Question

Your first day at on Monday morning is joyce Robbins. she is new to your practice. She has filled out a parodontal assessment questionnaire to assist you and determining her assessment. She states that she has never filled one out before and is concerned that she has received poor quality dental work as a result. As she entered your operatory you notice that she is very petite well-dressed woman her medical history and periodontal assessment questionnaire reveals about Joyce is a 58 year old college professor. She has stage 1 hypertension and I takes 20 mg of lisinopril daily as a result. She Has a family history of cardiac disease (from both her mother and father) And her father developed type 2 diabetes at age 50. she takes simvastatin for high cholesterol. she is borderline diabetic and her blood sugar levels have been rising at each Primary Care visit. She suffers from osteoporosis of the spine and hip. She is presently a non-smoker but did smoke while she was in college. Her oral exam and Readygrass revealed that she has generalized slight or session, generalized horizontal bone loss, generalized 3 mm Pockets, thumbs 4 and 5 mm pocket on the posterior teeth, little plaque biofilm, but General a slight to moderate supragingival and subgingival calculus deposit. She flosses daily but hasn't had her teeth cleaned in 5 years. She frequently gets food stuck between her teeth, and is increasing becoming concerned about “the way her teeth look and feel”. She wants to know what she can do to maintain her “pretty smile”, and why no other office was at thorough with her care.

What do you think have may causes the patients generalized recession?

What factors may be contributed to the patient’s disease progression?

How will you discuss the balance between periodontal health and disease?

Is there an ethical dilemma involved?

Answer 1

Q. No 1. Answer :

Generalised recession : It is one type of the Gingival recession.

It is also known as receding gums.

It is caused by due to loss of gum tissue , or the retraction of the gingival margin from the crown or lower teeth and there is a exposure of roots of the teeth.

* Causes like gum diseases or periodontal disease ,

* Aggressive brushing

* Improper flooshing

* Using hard brush.

* poor oral hygiene

These are the causes for the the patients generalised recessions.

Q. No 2. Answer :

She is having stage 1 hypertension, and boarder line diabetic, and increasing blood sugar levels at each visit, osteoporosis, and she is having oral and dental problems like, generalized slight, horizontal bone loss, posterior teeth problem, and plaque formation, sub gingival and supragingival calculus deposit, food strucking in the tooth. Ect.

* To improve patient condition we will advise like

* doing daily brush with soft tooth brush.

* avoid flooshing hardly.

* by avoiding smoking.

* by regular taking of mouth care with mouth wash. It may fight with plaques.

* for diabetes and hypertension regular health check ups.

* and dietary modifications

* exercises

* and maintaining weight and monitoring levels regularly.

These all factors may improve the patient disease progression.

Q. No 3. Answer :

Periodontal health is important to all.

Because if it is good the peoples can take food normally and digestion taken place from mouth.

Disease is a disorder of the human structur of function of the body.

If periodontal health is good there is a less chance to come other diseases like hypertension and hyperglycemia ect.

Q. No 4. Answer :

Yes, there is a ethical dilemma like " age factors ", if they take how much care also as the doctor advices, due to increased age they won't improve the disease or periodontal health.

So it is one of the ethical dilemma here.