PERIODONTAL CARE PLAN

Patient Name: Jeffrey DeLord Age:59

Date of initial exam: 09/19/2017 Date completed:11/16/2017

1. Medical History: (systemic conditions altering treatment, pre-medication, medical clearance) explain
steps to be taken to minimize or avoid occurrence, effect on dental hygiene diagnosis and/or care.

-He is taking a natural prescription for Hypothyroidism called Nature-Throid. He also has
reflux/GERD but is not taking any medications for it.
-He is allergic to the antibiotic Augmentin.

2. Dental History: (past dental disease, response to treatment, attitudes, dental I.Q., chief complaint,
present oral hygiene habits, effect on dental hygiene diagnosis and/or care)

- Localized gingival bleeding while probing but says he does not bleed when brushing or flossing. He says he
brushes twice a day morning and night. He also stated he does not floss. He does not use mouth
wash on a regular basis but stated when his wife buys it he uses it everyday morning and night
until it runs out. The only other home fluoride treatment he receives is from the water out of the
faucet.

- He clenches his teeth mainly when mowing grass which could lead to tooth damage,
periodontium damage, and jaw pain. Also, could lead to attrition and further damage could cause
exposure to the dentin. He also stated he is a mouth breather at night but stated during the day he
has good saliva quantity.

3. Oral Examination: (lesions noted, facial form, habits and awareness, consultation)
- He clenches while mowing grass and stated that is the only time he notices he is clenching,
and stated that he is unsure if he is clenching throughout the day. Due to patient having bilateral
linea alba this shows he is more than likely clenching throughout the day. These parafunctional
habits can exert excessive forces on the teeth and to the periodontium, also possibly causing TMJ
problems. When checking the TMJ area I noticed when he opened and closed his mouth that his
jaw deviates to the left when closing which may be caused by his clenching habit. He also has bi
later tori. Occlusal examination showed the right molar and canine were Class I and left molar
and canine were Class III. He also had no open bite or cross bite but showed an overbite of 5mm
and a mid-line shift 2mm to the right. When overlooking his toothbrush habit, he brushes with up
and down and horizontal strokes which can cause tooth abrasion and gingival irritation. He did
have an abfraction on the facials of 20 and 21. His gingiva was generalized scalloped but had
localized red color on the of teeth #23-#26. His consistency is localized edematous and spongy
on teeth #23-#26. His margins were rolled on the facials of teeth 3, 12- 14, 19, 21, 27-29. His
papillae were within normal limits and had no suppuration. The surface texture of the papillary
and marginal was smooth generalized and the surface texture attached was generalized stippled.
Other findings included localized bleeding on probing. He had 1mm of recession on the facials
of 5,12,13,14,23,25 and 29. He had 1mm recession on the mesial facial and distal facial of 18
and 19 and 2mm recession on the facials. He had 3mm recession on the facial of 20 and 24 and
5mm on 21. He had 2mm recession on the facials of 28,30,31 and 1mm recession on the mesial
buccal of #30. He also had 1mm recession on the lingual facials of 3,12,23,26,30 and 2mm
recession on 24 and 25. Recession indicates bone loss which is periodontitis. He is a prophy class
4- which means he has extensive calculus on his tooth surfaces. Calculus can lead to plaque
biofilm retention that is difficult or impossible for a patient to clean. It is difficult to bring
periodontitis under control in the presence of dental calculus on affected teeth. He is also a
periodontal case 3 due to the moderate bone loss around his lower right and lower anterior teeth.
He has mild periodontitis on the upper right/left, and lower left quadrants.

4. Periodontal Examination: (color, contour, texture, consistency, etc.)

a. Case Classification: 4 Periodontal Case Type:III

b. Gingival Description: Localized papillary gingival inflammation

App't 1: (09/19/2017)
-My patient has generalized scalloped architecture and the tissue color is localized red on 23-26.
The consistency was localized edematous and spongy on 23-26 and the margins were rolled on
teeth 3,12-14,19,21,27-29. His papillae were within normal limits and there was no suppuration.
He had generalized smooth surface texture on the papillary and margins, and generalized stippled
on the attached. My patient does have periodontitis with moderate recession. We know this
cannot be reversed, but with proper brushing and flossing techniques, I know my patient and I
can halt his disease progression and get healthy gingival tissues again. He brushes twice a day
and does not floss or use mouth rinse as he should. With adequate education and good technique,
I believe we can get his oral health restored.

