Class II Periodontitis
By: Sue Baughman, RDH
December 12, 2017
The Challenge:
The patient has Class II periodontitis with a lack of home care and recall. Through periodontal therapy, our goal is to establish a remission of the disease and establish a healthier bacterial load to reduce oral/systemic complications. Through education, our goal is to establish home care habits to assist patient’s remission and stress the need for recall not just for health of periodontium but overall health.
The Background:
- Age: 54
- Sex: F
- Medical History: High blood pressure and allergy to penicillin
- Family Medical History: Diabetes, cardiovascular disease, stroke and cancer
- Last Dental Visit: 6 years ago
- Home Care: Manual toothbrush 1-2x per day with occasional antibacterial mouth rinse and tongue brushing
- Nutrition: Diet soda daily, tea with honey
- Patient Chief Complaint: “Bleeding gums when brushing, possible cavities and tooth crowding.”
- Clinical Assessment: Deteriorating margins of amalgam restoration, recurrent decay diagnosed by exam and radiographs. Generalized plaque with moderate calculus.
- Periodontal Assessment: Class II periodontitis. 110 out of 168 points of bleeding, all 28 teeth with generalize 4 mm probe depths with localized 5mm probe depths. Bone loss of 1-10% including both horizontal and vertical throughout.
The Solution:
- Date of Pre MyPerioPath® (pre-therapy test): 6/15/2017
- Periodontal Therapy: 4 quadrants scaling and root planning and doxcycline subgingivally in all areas.
- Systemic Antibiotics Used: Ciprofloxacin & Metronidazole per results
- Home Care: Chlorhexidine rinse at home 2x daily
- Date of MyPerioProgress® (post-therapy test): 10/5/2017
The Result:
At the 6-week tissue check, this patient has been using an electric toothbrush 1-2x per day, flossing a couple times per week, utilizing a tongue scraper, and using the chlorhexidine mouth rinse. Patient discontinued the rinse after 2 weeks due to increasing sensitivity. Post-therapy periodontal charting was completed with 1 localized 4mm residual pocketing and 12 out of 168 bleeding on probing. The post therapy MyPerioPath saliva sample was collected. A prophy, polishing, flossing was also completed. Patient will be seen every 3 months for periodontal maintenance. MyPerioProgress results showed reduced periodontal pathogens reductions from 7 pathogens above reference lines to 0 above. The patient was called, and results were reviewed, she then received a copy to give to her medical doctor.
About the Author:
