CHAPTER 5, CH 5, CASE 1 A patient new to your dental team has been appointed with you for a dental prophylaxis. The patient has just relocated to your town. The patient tells you that he saw a dentist just before moving who told him that he has gingivitis. During your discussion with the patient, he asks if there is some way he can tell at home if he has gingivitis. How might you reply to this patient’s question?, CASE 2 Reading through your patient’s treatment notes from the previous visit, you notice the clinician documented “presnce of gingival inflammation.” Explain why this statement is not adequate documentation. What would you add to the description to provide another clinician with a clear verbal description of the clinical features of the patient’s gingival tissues?, CASE 3 You are scheduled to perform nonsurgical periodontal instrumentation on a patient with a diagnosis of localized severe biofilm-induced gingivitis. At the time of the appointment the patient informs you that she is pregnant. With this information in hand, what would be the most appropriate periodontal diagnosis?, CASE 4 A patient who has been cared for by your dental team suddenly exhibits poor self-care with quite a bit of plaque biofilm accumulation. This is unusual for this patient. Discussions reveal that the patient is having difficulty with brushing and flossing due to soreness of the mouth. Examination reveals numerous small mucosal ulcers. Further discussions reveal that the patient has been experiencing this soreness since she began using tartar control toothpaste. How might your dental team manage this patient’s diminished effectiveness of self-care?, CASE 5 Your patient reports a change in his medical history from last visit; he is now taking Depakote as a mood stabilizer. The drug reference manual states it is an anticonvulsant and may cause gingival enlargement. How will this new information alter your plan for dental hygiene care and patient education?, CASE 6 Your patient reports a change in his medical history from last visit; he is now taking Depakote as a mood stabilizer. The drug reference manual states it is an anticonvulsant and may cause gingival enlargement. How will this new information alter your plan for dental hygiene care and patient education?, CHAPTER 19, CH 19, CASE 1 While visiting a dental office, you observe a member of the dental team performing a periodontal assessment. You note that while searching for furcation invasion, the clinician is using a straight calibrated periodontal probe. What critical information might be lost because of instrument selection for this step in a periodontal assessment?, Since furcation invasions due to periodontitis are horizontal and involve loss of attachment and bone between the roots of multirooted teeth, using a straight calibrated periodontal probe would not give accurate results when checking for furcation invasions. The findings would not be accurate because the straight probe could not be directed horizontally between the roots of multirooted teeth. A specially designed curved probe would make it possible to check for this horizontal (under the crown) furcation invasion. Many of these curved furcation probes are available with calibrated markings on them, also to aid in quantification of the severity of any furcation invasion., CASE 2 During a comprehensive periodontal assessment, you note severe inflammation of the gingiva over the facial surface of a lower right molar tooth. On the dental chart you are using, there is no obvious mechanism to record this important piece of periodontal information. How should you proceed?, All members of the dental team should be aware that most dental charts do not allow for recording every detail of the periodontal status. It is frequently necessary when documenting a thorough periodontal assessment to supplement whatever findings can be recorded on the patient chart with some additional information in a daily treatment record entry. In this case, since there is no obvious place to record gingival inflammation on the chart, the finding should be added to the daily entry., CASE 3 During a periodontal assessment of a periodontitis patient, you are trying to determine the clinical attachment level on the facial surface of a canine tooth. On the facial surface of the canine tooth, you have measured 3 mm of gingival recession and a probing depth of 6 mm. How much attachment has been lost on the facial surface of this canine tooth?, CHAPTER 20, CH 20, CASE 1 Mr. Jones is a new patient in your dental office. He brings with him some recent full-mouth radiographs that reveal no evidence of alveolar bone loss. While studying a copy of the patient’s dental chart, you note that there is a diagnosis of Stage II, Grade A periodontitis. How might you explain the apparent discrepancy between the lack of radiographic evidence of bone loss and the diagnosis of periodontitis?, CASE 2 During a periodontal assessment for a new patient, you detect clinical attachment loss. When you suggest that the patient needs dental radiographs, the patient objects because she does not want to be exposed to “unnecessary x-rays.” How might you address the patient’s concerns?, CASE 3 While reviewing a new set of dental radiographs for a patient, you note numerous sites of obvious alveolar bone loss. How can you determine if the radiographs display horizontal or vertical bone loss?, CHAPTER 25, CH25, CASE 1, CASE 2, CASE 3, CASE 4, CHAPTER 26, CH26, CASE 1, CASE 2, CASE 3, CHAPTER 27, CH27, CASE 1, CHAPTER 28, CH28, CASE 1, CASE 2, CASE 3, CASE 4, CHAPTER 30, CH30, CASE 1, CASE 2, CASE 3, CASE 4, CHAPTER 31, CH31, CASE 1, CASE 2, CASE 3, CHAPTER 38 (look at rads in textbook), CH30, CASE 1, CASE 2, CASE 3, CASE 4, CASE 5, CASE 6

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