Southwestern College Non Surgical Periodontal Case Study

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Southwestern College

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CASE 26: Just Clean His Teeth

Linda Boyd

MCPHS University, Massachusetts

Mary Fordham, RDH, works in a busy general office and sees a

large number of patients who are in need of initial nonsurgical

periodontal therapy. Upon reviewing the medical history of a new

patient, Mr. Donald, the patient reports he has “borderline

diabetes.” Further questioning reveals that he is under no treatment

for diabetes such as oral medications, dietary or lifestyle

modifications, or insulin. Mr. Donald is unable to provide

information on his hemoglobin A1c (Hb A1c) and does not

remember the last time it was checked. Mary continues on with

vital signs, risk assessments, and an intraextra oral examination and

determines a full-series of radiographs is needed because Mr.

Donald has not been to a dentist in 20 years. Continuing with a

comprehensive periodontal examination, Mary finds the patient has

generalized bleeding on probing with localized areas of exudate

with 4 to 6 mm pocket depths suggesting generalized moderate

chronic periodontitis.

At this point, Dr. Perry enters the operatory to complete the

dental examination and review the assessment data. Dr. Perry and

Mary discuss the diagnosis and treatment plan for the periodontal

disease and Mary suggests that a consultation with the primary

care provider is needed before continuing with periodontal care

because Mr. Donald does not know his Hb A1c

. Mr. Donald gets

upset and says he just wants his teeth cleaned, and it has nothing to

do with his “borderline diabetes.” Dr. Perry placates Mr. Donald by

saying that it is not necessary to consult with the primary care

provider and that Mary will go ahead and perform the nonsurgical

periodontal therapy.

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Running Head: NON-SURGICAL PERIODONTAL

Non-Surgical Periodontal
Name
Institution

1

NON-SURGICAL PERIODONTAL
Non-Surgical Periodontal
The association between diabetes and chronic periodontal disease has been long
established. In the case of Donald the last time he visited a doctor he was diagnosed with
diabetes. However, he was no longer under medication or treatment. When Mary was carrying
some assessment on his situat6ion she concluded that information from the primary caregiver is
i...

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UC Berkeley

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