[Answered]: Group 1 Case study Patient History Patient…

Group 1 Case study Patient History Patient Profile: This 29-year old African-American female presents in your office and indicates she has never had her teeth “cleaned” and is a bit nervous about that. She is single and works in a major clothing store. She shares an apartment with her younger sister and mother. Her parents divorced when she was 8 as her father was an alcoholic and drug addict. She is 5’4” and weighs 150 lbs. She is very well dressed and appears to take very good care of herself. She considers herself to be in good health. Chief Complaint: “My gums bleed when I brush. I have sensitivity to hot and cold most of the time and I have a sore on my tongue.” Medical History: The patient is not under the care of a physician and is reluctant to have a physical examination. Her family history includes diabetes, hypertension, oral cancer, alcoholism and substance abuse. She currently takes no medications. Her blood pressure was recorded at 138/89; her pulse was 80 bpm; and her respirations were 18. She considers herself to be in good health. Dental History: Her last dental visit was over ten years ago when she had a wisdom tooth extracted. She rinses with a phenol mouthrinse several times daily but mixes it with water to reduce the burning sensation. She uses a medium bristled toothbrush once daily but has never flossed or used other interdental aids. She is not sure if her toothpaste contains fluoride. She questions why her tongue has a white spot. She is worried as her grandmother had oral cancer 5 years ago. Health Behaviors: She recently started smoking one pack of cigarettes daily. Extraoral Examination: All extraoral findings were within normal limits. No enlargement of lymph nodes were detected. Intraoral Examination: Cheeks, lip and pharynx were all within normal limits. A white circular lesion was noted on the lateral border of the tongue. She indicated it was painful upon palpation. The oral mucosa was heavily pigmented and the marginal gingivae were red and inflamed in numerous regions, more particularly the posterior lingual margins. The maxillary arch was narrow and elongated with protrusion of the central incisor teeth. Bleeding Index: 40% Plaque Score: 60%