CASE I (QUESTIONS 1-3) Your patient, Virginia Carson is a lo…
CASE I (QUESTIONS 1-3) Your patient, Virginia Carson is a longtime patient of yours. She dislikes “going to the dentist” has been non-compliant with recall appointments. However, she recently received a new upper denture. The last time she was in to see you was 14 months ago for scaling and rootplaning. She did not return for her re-evaluation appointment. As you bring her back to the operatory, she appears to struggle getting there and getting situated in the treatment chair. She wheezes and appears out of breath with each movement. It has taken a lot of effort for her to get to this appointment today because she does not drive. She generally relies on the community’s senior citizen transportation, but today her son accompanies her. Although she dislikes dental appointments, she knows that she needs to be here. Please review the photos and case information below: 66 year old female presents for periodontal maintenance visit 5′ 3″ 165 lbs Vitals at time of appointment BP 135/80 Pulse 69 Respiration 14 rpm Medical History Congestive heart failure Heart attack (five years ago) COPD Medications Atenolol (beta 1 adrenergic blocker) Digoxin (Lanoxicaps) Cardiac glycoside Fluticasone proplonate/salmeterol (Advair Diskus) respiratory inhalant Social History Smokes tobacco (1 pack per day) Widow Lives in assisted living home Oral Hygiene Poor oral hygiene Heavy biofilm, calculus and stain Brushes 1x daily No flossing