App't 2: 09/28/2016
My patient has generalized scalloped architecture and the tissue color is localized red on 23-26.
The consistency was localized edematous and spongy on 23-26 and the margins were rolled on
facials of teeth 3,12-14,19,21,27-29. His papillae were within normal limits and there was no
suppuration. He had generalized smooth surface texture on the papillary and margins, and
generalized stippled on the attached.

App't 3: 10/16/2017
My patient has generalized scalloped architecture and the tissue color is localized red on 23-26.
The consistency was localized edematous and spongy on 23-26 and the margins were rolled on
facials of teeth 3,12-14,19,21,27-29. His papillae were within normal limits and there was no
suppuration. He had generalized smooth surface texture on the papillary and margins, and
generalized stippled on the attached. There were no changes in his gingiva since the first two
appointments except he had a bump on his lip from trauma.

App't 4: 10/23/2017
My patient has generalized scalloped architecture and the tissue color is localized red on 23-26.
The consistency was localized edematous and spongy on 23-26. The margins had some
improvement and were no longer as rolled and were slightly rolled on facials of teeth 3,12-14,19.
The gingiva also appeared healthy and pink on the maxillary quadrants. Margins were still rolled
on teeth 21,27-29. His papillae were within normal limits and there was no suppuration. He had
generalized smooth surface texture on the papillary and margins, and generalized stippled on the
attached.

App't 5:10/30/2017
My patient has generalized scalloped architecture and the tissue color is still localized red on 23-
26 but did show slight improvement on less redness then before I cleaned the mandibular left
quadrant. The consistency was still localized edematous and spongy on 25 and 26 but within
normal limits on 23 and 24. The margins on the maxillary quadrants have improved and were no
longer as rolled and were slightly rolled on facials of teeth 3,12-14,19. The gingiva also appeared
healthy and pink on the maxillary quadrants. Margins were still rolled on teeth 21,27-29. His
papillae were within normal limits and there was no suppuration. He had generalized smooth
surface texture on the papillary and margins, and generalized stippled on the attached.

App't 6: 11/13/2017
My patient has generalized scalloped architecture and the tissue color is still localized red on 23-
26 but has shown improvement from his previous appointment. The consistency on 23-26
showed significant improvement and was within normal limits. All 4 quadrants showed less
defined rolled margins but were still noted on 3,12-14,19,21,27-29. All 4 quadrants showed pink
gingiva. His papillae were within normal limits and there was no suppuration. He had
generalized smooth surface texture on the papillary and margins and generalized stippled on the
attached.

c. Plaque Index: App’t 1) .6-Good 2) .5-Good 3) .3-Good 4) .3-Good 5) .1-Good 6 ).1-Good

d. Gingival Index: Initial: 1.12-Fair Final: 0.6-Good

e. Bleeding Index: App’t 1) 2.3% 2) 1.1% 3) 5.5% 4) 2.7 5) 2.7% 6) 2.3%

f. Evaluation of Indices:
1. Initial- Plaque index is good and gingival index is fair. The plaque index is important in
judging how the quality of his plaque removal changes from the first appointment to the last. The
gingival index assesses the severity of his gingivitis based on color, consistency, and bleeding on
probing. Generally, the condition of his gingiva was localized papillary

2. Final-- Plaque index is good and gingival index is good. Both my patient’s plaque and
bleeding score have improved every appointment by lessening or staying the same as the
appointment before. I commended my patient for lowering his plaque and bleeding score because
this means he applied what he learned in the patient-ed sessions I taught him. Although my
patient’s plaque score was brought down to .1 by the re-evaluation appointment there is still
room for improvement to hopefully bring his plaque score down to 0. My patient stated that he
started flossing 1x a week which is a significant improvement because he was not flossing before
which may be the cause of why he still presents with a bleeding score.
g. Periodontal Chart:(Record Baseline and First Re-evaluation data)
1.Baseline:(09/19/2017)
- He had generalized 4mm pocket depths in the posterior regions. He had a localized 5mm
pocket on the distal lingual of 14. Bleeding while probing was slight and localized on the mesial
facial of 3, mesial lingual of 28 and 29, and distal facial of 19. He had 1mm of recession on the
facials of 5,12,13,14,23,25 and 29. He had 1mm recession on the mesial facial and distal facial of
18 and 19 and 2mm recession on the facials. He had 3mm recession on the facial of 20 and 24
and 5mm on 21. He had 2mm recession on the facials of 28,30,31 and 1mm recession on the
mesial buccal of #30. He also had 1mm recession on the lingual facials of 3,12,23,26,30 and
2mm recession on 24 and 25. He had no suppuration. He has teeth 1,16,17, and 32 missing. On
teeth 2 and 4 there is an occlusal metallic restoration. There is a porcelain fused to metal crown
on tooth 3. On tooth 14 there are two occlusal metallic restorations and on 15 there are two
occlusal metallic restorations and a lingual metallic restoration. Teeth 18,19, and 30 have full
gold crowns and 31 has a white gold crown. There is a distal occlusal met rest on th 20 and
abfraction on the facials of 20 and 21. On tooth 24 there is a incisal facial tooth colored
restoration. Also tooth 9 has torsoversion and 25 has labioversion.

