Scenario 4

Scenario 4

1. aged 75

2. arthritis in hands

   • limited dexterity
     • inadequate plaque removal
       • studies show oral health improves once adequate plaque removal recommences

3. previous nursing home

   • biscuits
   • residents cleaned own teeth
     • arthritis
       • limited dexterity
         • inability to effectively clean teeth alone
   • when did she move into her new home?
     • oral health should improve with better care

4. white plaque

   • after antibiotics
     • possible cause?
   • when did she first notice the white plaque build up?
   • possibly oral candidiasis?
     • possible causes:
       • denture wearing
       • diet
       • diabetes
       • antibiotics
     • possible treatment
       • antifungals
       • denture hygiene

5. denture

   • loose adjacent tooth
     • which tooth/teeth are loose?
     • possibly due to inability to effectively clean teeth
       • limited dexterity (arthritis)
   • how long has she maintained a denture?
   • possibly toothbrushing instruction specifically related to dentures
     • refer to oral candidiasis

6. tooth sensitivity

   • how often does she experience tooth sensitivity?
   • incisal wear?
     • possibly due to old age?
     • possibly due to vigorous brushing?
   • receding gingiva?

7. diabetic

   • oral candidiasis cause?

8. recent medical and dental history?

   • recent periodontal chart/radiograph?

9. current oral hygiene routine?

10. dietary intake?

11. are finances an issue?