1. Build Rapport: By building rapport, I want to make sure the patient mentally and emotionally understands that I want the best care for her and she is in good hands. I would start by welcoming and thanking her for coming to my office, and ask if there is anything I could do to make her feel more comfortable.
2. Medical Health History & Oral Health Screening: Taking a medical health history would allow me to obtain a complete picture of the patient. This includes but does not limit to past and current medications, allergies, social history, and medical and dental history. Her vitals (blood pressure and blood sugar levels) would be taken, and an oral health exam would …show more content…
Caries Risk Assessment: A caries risk assessment via visual, tactile, and radiographs would be completed. She has a high caries rate, so I would restore the reparable teeth and following the treatment plan discussed with her.
4. Preventive Plan: I would explain to her that in my office I like to practice more of preventive dentistry rather than reparative dentistry. She can practice preventive dentistry at home along with coming into the office for her regular cleanings and oral health check ups.
a. Caries: Explain to the patient that cavities or caries are caused by specific bacteria, infectious, carbohydrate mediated, but is reversible.
b. Strep Mutans: Once the patient has the bacteria, her teeth will never be “clean.” Unfortunately, there is not a way to kill the bacteria yet.
c. Infectious: Strep mutans are infectious, so avoid sharing eating utensils especially with babies from 6 to 36 months old because their newly erupting teeth are especially susceptible.
d. Carbohydrate mediated: Strep mutans love carbohydrates! That is what fuels their energy. Hence, advice the patient to change their high carb eating habits, try to locate where the patient is acquiring the most sugar (like candies, coffee, sweet tea, etc.), and try to find a substitute for those …show more content…
Show her on a dentoform how to properly brush and floss. Encourage her to brush and floss after meals. iii. Explain to her the importance of fluoride in her toothpaste. Fluoride helps to remineralize the crystals in the outermost layer of her teeth – enamel. Hence, try not to rinse with mouthwash or water after brushing your teeth because it removes all of the fluoride the toothpaste applied on her teeth. Because she has a high caries rate, she needs a substitute high dose (5000 ppm) fluoride toothpaste and fluoride rinse that can be found over the counter. Along with increasing her office visits to every 3 months to apply office fluoride (Clear Shield), she should use this toothpaste and rinse twice a day. iv. She can chew gum with xylitol (Mentos, ice cubes, or MighTeaFlow gum) as the top most ingredient. Recommend the patient to chew 2 grams of xylitol gum for 3 times a day because she has a high caries rate. Xylitol selectively inhibits Strep mutans because the bacteria think it is food and get stuck to the gum, ultimately, killing the bacteria. However, xylitol cannot reach the deep pits and fissures of teeth; it only reaches the bacteria on the surfaces of the teeth. Saliva has buffering capacities for the acidic food we consume, calcium and phosphate to help remineralize our teeth after brushing and consumption, and antimicrobial properties, so the lack of salivary flow can lead to caries development. Xylitol with green tea (MighTeaFlow) will also help with her dry