2.Firstevaluation: (11/13/2017)
- After cleaning all 4 of my patient’s quadrants, we waited two weeks to allow the tissues to heal
before having him come back in for his re-evaluation appointment. I then did full perio charting
and noticed a lot of improvement in his pocket depths but also some pocket depths that were
deeper than his baseline perio charting. These few deeper readings of the perio pockets could
have been from incorrect angulation the first time I probed. He presented with generalized 4mm
pocket depths in the posterior regions, localized 7mm pocket on 30-DL, 6mm pocket on 31-ML,
and 5mm pockets on 3-MB, 18&30-ML, and 30-DB. He has a class 1 furcation on 19. There was
1mm recession on the facial of 5, 25, and 18. There was 1mm recession on 9, 25, and 30 mesial
facial. There was 2mm recession on the facials of 12, 13, 19, 20, 21, 30. There was 1mm
recession on 19 and 30 distal buccal. There was 3mm recession on 24 facial. There was 1mm
recession on the lingual of 3, 22, 23, and 19. There was 3mm recession on the lingual of 24, 25,
and 26. Bleeding on probing was on the mesial and distal buccal of 3, the distal lingual of 8, and
the distal buccal of 31. Overall my patient does still have periodontal disease, his pocket depths
have improved in areas and now that he has had a thorough cleaning he will hopefully be able to
maintain good home care and keep up with regular dental visits and we can see an overall
improvement. I will see the patient in 3-4 months for his dental cleaning to help keep his bone
loss halted.

5. Dental Examination: (caries, attrition, midline position, mal-relation of groups of teeth,

occlusion, abfractions)
-There was no caries found. He had an abfraction on the facials of 20 and 21. Occlusion: right
molar and canine were class I and left molar and canine were class III. He had a slight midline
shift of 2mm to the right. He is missing wisdom teeth 1,16,17, and 32. He has overbite and
overjet of 5mm which can influence harboring of bacteria and food and trauma to the teeth from
different biting pressures.

6. Treatment Plan: (Include assessment of patient needs and education plan)

 Reviewing medical history
Pre-rinse
New plaque and bleeding score
Gingival assessment and notes
Ultrasonic scaling with fine scaling
Full periodontal charting per quad
Chair side patient education
LTG 1: Bring plaque score down by .1
STG: Define plaque
STG: Define and demonstrate brushing (2x day)
STG: Evaluate patients brushing method with typodont and on him.

LTG 2: Halt disease periodontitis and its progression.

STG: Define periodontitis
STG: Define and demonstrate correct flossing method.
STG: Reduce bleeding score by .2% at each appointment.

LTG 3: Daily use of fluoride.

STG: Define fluoride.
STG: Educate on the benefits of fluoride.
STG: Use fluoride/fluoride products on a daily basis.

App’t 1: 09/28/2017
At my patients first appointment I will take a new plaque and bleeding score. After, I will do a
gingival assessment and make thorough notes. I will take pictures with the intraoral camera to
help document progress and to compare to the patient’s post-op pictures. I will then ultrasonic
the maxillary right quadrant and get a scale check; if any spots are missed I will go back and
scale those spots. After this I will do a full periodontal chart with 6 pocket depths, tissue heights,
and clinical attachment level per tooth. I will then fine scale any remaining calculus. I will also
do our first patient education session over plaque. Our long-term goal for this session is to reduce
his plaque score by .1 or less by the time of his reevaluation appointment, with short term goals
being defining plaque, define and demonstrate brushing twice daily, and evaluating his brushing
method. I will explain that plaque is a white sticky film that is made up of bacteria and food
debris. I will explain how plaque demineralizes the tooth surface and leads to eventual decay,
gingivitis, and possible periodontitis and tooth loss. I will demonstrate on the typodont the
correct brushing technique angling the toothbrush at a 45-degree angle towards the gingiva and
removing plaque from all surfaces. I will watch him at the sink using the information and the
technique I just taught him to be sure he is applying what I taught him. Lastly, I will review what
we went over and ask him questions regarding plaque and toothbrushing to be sure he
understood what I taught him.

