Dental Management: A Case Study

1676 Words 7 Pages
Additionally, I will do a review of systems to elucidate more information regarding his medical history since numerous medical conditions could affect dental management (Wilson, Kornman, Steffensen, & Sottosanti, 2003). Furthermore, because diabetes affects multiple organ systems, it is important to determine if complications have set in. Complications of diabetes include premature vascular disease such accelerated onset of non-specific atherosclerosis or serious microangiopathy affecting the ocular and nephrotic vessels (Little et al., 2013). For example, I will ask if he also has a heart condition as some cardiac problems would necessitate antibiotic cover to reduce the risk of infective endocarditis (Clerehugh et al., 2010).
I would ask
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Fortunately, he is not in acute distress at the moment. In the meantime, relief of pain will be provided. The enamel caries which are classified as radiographic C1 and C2 and the incipient enamel lesions located on the labial surfaces of 11, 21, 13 and 23 will be treated conservatively with the application of high fluoride varnish (Duraphat 22600 ppm fluoride) to reduce sensitivity as it has been shown to remineralise teeth even in the presence of plaque (Hellwig, Klimek, Schmidt, & Egerer, 1985). These areas will be monitored regularly with radiographs every 6 months as Ben is a high-risk patient (Thomson & Johnson, 2012). I will place Fuji VII Pink EP (by GC) on any cavitation if I find any, to slow caries progression and alert other clinicians to its temporary nature. In addition, oral hygiene education regarding the relationship of plaque with gingival bleeding and dental caries will be given. I will show him the results of his radiographs to educate him on the effects of plaque on hard tissue, particularly how the accumulation of plaque in retentive areas cause a drop in pH levels. A pH drop to 5.5 will induce demineralisation of enamel (Stephan, 1944); however, removal of plaque would allow a rise in pH and remineralisation of teeth (Fejerskov, Kidd, Nyvad, & Baelum, 2008). In addition, …show more content…
I will emphasise that oral hygiene is vital as infections in T1DM can progress rapidly and alter the course and treatment of his systemic condition (Wilkins, 2013). I would advise him to limit sweets and cold drinks as this induce the pain or eat on the other side of the pain. In addition, I would recommend he goes to his attending physician for appropriate pain relief as some non-steroidal anti-inflammatory drugs are known to lower insulin concentration (Bullock & Manias,

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