CASE A: A 50 year old male presents for his 4 month periodontal maintenance appointment. His FMX, FMP and all risk assessment are current. Health history is significant for alcohol use (1-2 beers per day at dinner), social smoker (vaping) and pre-diabetes. He thinks the calculus build up is irritating the lesion on the floor of his mouth. His main goal today is to get his teeth ‘cleaned.’  The lesion was not documented in his chart from the last periodontal maintenance (4 months ago). The patient said he just noticed it on the floor of his mouth, hence he believes it is only because he needs his teeth cleaned. Answer the questions with this case information.     

A 24 year old female present for a dental hygiene prophy appointment. The patient was in recovery for Methamphetamine use; however, she reports during the health history review that she has relapsed and started using methamphetamines again. Which follow up question is the best to determine if you can provide treatment at this appointment? 

What is the most common oral manifestation associated with Bulimia Nervosa?

CASE A Question What should be in the dental hygiene care plan for today?  1. Periodontal maintenance 2. Intraoral photos 3. DDS exam 4. Documentation of lesion description 5. Referral for biopsy   

Which life-threatening emergency is characterized by a spike in blood pressure and a severe headache in a patient with a spinal cord injury at T-6 and above, and requires immediate action (raising the patient to a vertical position and removing the offending stimulus)?

Which life-threatening emergency is characterized by a spike in blood pressure and a severe headache in a patient with a spinal cord injury at T-6 and above, and requires immediate action (raising the patient to a vertical position and removing the offending stimulus)?

A 24 year old female present for a dental hygiene prophy appointment. The patient was in recovery for Methamphetamine use; however, she reports during the health history review that she has relapsed and started using methamphetamines again. Which follow up question is the best to determine if you can provide treatment at this appointment? 

Your patient, Sherry, is a 26 year-old single mother and a graduate student.  She tells you that she had a previous negative dental experience, and that it has been many years since she has had professional dental care.  Her chief complaint is tooth pain on the right side of her mouth.  Her medical history indicates that she is taking Lorazepam (a benzodiazepine) and Ambien, but is otherwise healthy.  During the appointment you notice that Sherry has become flushed, appears to be sweating and she begins to choke.  She tells you that she is having trouble breathing and is having chest pains.  Based on her symptoms, social and medical history, which of the following conditions is the probable cause?

What is the International Normalized Ratio (INR) range for a patient on coumarin therapy that generally permits routine dental hygiene care (e.g., scaling and root planing) without requiring the physician to alter the medication dosage?

What is one oral clinical sign of Anorexia Nervosa?