App’t 2: 10/16/2017
 At my patients second appointment I will take a new plaque and bleeding score. After that I will
do a gingival assessment and make thorough notes. I will then ultrasonic the maxillary left
quadrant and get a scale check; if any spots are missed I will go back and scale those spots. After
this I will do a full periodontal chart with 6 pocket depths, tissue heights, and clinical attachment
level per tooth. I will then fine scale any remaining calculus. I will also do our second patient
education session over periodontitis. Before we get started I will commend the patient if he has
lessened his plaque and bleeding score since his first patient ed session. I will ask him if he can
define plaque and demonstrate on the typodont the correct brushing technique. I will answer any
questions that he has. I will go over our long and short-term goals for this session. Our long-term
goal for our second session is to halt periodontitis and its progression. I will define periodontitis
which is bone loss and tissue destruction due to bacteria being present for an extended period of
time. I will educate him on how periodontitis progresses over time and cannot be reversed, but
can be halted. Then I will demonstrate the correct flossing technique. This includes making a C
shape loop around each interproximal tooth surface and using an up and down motion to remove
any bacteria and being sure to go up and over the interdental gingiva. I will watch him at the sink
using the information and the skills I just taught him. I plan for us to reduce his bleeding score by
.2% each appointment. Lastly, I will review what we went over and ask him questions regarding
periodontitis and flossing to be sure he understood what I taught him.

App't 3: 10/23/2017
At my patients third appointment I will take a new plaque and bleeding score. After that I will do
a gingival assessment and make thorough notes. I will then ultrasonic the mandibular right
quadrant and get a scale check; if any spots are missed I will go back and scale those spots. After
this I will do a full periodontal chart with 6 pocket depths, tissue heights, and clinical attachment
level per tooth. I will then fine scale any remaining calculus. I will also do our third patient
education session over fluoride. Before we get started I will commend the patient if he has
lessened his plaque and bleeding score since his last patient ed session. I will ask him if he can
define periodontitis to me, and demonstrate the correct flossing technique on the typodont. I will
answer any questions that he has. I will go over long and short-term goals for this session. Our
long-term goal for our third patient education session is to use daily home fluoride. I will explain
that fluoride is a chemical compound added to certain things like toothpaste, water, and mouth
rinses. I will educate him on the benefits of fluoride being that it helps reduce cavities by
remineralzing and strengthening the enamel. Then we will come up with a plan for him to use
fluoride daily at home. I will bring the patient to the sink, disclose, and watch the patient brush
and floss in the mirror using the skills I have taught him. Lastly, I will review what we went over
today and ask questions regarding fluoride to be sure he understood what I have taught him.

App't 4: 10/30/2017
At my patients fourth appointment I will take a new plaque and bleeding score. After that I will
do a gingival assessment and make thorough notes. I will then ultrasonic the mandibular left
quadrant and get a scale check, if any spots are missed I will go back and scale those spots. After
this I will do a full periodontal chart with 6 pocket depths, tissue heights, and clinical attachment
level per tooth. I will then reinforce all our patient education session and make sure that I have
answered any questions that he may have. I will acknowledge his challenging work in learning
and demonstrating correct technique and being teachable and willing to learn new things each
appointment, and for also any areas that are clinically improved. I will polish and plaque free,
and give a fluoride treatment. I will then schedule his last appointment in 2 weeks for a final
evaluation.

App't 5: 11/13/2017
This is our last appointment two weeks after scaling his last quadrant. I will take a new plaque
and bleeding score. I will re-check and fine scale all areas and have this checked. I will do full
perio charting to see if his pocket depths have changed. I will place Arestin in the perio pockets
5mm and above and instruct him not to brush in these areas for 24 hours and not to floss in these
areas for 10 days. I will inform him where these areas are located. I will answer any questions
and commend him again for any clinically improvement that I see. I will place him on a recall of
3-4 months.

7. Radiographic Findings: (crown root ratio, root form, condition of interproximal bony
crests, thickened lamina dura, calculus, and root resorption)

Wisdom teeth 1,16,17, and 32 are missing. He has mild horizontal bone loss in the upper
right/left and lower right. He has moderate horizontal bone loss in the lower anterior and lower
right. There is a loss of crestal lamina dura in upper right/left, lower right/left, and lower anterior
means there are signs of mild periodontitis. There is calculus on the mesial of 25, mesial distal of
24 and distal of 22 which without removal could cause bone loss to progress. There is a defective
restoration of 31, crown is not seated and meeting with the tooth. There is also close root
proximity in the lower anterior.

