By: Brenda McNevin RDH
November 13, 2018
A 15-year-old patient with multiple years of periodontal concerns being co-managed with a periodontist without resolution.
Additional Comments: Her appearance was pale and very thin. The mother reports for several years being unable to motivate the patient in areas of oral and personal hygiene.
Additional comments: Further medical investigation was recommended such as checking of Vitamin D levels, estrogen & progesterone levels and thyroid.
Therapy has been suspended. In consult with the mother about the MyPerioPath® results and the recommended treatment plan, he mother reluctantly revealed the daughter was diagnosed with anorexia nervosa. I informed the mother I would be forwarding the test results to the daughter's pediatrician and periodontist. She made me aware that the daughter's Vitamin D level was very low and being tested every other day. In addition the daughter’s thyroid and hormone levels were significantly low too. The mother stated the daughter is now in a 6-week eating disorder program followed by outpatient care. The mother agreed to therapy once the eating disorder is under control. Upon a visit by the mother for another sibling’s care, the mother stated the daughter was improving but still has a long way to go.
I am appreciative of the level of care and concrete information I can now provide to my patients by utilizing OralDNA® salivary testing services. In conclusion, the underlying cause for this patient’s gingival hyperplasia and low to moderate bone loss is anorexia nervosa. Early in this patient’s care, I was suspicious there may be some depression concerns. This in addition to the clinical signs was a reason for referral to the specialist and a non-conclusive diagnosis. Now with testing I can rule in or rule out bacteria being a cause for the inflammation so we can explore other possible reasons for the inflammation and provide more timely care.