Implementation Phase
Phase I (Non-surgical Phase): MX/DX, OI, PASS, PSR, PI, OHI, DC, X-RAY with interpretation, intraoral photos, tobacco cessation, nutritional counseling. Scaled all quadrants, comprehensive periodontal charting was done on all quadrants after scaling. A lot of the findings were the same bleeding was still not as prominent as first appointment. General marginal redness was also still present. Tooth number 15 had now been extracted. Mr. J stated that the infection had gotten worse to the point of swelling of his left facial area. PASS score was at a 75% at this visit. Mr. J is now classified as B calculus type. I asked Mr. J about the home care instructions that were given and he admitted that he has not been flossing but he does use the tips and brushing techniques that I reviewed with him. Mr. J also stated that his diet has not improved, saying that he is “too busy” to worry about what he eats. Referral given for periodontist. Four appointment were needed then Mr. J returned for a 4-6 week re-evaluation appointment.
Phase III (Restorative Phase): Tooth numbers 8, 9, 14, 15, and 16 have moderate to severe horizontal and vertical bone loss. recommendations would be to remove and place with either a fixed partial denture or ,if affordable by patient, dental implants could be placed. Dental implants or fixed partial denture was also recommended for mandibular right to avoid supra-eruption of opposing maxillary teeth.
Phase IV (Maintenance Phase): It was recommended that Mr. J return for nonsurgical periodontal maintenance every 3 months. However, SPC Dental Hygiene clinic have prophylaxis maintenance every 6 months which was explained to the patient. It was recommended that the patient should see his dental home for the other treatments days. When patient returned for re- evaluation appointment, recommendations for 3 month periodontal maintenance still remained along with continued motivation and reviewing of home care instructions to direct the patient towards a path of optimal health.
Phase III (Restorative Phase): Tooth numbers 8, 9, 14, 15, and 16 have moderate to severe horizontal and vertical bone loss. recommendations would be to remove and place with either a fixed partial denture or ,if affordable by patient, dental implants could be placed. Dental implants or fixed partial denture was also recommended for mandibular right to avoid supra-eruption of opposing maxillary teeth.
Phase IV (Maintenance Phase): It was recommended that Mr. J return for nonsurgical periodontal maintenance every 3 months. However, SPC Dental Hygiene clinic have prophylaxis maintenance every 6 months which was explained to the patient. It was recommended that the patient should see his dental home for the other treatments days. When patient returned for re- evaluation appointment, recommendations for 3 month periodontal maintenance still remained along with continued motivation and reviewing of home care instructions to direct the patient towards a path of optimal health.