Oral Hygiene

Instruction Case
Study Presentation
Natasha N. London DH2
220A

First Appointment

Patient Information
Reports brushing routine to be 3-5x/week, no
interproximal cleaning
Reports moderate to high exposure to sugary foods
and drinks
Is concerned about bad breath
Would like to actively prevent caries
Patient came to two appointments, one month apart

Plaque free index score: 22% plaque free

All interproximal surfaces
Majority of molar surfaces

First Appointment cont.

OHI recommended: Tell, Show, Do the

following
Sulcular brushing, Bass method, including
duration (2 minutes) and frequency (twice a day)
C-shaped flossing, explaining the importance of
cleaning all tooth surfaces and relating any
remaining plaque to halitosis and caries formation
Perio-aide, relating importance of disturbing
subgingival bacteria to periodontal health
Soft picks, to encourage interproximal cleaning
Suggested reducing sugar exposure

Patient motivation goals

are to reduce or eliminate:

Bad breath
Gingival sensitivity
Gingival bleeding
Caries risk.

First Appointment

Second Appointment

The patient was observed to remember the

learned Bass technique well when brushing
teeth in the clinic
Gingival tissues of previously debrided areas
showed a marked decrease in inflammation
The remaining areas showed a slight
decrease in bleeding and inflammation
Plaque free index score: 90%
Mostly interproximal

Second Appointment

Patient response to home care goals

patient had challenges brushing for two minutes
brushing two times a day became easier over the course of
the month
Flossing was unpleasant

Patient motivation
Patient was very motivated to increase brushing frequency
She reported to notice a difference in the way her breathe
smelled within the first week
Patient is still challenged to brush for that long! or to floss
Patient is still motivated by the original goals
Reducing gingival inflammation, sensitivity, bad breath, and
caries risk

Second Appointment

New recommendations for OHI

Continuing practice brushing for two minutes
reinforcing the importance for plaque removal in
relation to calculus buildup and gingival
sensitivity

Second Appointment

Reflection

My patient was very pleased with the

results of achieving some short term oral
health goals, which made this an enjoyable
assignment. I learned new ways to deliver
instructions and relate them to a persons
personal oral condition. I was able to apply
these new skills to subsequent
appointments with other patients. It was
great to have a solid visual aid (intraoral
photos) to assist in patient motivation.