8. Journal Notes: (Record in detail the treatment provided, oral hygiene education, patient
response, complications, improvements, diet recommendations, learning level, progress towards
short and long term goals, expectations, etc.) The progress notes should be written by
appointment date.
- (09/19/2017): Today was my patients first appointment with me. We finished all paperwork
including gingival index and I took a full mouth x-ray with horizontal bite-wings. We discussed
the number of appointments it would take and time commitment and he stated he is willing to
make the time to get his cleaning, education, and his oral hygiene at its best. I explained to my
patient the importance of brushing and flossing twice a day and using a mouth rinse, all to help
aid in interrupting plaque formation. I demonstrated the proper tooth brushing technique and
angulation and explained how this allows the toothbrush bristles to slide under the gingiva,
removing plaque. His learning level is self-interest and is interested in learning and applying the
knowledge I provide him.

-(09/28/2017): Today was my patients second appointment. We reviewed medical and dental
history, pre-rinsed, and took his plaque and bleeding score. He showed improvement in lowering
his plaque and bleeding score. We did his first patient education session: reviewed his long and
short term goals, taught him the definition of plaque and its role in the development of
periodontal disease. We discussed the Bass method brushing technique, demonstrating on a
typodont and using my flipbook pictures, that the brush needs to be at a 45 degree angle towards
the gum line to remove the plaque that is in the pocket allowing the bristles to slide under the
gingiva. I also stated the importance of brushing at least 2x per day for 2 minutes and brushing
the tongue doing 3-4 strokes to prevent bad breath. We went to the sink and I disclosed and he
showed me the new brushing skill he learned. At the end of the session, he seemed confident in
reaching these goals. The learning level at this appointment is action. After, I perio charted and
ultrasonic scaled maxillary right and began to fine scale it. There were no complications during
treatment.

-(10/16/2017): Today was my patients third appointment. We updated his medical and dental
history, pre-rinse, and took his plaque and bleeding score. We did his second patient education
session and reviewed the topics from the previous education session as well as long and short
term goals. The patient showed improvement in brushing due to the lowered plaque score
recorded and attained all the STGs from the first patient education session. After, I taught the
patient the definition of periodontitis and how it affects the oral cavity. We also discussed
flossing and how it’s essential to remove plaque in between teeth where the brush cannot reach. I
demonstrated to the patient the “C-method” and the seesaw technique when inserting the floss
using a typodont. We then went to the sink to test his new learned skill and he did great. The
patient’s learning level at this appointment is action. After, I perio charted, ultrasonic and fine
scaled mandibular right and finished fine scaling maxillary left. There were no complications
during the treatment.

-(10/23/2017): Today was my patients fourth appointment. We updated his medical and dental
history, pre-rinsed, and took a plaque and bleeding score. We did his third patient education
session and reviewed the topics from the first and previous session as well as long and short term
goals. He showed improvement in flossing due to the lowered plaque and bleeding score
recorded and attained the first two STGs from the second patient education session. My patient
stated he has not started flossing since our last patient ed session. I explained to him the
importance of having re-call appointments to maintain good oral health and the importance of
starting to floss. I told him that dental cleanings along with his oral home care will ensure his
periodontitis doesn’t reoccur. We then went to the sink to test one last time the previously taught
techniques of brushing and flossing and did good once again. His learning level at this
appointment was action. After, I perio charted, ultrasonic and fine scaled mandibular left. There
were no complications during the treatment.

