Dental Caries Case Studies

Oral health is often overlooked in geriatric and adolescent population. You are not healthy without good oral health. Dental caries have been an issue for the geriatric and adolescent population for centuries. As a hygienist it is our job to acquire a thorough health history and overall assessment to customize treatment and to provide assistance for the benefit of the patients overall and oral health. Approximately three hundred thousand children are affected by dental caries and approximately seventy percent of the geriatric populations are affected. Dental caries do not only affect the aesthetic appearance of teeth but they affect a person ability to eat certain foods, interfere with swallowing, speech, and there overall health. My adolescent patient was an eighteen year old female that after full assessment I noted was in overall good health. My patients health history noted no known about conditions and the only
medication she was prescribed was a birth control contraceptive. The birth control contraceptive my patient is currently using is the Nexplanon implant that had relevant side effects such as xerostomia, high blood pressure and sporadic cramping. These side effects revealed themselves during the oral inspection portion of my assessment when I noted a heavily coated tongue. I then questioned my patient about the dry mouth, she responded that she constantly felt her mouth being extremely dry and finds herself more than none reaching for her pop of choice mountain dew to moisten her mouth. I then moved forward with the rest of my assessment not finding anything that would be considered abnormal for her age group. What I noticed in my adolescent patient when doing the gingival assessment I noted erythema, edema and rolled margins in almost every sextant. I then explained to her that she fell under the plaque induced gingivitis category and that gingivitis is completely reversible but she would have to start flossing as much as possible. I advised her to go from not flossing at all to try and floss at least three times a week. After her doctor exam the doctor and I advised her that due to her recent change in birth control it was super important for her to understand that the side effect of xerostomia could potentially cause carious lesions down the road. The doctor and I suggest that she started using a fluoride toothpaste at home to prevent this from happening. My patient was willing and able to make these changes in her home care. I provided care for a geriatric patient that had severe xerostomia and several past carious lesions.
After looking at prior radiographs I noted there were several interproximal composites from past carious lesions. I noticed while debriding her mouth that she has little to almost no salivary flow. I looked at his health history and noted that she was on several medications. After looking those up, I noticed that many of them have the side effect of xerostomia. After questions the patient she said that she frequently has dry mouth and is constantly wanted a beverage to keep the oral cavity moist. I demonstrated oral hygiene instructions and made sure she knew how to floss, since most of her carious lesions were interproximal. I also recommended she use bioten and when she found herself thirsty due to her dry mouth to try and drink water instead of a sugary beverage. My patient was willing and able to adapt to these lifestyle changes. At her next visit I will assess and see how she is doing and to make sure there was no periodontal
progression. While comparing my assessment on both my adolescent and my geriatric patients I noticed that while there were many similarities there were also many differences. One of the biggest differences that I noticed had to do with mobility of the patient. My adolescent patient had no problem being laid back and needed no time at all to get up and move to take radiographs where as my geriatric patient was a little apprehensive about being laid back and we had to take each thing we did at a very slow pace. Understanding that some patients may need small alterations in treatment in the long run will make you a better hygienist. It can be a little frustrating your first time having to adapt to different positions when cleaning teeth but as time goes on it becomes second nature when understanding that time has done a toll on their bodies and they can no longer sit in certain positions for long periods of time.
What I took away from this paper was the understanding that every patient is different no matter what their age. And it is our job to alter the treatment in a way that suits that specific patient. Our main goal in being a successful hygienist is to adapt to the ways of others so they feel most comfortable while they are receiving treatment. Even though both my patients needed very minimal treatment alterations I understand that in in the near future there could be serious changes like me standing up to scale to assure that a patient is in their most pain free position while getting there dental cleaning. As a hygienist you will encounter many different patients ranging in age, ethnicity, and gender. It is our jobs as hygienist to know what is normal and what is abnormal in the assessment data we collect. We need to know what is normal for an adolescent compared to a geriatric patient in order to customize the best treatment plan for their needs. The purpose of this research is to show that many differences and similarities are prevalent in both geriatrics and adolescents but the causative factors of each is different. We need to know how to educate our patients based on their health history, lifestyles, and diets. As hygienists it is our jobs to educate the patient on what is going on in their oral cavity and how they can do their part in preventing caries and periodontal disease.
Special concerns should be taken for each of the populations due to the prevalence of dental decay. As hygienists it is our role to educate our patients on dental caries we need to be providing thorough oral hygiene instructions and assure they understand that what happens in their oral cavity effects the body as a whole. For the geriatric patients that have difficulties brushing, we need to show them modifications and help them to achieve the best oral hygiene. For the adolescents we can recommend fluoride mouth rinses and make sure they are using toothpaste with fluoride in it. Since the first and second molars grow in at a young age it is wise to put a sealant on them to protect them from dental caries. There are many oral characteristics common in each population. One common characteristic is tooth loss for every decade of life, the average adult will lose a tooth the importance of oral hygiene in the two age groups differ greatly. Getting a teeth cleaning is not number one on the priority list of an adolescent. While the geriatric population tends to get their teeth cleaned regularly, they are sometimes not able to practice good oral hygiene at home. While both groups lack differently in oral hygiene, dental problems are most commonly caused by unwanted bacteria in the mouth. When either group consumes a food with a high sugar content the bacteria in the oral cavity digests the sugar and produces an acid that demineralizes the enamel potentially creating a carious lesion. If the cavity is not treated by a dentist, the decayed tooth can be lost. Since the geriatric population is likely to have xerostomia, they need to take care of their teeth and be cautious of what they consume to protect their teeth. One third of all noninstitutionalized adults sixty-five years of age and older have reportedly lost all their natural teeth (vargas&kramarow&yellowitz, 2001) Dental hygienist play a vital role in the health of all populations the age of geriatric patients are increasing and more children are being born it is our job to educate and prevent oral health issues since the cause of dental problems can be different in the populations, it is our job to customize each treatment plan and treat each patient according to their individual need by getting to know our patients on a personal level can help their trust in us and they may apt to do their part outside of the dental office. The needs of each population are different and it is important to knowledgeable of all of them research on these two topics will expand your knowledge on the different populations and help you know there needs before taking care of them.