Dental Hygiene

Instructions
Please review the below case study and submit questions and answers as a word document. Pictures, radiographs, and charting are attached.
PATIENT PROFILE
Mr. Wilton is a 52-year-old manager of a local gardening store who has come to your dental office for an initial visit. During his patient interview, Mr. Wilton informs you that he made this appointment at his wife’s insistence. He states that his wife wants to know if there is anything that can be done about his bad breath. Mr. Wilton informs you that he cannot seem to get his bad breath under control using mouth rinses.
PATIENT HEALTH HISTORY
• At the time of his initial visit, Mr. Wilton’s blood pressure is 164/100 mm Hg and his pulse rate is 74 per minute.
• Mr. Wilton informs you that he is taking Amoxicillin prescribed by his physician for an ear infection.
• Mr. Wilton tells you that he had high blood pressure once and that he did take a prescribed medication a few years ago for that condition. He tells you that he was feeling just fine so he stopped taking the prescribed blood pressure medication.

DECISION-MAKING QUESTIONS FOR CASE: MR. WILTON
1. What information should your team give Mr. Wilton regarding his wife’s concern about his bad breath? Note that this was the complaint that prompted Mr. Wilton to make an appointment in your office.
2. What factors in Mr. Wilton’s profile indicate that achieving an acceptable level of patient self-care may be a problem for the dental team?
3. What factors revealed in Mr. Wilton’s health history will be critical for the dental team to consider during periodontal evaluation or treatment?
4. What signs of gingival inflammation are evident in Mr. Wilton’s clinical photographs?
5. What etiologic risk factors for gingival and periodontal diseases are evident in Mr. Wilton’s clinical photographs?
6. Does Mr. Wilton’s periodontal evaluation indicate that he has attachment loss present on some teeth?
7. In response to your questions, Mr. Wilton informs you that the spaces between his front teeth were not there a few years ago. What do you think may be causing these spaces between his teeth to appear?
8. What etiologic factors for gingival and periodontal diseases are evident in Mr. Wilton’s dental radiographs?
9. On Mr. Wilton’s radiographs, what specific findings indicate that he has alveolar bone loss present?
10. How would you characterize Mr. Wilton’s periodontal condition? Do you think that he has gingivitis, periodontitis, neither, or both? What clinical or radiographic findings did you use to reach your conclusion?
11. Write a suggested step-by-step plan for nonsurgical periodontal therapy for Mr. Wilton.
12. What is the AAP classification based on the 2017 guidelines for Mr. Wilton?
13. What information should your team give Mr. Wilton about his periodontal condition?