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Comprehensive Dental Treatment Plan for 59-Year-Old Patient with Gingival Hyperplasia

This case presents 59-year-old Daisy Fuentes, who has a history of gingival enlargement exacerbated by plaque accumulation. She is allergic to penicillin and experiences heart racing with vasoconstrictor anesthesia. The treatment plan includes horizontal bitewings, meticulous oral hygiene instructions, and two scaling appointments. Local anesthesia without vasoconstrictor will be used. Selective polishing and fluoride treatment will be provided, with a follow-up every three months due to her gingival hyperplasia related to her medications for pulmonary hypertension and menopause.

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Comprehensive Dental Treatment Plan for 59-Year-Old Patient with Gingival Hyperplasia

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Presentation Transcript

  1. Mock Patient Case 27 Reina Ligeralde DEH 11 Fall 2007

  2. Daisy Fuentes • 59-year old • Last dental x-ray: FMX at RCC in 2004 • Allergic to penicillin • Local anesthesia with vasoconstrictor makes her heart race • Takes Estroven (soy) for menopause symptom relief • Takes NIFEdipine for pulmonary hypertension

  3. Daisy’s Gingiva • ASA II: Because of medication and penicillin allergy • Had deep pseudopockets with gingival embrasures covering proximal contacts • Plaque exacerbates gingival enlargement.

  4. Treatment Plan

  5. Treatment Plan

  6. Treatment Plan

  7. Treatment • 4 horizontal BWX • OHI: disclosing, toothbrushing - extra soft toothbrush using the Bass method but recommend electric toothbrush, and floss - Oral B Superfloss because she has bridges and a gap • 1 appointment for LL & UL scale, another appointment for LR & UR scale • Anesthesia (plain) because local anesthesia with vasoconstrictor makes her heart race • IA, PSA, GP, and AMSA nerve blocks due to localized periodontal probing of 5s & 6s

  8. More on Treatment • Selective polish: fine, cocoa mint flavor • 2% NaF due to restorations • 3-month recall due to her gingival hyperplasia

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