Section IX: Re-evaluation: Assessment of Treatment and Referrals – Restorative/Periodontal The patient should be brought in 4-6 weeks after the completion of scaling and root planning for a re-evaluation to allow the gingiva and appropriate amount of time to adequately heal. At the re-evaluation, I would expect to see a decrease in probing depths due to the formations of a long junctional epithelium since bone does not reform on its own and a decreased presence of inflammation, bleeding, and exudate. The level of pain and the presence of a bad taste would hopefully be reduced as well. A new periodontal assessment should be performed to be able to compare measurements. This would include current probe measurements, CAL, BOPs, presence of
…show more content…
There is a still chance that the probe stopped on a piece of calculus. Continued watch is advised on this tooth. Furcation and mobility will not be increased due to increase in bone levels, but changes in gingival attachment may either cover or expose the presence of furcation respectively. Since the majority of probe depths have improved, I would expect to see less BOP and presence of exudate because the body appears to be in control of the disease. Inflammation should be reduced as well. Periodontal surgery will be needed to replace bone to fix the patient’s mobility and furcation involvement. Since the majority of probing depths have improved, I would recommend to rescale the pockets that seem to have deepened to make sure no calculus was left behind and then re-evaluate in 4-6 weeks. If the pockets continue to increase in depth, then there could be localized areas of aggressive periodontitis and would require flap surgery to instrument the roots for calculus and possibly an antibiotic prescribed; such as low-dose doxycycline. If the pockets improve, most likely the calculus didn’t allow for accurate probing …show more content…
Her stress levels can decrease her host response which can expedite her disease progress. Also, since she didn’t finish her scaling and root planning, I would want to make sure that the patient understood why this process is crucial to her health. Yes, at first she canceled due to an illness, but then she didn’t reschedule due to her busy life which may indicate her lack of urgency for her dental care. I would specifically try to use reflective listening, affirmation, and evoking in attempting to motivate the patient. I feel like this patient likes to think for herself and tries to strive to do her best when it comes to things she cares about. Therefore, I would try to get her to realize the importance of getting her periodontitis under control, as well as affirming what she is doing (like brushing 2-3 times a day). This way she will see it as something she needs to prioritize and tackle herself and that she is doing somethings correctly so it doesn’t seem like a daunting task. Then I would try to evoke her natural drive she has towards challenges at her home care and attending her appointments regularly. Banu should have 3 month regular appointments because she will now continue to be a periodontal maintenance patient. Once a year she should receive a set of 4 BWX and an updated intra and extra oral
There is a still chance that the probe stopped on a piece of calculus. Continued watch is advised on this tooth. Furcation and mobility will not be increased due to increase in bone levels, but changes in gingival attachment may either cover or expose the presence of furcation respectively. Since the majority of probe depths have improved, I would expect to see less BOP and presence of exudate because the body appears to be in control of the disease. Inflammation should be reduced as well. Periodontal surgery will be needed to replace bone to fix the patient’s mobility and furcation involvement. Since the majority of probing depths have improved, I would recommend to rescale the pockets that seem to have deepened to make sure no calculus was left behind and then re-evaluate in 4-6 weeks. If the pockets continue to increase in depth, then there could be localized areas of aggressive periodontitis and would require flap surgery to instrument the roots for calculus and possibly an antibiotic prescribed; such as low-dose doxycycline. If the pockets improve, most likely the calculus didn’t allow for accurate probing …show more content…
Her stress levels can decrease her host response which can expedite her disease progress. Also, since she didn’t finish her scaling and root planning, I would want to make sure that the patient understood why this process is crucial to her health. Yes, at first she canceled due to an illness, but then she didn’t reschedule due to her busy life which may indicate her lack of urgency for her dental care. I would specifically try to use reflective listening, affirmation, and evoking in attempting to motivate the patient. I feel like this patient likes to think for herself and tries to strive to do her best when it comes to things she cares about. Therefore, I would try to get her to realize the importance of getting her periodontitis under control, as well as affirming what she is doing (like brushing 2-3 times a day). This way she will see it as something she needs to prioritize and tackle herself and that she is doing somethings correctly so it doesn’t seem like a daunting task. Then I would try to evoke her natural drive she has towards challenges at her home care and attending her appointments regularly. Banu should have 3 month regular appointments because she will now continue to be a periodontal maintenance patient. Once a year she should receive a set of 4 BWX and an updated intra and extra oral