Do you know about - Dental Case Study - Ms sick person
Dental Implants Chicago! Again, for I know. Ready to share new things that are useful. You and your friends.49 year old married female with multiple sclerosis. She is very open to discuss her disease and the impact it has on her life. She practises yoga and leisure therapy. A friend of hers mentioned that Ms was caused by mercury toxicity from dental amalgam fillings. Her chief complaints were sensitivity to hot, cold in her upper left lower right quadrant, bleeding gums, potential amalgam dismissal and dry mouth. Client used to see her dentist commonly for dental check ups but stopped all of a sudden. Her last dental visit was at a Dental Hygiene College 3 years ago. In 1976 She reported to have trigeminal neuralgia that lasted about 2 months, and previous use of cigarettes and marijuana from (1974 to 1988). She also reported to have problems with urine leakage. She sees her physician and neurologist bi-annually. Her vital signs were within general limits, she was hospitalized two times due to acute Ms episodes one in 1978 and the other in 1992. She reported taking medication to prevent the progression of Ms, and gets injected every other day with Betaseron 5mg and Copaxone 20mg; diazepam 1mg twice daily; ibuprofen 800mg three times a day and baclofen 10 mg four times a day. Dry mouth is a frequent side follow of these medications. Client is disabled she must use a walker to walk. Fatigue has affected her oral hygiene before bedtime so she often brushes only in the morning. This client lacks hand-operated dexterity and coordination due to the deadness and pain in her hands. Her diets consist of fried foods and lots of soda.
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Clinical estimation Data
On the first appointment the following things were completed. Extra and intraoral, periodontal hard tissue examination, a full mouth serious, intraoral photographs were taken and homecare practices were observed and discussed. Significant findings included the following.
Extraoral: Unilateral swelling on the right side of the face; bilateral firm masseter muscles; Tmj crepitation; occasional pain upon opening mouth in the morning and nocturnal bruxing.
Intraoral: Linea Alba bilateral 6mm on both sides; small tori on the palate and decreased salivary flow. Moderate subgingival calculus with grayish extrinsic stains.
Periodontal: Generalized 2-6 mm probing depth and localized 5mm readings on the posterior interproximal areas; furcations settled on 16,14,47,46. Bleeding upon probing on all posterior teeth.
Hard Tissue: Generalized wee attrition. Multi covering restorations on most posterior teeth.
Plaque control Record: Plaque-free score 75%; Radiographs: Generalized bone loss 10 to 30% horizontal bone loss; localized wee vertical bone loss in posterior; graphic calculus spicules; suspected caries on #15 under restoration.
Nutrition: Meal pattern consist of breakfast, snack, lunch, snack, dinner, snack. Calorie intake is inadequate. Food Groups consumed daily are in general Meat and alternatives. Fat intake high. Body weight above healthy. Activity level low.
Social: Regardless of having Ms client feels her comprehensive condition is good. The client has no insurance, so that's why she has been avoiding dental care but she is ready to make a lifestyle change. She has a keep system to aid her with transportation
Dental hygiene rehabilitation care plan
1. Take vital signs at each appointment to ensure that V/S are Wnl
2. Modernize curative history for any potential contraindication to treatment.
3. Report her medication intake to settle any side follow that might compromise the treatment.
4. Book the patient at morning appointments since morning appointments tempt to be less stressful to patients with neurological problems.
5. Ensure a quite and relaxant environment for the patient during the appointment.
6. Allow multiple brakes during the appointment to help relaxing her facial muscles and allow Significant frequent urination.
7. Minimize fatigue by complying with the patient daily regime and relax during rehabilitation (positioning the chair in the most comfortable position for the patient).
8. Monitor oral conditions that are linked with client at every appointment and make referral if necessary, (to settle any intra extra oral changes that might compromise rehabilitation or patient health).
9. Use clorhexidine prior to rehabilitation to sell out bacterial flora within the oral cavity.
10. Debridement of calculus and plaque by ultrasonic (One quadrant at the time) to sell out the scaling time. 1-2 appointments.
11. Debridement by hand scaling ( one quadrant at the time) to make sure that all the calculus and dental plaque left after using ultrasonic is removed. 1-2 appointments
12. Selective polishing to selectively remove intristic stain. (Whiter teeth are linked with beauty and a healthier lifestyle)
13. Use fluoride rinse Neutral sodium 2% to help re mineralize clients teeth.
14. Take an impression on lower anteriors to make a mouthguard that will prevent supplementary attrition on the lower anteriors due to buxism.
15. Referral to Dds for recovery due to clients request to replace old amalgam fillings with white recovery material
16. Diet counseling to increase salivary flow. ( during intra oral test xerostomia was clear possibly from medication side effects)
17. Consider Local anesthetic ( Lidocaine 2% in case Topical anesthetic 2% is not enough in manufacture client comfortable during the appointment.
Osc planning
1. Prescribe antisensitivity toothpaste to eliminate sensitivity to hot and cold.
2. Recommend addition of H2o consumption to increase salivary flow in the oral cavity.
3. Client will be educated in the connection that Ms has on her oral cavity to increase her cognitive knowledge towards Osc (for example bruxism, subluxation, crepitation, xerostomia).
4. Discuss the relation between Ms patients and the high risk of caries activity.
5. Demonstrate floss and brushing aids to the client. ( proxy brush, floss aid, modified brush handles.) to improve patients Osc skills.
6. Use disclosing agent to show to the client the problematic areas that are missed during at home oral self care. This will increase the awareness of the client to the present oral situation.
7. Recommend powered toothbrush to increase the brushing time due to clients compromised plaque dismissal skills.
8. Recommend dissimilar modifications to the Osc aids that client will feel comfortable with, to increase relax in grasping oral aid handles
9. Recommend water pick to allow a distinct degree of independence in cleaning interproximal areas from plaque.
10. Recommend dissimilar physical activities ( like yoga) to improve the dexterity that will help client with self oral care.
Multiple Sclerosis and Dental Hygienist
Treating patients with Ms provides dental hygienists with many opportunities to learn. The multiple links between oral conditions and Ms symptoms enable dental hygienists to fulfill their roles as primary holistic condition care providers. Ms is the most prevalent demyelinating disease of the Cns, and the third prominent cause of neurological disability in the United States. For patients presenting with Ms, the dental hygienist can contribute by promoting both physical and oral comfort. Appointments that adapt special physical needs and rehabilitation plans that offer meaningful condition promotion and disease arresting plans are ways to raise Ms patient compliance. Current knowledge about Ms symptoms, etiology, physical limitations, treatments, and Cam will aid the dental hygienist in providing optimal care.
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