My Special Patient

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Friday, April 13th, was my last day of clinic and it was a very intense day. I completed my special need patient, an extra patient that may count as an adolescent if Ms. Jones approves it, and screened my board patient. My special need patient was MB, a 39 year old female who suffers from bipolar disorder, depression and stomach ulcers due to medications. My patient is under a physician’s care and is taking her medications. Her vitals were BP: 116/77, R: 20, P: 75, and her intraoral and extraoral exam was within normal limits. Her AAP classification is III and her case type is 2. During her last appointment, patient was given a referral to Kool Smile to check some suspicious areas that Dr. Landry found, but patient has not completed the …show more content…

For her appointment, I had in mind to use Oraqix as needed to do the whole mouth debridement, because she presented light supragingival calculus on mandibular teeth and generalized moderate gingival and interproximal plaque. The patient does not have deed pockets, but has generalized recession. I did the prophylaxis with hand instrument, but it represented a challenge because patient at one point refused that I use the instruments because it was bothering her while I was removing soft deposit supragingival. In this situation, I had to think outside the box and come up with a way to remove plaque and calculus and make the patient comfortable. I decided that brushing the patient and flossing will help me to remove the plaque, and this way I would only had to focus on removing the calculus. Thanks god, it worked. It took a lot of patience, positive encouragement and feedback on how much she has improved since her last visit, but I was able to complete the prophylaxis. For her next visit, I think that do to her generalized recession and sensitivity, the patient will benefit by having LA during her prophylaxis, even if it means that she will have …show more content…

DH has a high prevalence worldwide, affecting 25%-46% of 18–70 years old people, and it is consider a clinical oral health problem. The most acceptable theory that explain how DH occurs is the “hydrodynamic theory”, which states that pain is the result of the activation of pulpal nociceptors by the movement of dentinal fluid inside the dentinal tubules. Based on this theory, there is two ways to treat DH, one is by blocking neural transmission from the pulp, and the other, is by occluding the dentinal tubules. Therefore, desensitizing toothpaste containing potassium salts is recommended as a treatment since it is known to have nerve numbing effects. In addition, calcium sodium phosphosilicate (CSPS), it used to close the dentinal tubules by delivering silica and ionic calcium, phosphorus, and sodium to the surface of the tooth. Even though there is not a therapeutic gold-standard treatment that completely and predictably eliminates DH, self-administered dentifrice is the first choice of treatment for generalized DH because is simple and inexpensive. In-office treatment is usually target DH localized to one or more teeth (Zhu,

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