-(10/30/2017): Today was my patients fifth appointment. We updated his medical and dental
history, pre-rinsed, and took a plaque and bleeding score. The patient showed improvement in
brushing and flossing due to the lowered plaque score recorded and attained all the STGs from
the third patient education session. I perio charted, ultrasonic and fine scaled mandibular right. I
polished, flossed, and ensured he was plaque free before applying 5% fluoride varnish.. I then
explained to him that at the next appointment I would be applying Arestin, an antibiotic that is
applied to the deep pockets he has in his mouth that will help aid in faster healing. I emphasized
the importance in home care to successfully complete the treatment and maintain good oral
health along with keeping a 3-4 month recall for his dental cleanings to keep his periodontitis
halted. The learning level at this appointment is action. There were no complications during the
treatment.
-(11/13/2017): Today was my patients sixth appointment. We updated his medical and dental
history, pre-rinsed, took final plaque score, bleeding score and gingival index. I completed a full
post perio charting and explored mouth to look for any residual calculus. I overlooked his
gingiva and made journal notes of areas of improvement or worsening. After, I placed Arestin on
the areas 5mm and above, I told him to avoid flossing in the area for 10 days. My patient’s was
very interested in how Arestin worked and liked the idea of having the antibiotic placed in his
perio pockets of 5mm and greater. I emphasized the importance of home care to successfully
complete the treatment and maintain good oral health. I emphasized the importance of getting in
the habit of at least flossing once a day since patient admitted to only flossing once a week but
commended him on flossing once a week since before his patient-ed he was not flossing at all.
Learning level is action. There were no complications. He stated that he will return next semester
to continue the maintenance of his oral health and stay on a 3-4 month recall.

9. Prognosis: (Based on attitude, age, number of teeth, systemic background, malocclusion,

tooth morphology, periodontal examination, recare availability)

My patient portrays a ready-to-learn and apply attitude about halting his disease. He is 59 years
old and has all his natural teeth except 1,16,17, and 32 which he had surgically removed. He is
not flossing everyday which I think we can work together on this issue and plan for him to get in
the habit of flossing at least 2-3x a week. If he is willing to floss 2-3x a week and eventually get
in the habit of flossing 1x a day along with his regular 3-4 month recall prophylaxis, his
gingivitis can be reversed and his periodontitis halted. He has Class I occlusion on the right
molar and canine and Class III occlusion on the left molar and canine. He has an abfraction on
the facial of 20 and 21. He will be placed on a 3-4 month recall for thorough cleanings and
fluoride treatments, however, continued adequate home care is essential for successful treatment.
With further education, I think my patient and I can achieve optimal oral health.

10. Supportive Therapy: Suggestions to patient regarding re-evaluation, referral, and recall
schedule. (Note: Include date of recall appointment below.)

-I believe that my patients overall prognosis is good. During the re-evaluation appointment I
stressed the importance of starting to floss at least 1x a day since patient is only flossing once a
week. I also suggested him to use a mouth rinse that would aid in reducing the bacteria in his
mouth. I told him to make sure he continues to brush at least 2x per day for 2 minutes so that his
periodontitis does not return. I will place this patient on a 3-4-month recall visit for dental
cleanings to help stop any disease progression from occurring. If my patient does not comply, the
risk of periodontal disease progression is inevitable. This patient required no referrals and had no
areas of decay.

11. Assessment of Changes: (including plaque control, bleeding tendency, gingival health,
probing depths)
- After reviewing the plaque scores of my patient, he has shown improvement of his plaque
control, lessening or staying the same as the previous appointment at every appointment. This
proves that he is being successful in completing proper oral home care. There wasn’t a great
difference between bleeding scores but he did have healing. His gingival health has also
improved significantly. His gingival index has decreased by 0.5. Some of his probing depths
have changed by his post evaluation appointment, few of the 4mm pockets have gone down to
3mm as well as the CAL to 0-1mm. There were a couple of areas that had a greater probing
depth then before but overall, my patient has improved greatly in areas of plaque and gingival
health. If my patient continues the proper home care and starts to get into a routine of dental care,
our main goal of fully halting his oral disease can be reached.

12. Patient Attitudes and Cooperation:

-My patients attitude positive and attentive throughout every appointment. After I explained to
him the severity of his disease and how we must be aggressive in halting it, it made eager him to
want to get back into a good oral health state. At each patient ed session when I would review
what he learned the previous session he always remembered what he learned and demonstrated
properly on the typodont the skills I taught him. I was excited for him because it proved that he
was trying to improve his oral home care and health. He has a good emotional status which
allowed him to view things in a positive way to where it motivated him to become better. I
believe he will be very good at attending his 3-4 month recall appointment next semester.

13. Personal Evaluation/Reaction to Experience:

-Going through this with my patient has been an amazing learning experience. From his first
appointment I have learned so much by completing his perio care plan and was excited to see the
changes in his gingival tissues and lowered plaque score at his re-evaluation appointment.
Having him come one time a week 6 different times has truly helped me see the difference in the
gingival tissues after cleaning a quadrant by being able to compare to the quadrants I had not
started cleaning yet. Overall this was a great experience and I am excited to see him for his 3-4
month recall to see if he has kept up with his home care.