Treatment
What would be this patient’s calculus code?
Light/Medium
The patient’s BP was 130/80. You’d categorize his BP as?
Stage 1
Did smoking exacerbate his periodontal condition?
Yes, although he already quit, the residual effects are still present.
Which of his medications might this loss of taste be attributed to...
Enalapril (Vasotec), Warfarin (Coumadin)
what other way can the patient’s tobacco staining be addressed during treatment?
air polishing
What treatment should be done post-scaling to remove the tobacco staining?
Selective Polishing
The best explanation for the patient’s current BP reading is...
His BP's controlled by his medication, but his medication may require adjustment.
Based on this patient’s clinical, radiographic and historical findings, you'd classify his ADA status as...
Gen ADA III, local IV
Enalapril (Vasotec) is a medication taken for...
BP
The main contributors to his bad breath would be...
Xerostomia, poor oral hygiene, and perio condition.
LA injections that would need to be administered on #18-19 would be?
IA/Buccal
Based on his BP, history of stroke with residual effects, and medication use, the patient would be classified as an ASA...
ASA III
With the beginning of the furcation visible clinically on #19, you measure a recession of 3mm. The CAL is...
8mm
Warfarin (Coumadin) is most know for its effects on...
Increased risk of bleeding
The patient's occlusal status can BEST be described as...
Class I
What position should the patient be placed in due to his potential risk for orthostatic hypotension from his medication?
Semi-supine with legs/feet elevated.
To safely perform his cleaning, you must confirm that the International Normalized Ratio (INR) reading is...
2.0-3.0
Based on this patient’s clinical, radiographic and historical findings, you'd classify his AAP status as...
Stage III, Grade B
Based on the patient’s medication list, do any of the medications require special precautions for LA?
No
What type of interdental aid would best help in cleaning his furcation?
End-tuft brush or water flosser.
Do we administer Lidocaine 2% with Epi or Lidocaine 2% without Epi?
Lidocaine 2% with Epi.
Based on his medical history, precautionary measures include...
Monitoring INR levels, avoiding contraindications or medications (such as Warfarin), and scheduling short, stress-free appointments.
What are indications of active perio in patient?
BOP: 15%
Bone Loss: Horizontal bone loss, radiographic fuzziness
Probing Depths: Multiple 5mm pockets
Recession: Gen 1-2mm with localized 3mm
Furcation Involvement: class 1 on #3, class 2 on #19
Based on the patient’s medications and medical history, would he need a medical consult prior to treatment?
Yes. Although Lexidrug states that patients with a history of a stroke do not need need one, since Warfarin should not affect bleeding risks, as a precautionary measure, the MVC Clinic would require one.
Is the patient's age a factor of his periodontal disease?
No, but his poor oral hygiene, medications, and previous smoking habits are.