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Abstract: This is a 33-year-old female patient who has been wearing hearing aids for more than 8 years. She complained of severe oral odor, loose teeth, bleeding from brushing, pus overflowing from gums, inability to chew food normally, and tooth deformation for 2 years, and had been diagnosed as periodontal disease in an outside hospital. The whole mouth periodontal basic treatment was carried out, and the treatment effect was good.
Basic information】Female, 33 years old
Disease Type】 Periodontitis, dental caries
Hospital】Nei Mongol Autonomous Region Maternal and Child Health Hospital
Date of consultation】April 2021
Treatment plan】Basic periodontal treatment (supragingival scaling, subgingival scaling) + medication (minocycline hydrochloride) + oral care + removal of bad habits
Treatment period】2 times of outpatient treatment, 1 month of outpatient follow-up
【Treatment effect】Currently, the treatment effect is good, and the follow-up is once every six months
I. Initial consultation
The patient has been wearing hearing aids for more than 8 years. After repeated inquiries, the patient complained that for 2 years, he had severe oral odor, loose teeth, bleeding from brushing teeth, pus overflowing from gums, inability to chew food normally, and deformation of teeth, etc. Because of the above symptoms, he could not socialize with people normally. The patient was diagnosed with periodontal disease 2 years ago at an outside hospital and underwent scaling treatment, but has not been seen regularly since then. The patient was in good health, with no history of hypertension, diabetes, or heart disease, denied any history of food or drug allergy, no history of smoking, and no history of alcohol consumption, but often had the bad habit of involuntarily shaking his teeth with his hands.
Oral examination was performed on the patient for medical records: teeth misalignment, 11 labial shift, looseness Ⅰ°, full mouth calculus Ⅱ°, gingival redness, light probing bleeding, periodontal pockets about 4-5 mm deep, 25, 31, 41 periodontal pockets with pus, probing root surface rough with tartar, percussion pain (+), probing pain (+), looseness Ⅲ°, elongation, occlusal interference. 24, 45 visible porcelain full crown, crown The edges were not tightly fitted, 18, 28 elongated, percussion pain (-), probing pain (-), looseness (-), no abnormal gingiva, caries was seen on the joint surface.
Auxiliary examinations: the whole-mouth surface tomography film showed that there was horizontal resorption of alveolar bone height, 25, 32-42 alveolar bone horizontal resorption up to about 1/3 of root length, 46 visible root bifurcation low density image. The results of related tests such as infection four, coagulation four and blood routine were not abnormal. The comprehensive examination results confirmed the diagnosis of periodontitis and dental caries, and suggested the patient to perform the basic periodontal treatment (supragingival scaling and subgingival scraping).
II. Treatment process
After the full-mouth periodontal basic treatment (supragingival scaling and subgingival scraping), the patient indicated that there was no serious pain. In order to make the patient relax and better cooperate with the treatment, we talked with the patient while treating him. After performing thorough scaling and scraping, the patient’s dental area was rinsed alternately with hydrogen peroxide and saline, and minocycline hydrochloride was applied in the periodontal pocket. The patient was also given a detailed oral hygiene education, and a video of brushing was shown to the patient to instruct him more specifically on how to brush and floss his teeth. The patient was later advised to extract 25 and 28 to improve the left occlusal relationship. Restorative treatment was performed at a later stage, and regular postoperative reviews were conducted to maintain the efficacy of treatment.
III. Treatment results
The patient was satisfied with the treatment result of periodontitis, there was no obvious discomfort after the operation, the oral odor subsided after the operation, the tooth loosening was slightly relieved, the symptoms of gingival bleeding and gingival pus overflow disappeared, there was improvement in chewing food, the patient recovered well and the condition was well improved. One month after the operation, the patient reported that he is recovering well with no uncomfortable symptoms and no obvious tendency of recurrence, and in general the patient has a good treatment effect. The patient is recommended to have a follow-up examination every six months.
IV. Precautions
The patient had good medical compliance during the treatment of periodontitis, cooperated with the doctor to complete the periodontal basic treatment and achieved good results, and was very happy for the patient. Patients are advised to master the correct brushing method by themselves after surgery, clean the food soft scale and plaque attached to the teeth as much as possible, master the use of dental floss and water floss correctly by themselves, clean the food residue embedded between the teeth as much as possible, and avoid drinking carbonated drinks and a lot of sticky food with high sugar content. Cooperate with your doctor to adjust occlusal interference and remove bad restorations. Break bad habits and reduce adverse external forces on the teeth. Improve anxiety, which also helps recovery.
V. Personal insight
Periodontitis can occur in all age groups, often with swollen and painful gums and bleeding and overflowing pus, and even more so in patients with irregular teeth, with teeth shifting, with large amounts of food and soft tartar and calculus adhering to the tooth surface. During this patient’s visit, I was as patient as possible when communicating with him because of his hearing impairment. Sometimes I would draw pictures of the patient to express his condition and let him understand his condition as much as possible, make regular visits and urge him to follow up regularly. Most patients are resistant to periodontal treatment, not knowing that periodontitis can also lead to serious consequences if periodontal treatment is not done. However, periodontitis usually recovers significantly with aggressive and correct treatment.