OHI CASE STUDY

Jesse Grossman
Clinical Dental Hygiene DH 220A

PATIENT:

Elderly woman with periodontal disease; came to clinic for periodontal

maintenance.

FIRST APPOINTMENT

Dental Hygiene Diagnosis- Periodontal Case

Type II (Generalized slight horizontal bone loss)
Clinical Assessment Markers- Recession,
furcations, and IAG
Color- generalized normal with localized
hyperemia around crown margins
Contour- generalized recession with localized
festooned marginal gingiva on posterior
linguals

FIRST APPOINTMENT
Consistency- generalized slight fibrotic with
generalized slight edematous
Statement of Inflammation- generalized slight
marginal and papillary inflammation
Plaque Score- 40% plaque free, moderate
plaque at gingival third and interproximal
Deposit Evaluation- 1.5/1.5

FIRST APPOINTMENT

OHI

(Oral Homecare Instruction)

I recommended the patient brush for a full 2
minutes with her Oral B electric toothbrush.
(She did not realize her toothbrush had a timer on it.)

I showed the patient how to clean her

interproximal spaces in the posterior using soft
picks.

The Bass method is widely

accepted as an effective
method for dental biofilm
removal adjacent to and
directly beneath the gingival
margin.

FIRST APPOINTMENT

OHI

(Oral Homecare Instruction)

I explained the importance

of proper brushing and the
importance of removing all
of the plaque

(Bass Method)

FIRST APPOINTMENT

OHI

(Oral Homecare Instruction)

After finding out the patient likes to chew gum, I
recommended that she chew sugar-free gum that has
xylitol listed as the first ingredient.
I suggested Ice Breakers Cubes gum and Mentos gum,
as well as Ice Chips xylitol candy.

FIRST APPOINTMENT

OHI

(Oral Homecare Instruction)

Risk Factors I explained to the patient that she had periodontal disease
and sent her home with a pamphlet about periodontal
disease.
I told her that interproximal cleaning is important and must
be done daily, even if it hurts or causes her gums to bleed.

I explained that once her gums became healthy that they

would no longer hurt or bleed while cleaning interproximally.

Patient before first appointment.

SECOND APPOINTMENT
Patient Assessment-

Plaque Score- Patient went from 40% plaque free to 84%

plaque free between first and second appointments.
Extent of plaque- light interproximal
Home Care- patient was doing a great job with OHI. She had
bought and used xylitol products and was using the soft picks
from the first appointment.
Home Care Modifications- sent patient home with a new Oral B
toothbrush head, more soft picks, and added Biotene to be
used nightly for xerostomia. Demonstrated and told the patient
to make sure to brush systematically, cleaning each surface of
each tooth.

Patient at second appointment.

Patient Motivation At the first appointment patient was apprehensive about using
soft picks due to pain and bleeding.
She had given up on using a xylitol gum after a
recommendation for Spry in the past, and she did not like the
taste.

Her brushing was okay, but not great, as she was missing the
gingival third.
By the second appointment, the patient was chewing xylitol
gum several times daily because she found a brand that she
liked.
She was using soft picks regularly, and was brushing much
better than before, by getting the gingival third.