • Nutritional Counseling: Patient needs to consume more wholesome foods. Such as milk products, vegetables, fruits, whole grains, and low fat meats.

  11. Re-evaluation Visit • Gingiva: Generalized pink, firm, and stippled • Probings: Generalized 2-3mm (localized 5mm decreased 1mm). • PI: 39% • PFI: 61% • MBI: 0% • WLAC Calculus Code: Light 1 • OHI: Modified Bass technique, C-fold flossing technique, with interproximal cleaning aids (proxybrush). • Nutritional recommendation: Based on patient’s data.

  12. Cambra • The patient is considered a high risk patient because the patient has a history of restorations within a three year period. • Cambra recommends high risk patients to brush twice a day with a toothpaste containing 1.1% NaF. • Use a 0.2% NaFmouthrinse daily. • 3-4 month recall to evaluate caries risk and apply flouride varnish. • Saliva test and bacterial culture. • Chlorhexidinegluconate 0.12% (10ml). • Xylitol gum (6-10g daily). Two tabs a gum four times a day. • Use MI paste twice a day.

  13. What would I have done differently? • Premedication is a must for patients with coarctation of the aorta according to the American Heart Association. • Try to manage clinic time accordingly. My patient left on a two week vacation that prolonged the treatment plan. • Overall time management needs improvement.

  14. References • Removable prosthetics: Clinical Indication and Treatment Principles (2008). Retrieved June 10, 2009 from www.http//www.dentistrytoday.com • Rx for the Durable Partial Denture: Proper Maintenance Plan (2006). Retrieved June 10, 2009 from www.http//www.dentistrytoday.com • Dentures: Frequently asked Questions (2009). Retrieved June 10, 2009 from www.http//www.ada.org

More Related