Multiple Sclerosis
(Mock Case Study)
Demographics:
-Name: Jessica
-Age: 35 years old
-Gender: female
-Race: caucasian
Physical Assessment:
-Patient appears to have some weakness
-Walks with a cane
Mental Assessment:
-Patient is depressed and embarrassed by impaired mobility.
Social Assessment:
-Lives with younger sister
-Has to work part time now because of chronic pain
Medical Assessment:
-Patient states on medical history that she was diagnosed with MS 10 years ago
-Patient states symptoms of MS get worse in heat
Dental History:
-Implant on right mandibular first molar (tooth # 30)
-Generlized light supragingival calculus
-Localized moderate calculus on lower anteriors
-Composite resin fillings on tooth #'s 2, 3, 14, 19, and 31.
Extra-oral Assessment:
-Scar on left side of face lateral to nose 3mm x 8mm
-Popping on left side of jaw
-Generalized macules
Intra-oral Assessment:
-Attrition on anterior teeth
-Petechiae on right side of labial mucosa adjacent to tooth # 30
-Generalized slight inflammation of the gingiva
Communication:
-Review health history and determine what medications are being taken
-Write down home care instructions after going over homecare with patient
-Give patient appropriate pamphlets
-Give instructions to patient and patient's caregiver
Appointment Planning:
-Short early morning appointments (due to fatigue)
-Relaxed environment (to minimize stress)
-Patient may be sensitive to temperature and may need frequent bathroom breaks
Client Positioning:
-To prevent choking or aspiration, patient may need to be seated upright
-May need to assist patient with wheelchair (wheelchair transfers), walkers, canes, or guide dogs
-May need to use finger guards or mouth props
Dental Hygiene Procedures:
-Patients who are experiencing a relapse should not have elective procedures.
-Emergency care may be provided
-May need to consult physician
Safety Precautions:
-To help facilitate treatment, restraint or support devices, pillows, or help from the caregiver may be used
-Nitrous Oxide should NOT be used on patients experiencing numbness or tingling in their extremeties
Oral Hygiene Instructions:
-Recommend biotene products for dry mouth
-Recommend interdental aids for implant and restorations
-Praise patient for keeping up with tooth brushing, but recommend trying a power toothbrush
-Caregiver is also given these take home instructions as well as pamphlets
Personal Reflection:
I chose Multiple Sclerosis for my mock case study because it is the most common autoimmune disease of the nervous system and it is very important to be aware of this disease. I learned a lot about MS in my prerequisite classes and I find it very interesting how it progresses. It's frustrating knowing what this disease does to your brain while the cause is unknown. It is so important for the dental field to learn about all of the possible diseases patients may have and to manage our treatment accordingly.
Additional Information:
www.msassociation.org
www.nationalmssociety.org
Demographics:
-Name: Jessica
-Age: 35 years old
-Gender: female
-Race: caucasian
Physical Assessment:
-Patient appears to have some weakness
-Walks with a cane
Mental Assessment:
-Patient is depressed and embarrassed by impaired mobility.
Social Assessment:
-Lives with younger sister
-Has to work part time now because of chronic pain
Medical Assessment:
-Patient states on medical history that she was diagnosed with MS 10 years ago
-Patient states symptoms of MS get worse in heat
Dental History:
-Implant on right mandibular first molar (tooth # 30)
-Generlized light supragingival calculus
-Localized moderate calculus on lower anteriors
-Composite resin fillings on tooth #'s 2, 3, 14, 19, and 31.
Extra-oral Assessment:
-Scar on left side of face lateral to nose 3mm x 8mm
-Popping on left side of jaw
-Generalized macules
Intra-oral Assessment:
-Attrition on anterior teeth
-Petechiae on right side of labial mucosa adjacent to tooth # 30
-Generalized slight inflammation of the gingiva
Communication:
-Review health history and determine what medications are being taken
-Write down home care instructions after going over homecare with patient
-Give patient appropriate pamphlets
-Give instructions to patient and patient's caregiver
Appointment Planning:
-Short early morning appointments (due to fatigue)
-Relaxed environment (to minimize stress)
-Patient may be sensitive to temperature and may need frequent bathroom breaks
Client Positioning:
-To prevent choking or aspiration, patient may need to be seated upright
-May need to assist patient with wheelchair (wheelchair transfers), walkers, canes, or guide dogs
-May need to use finger guards or mouth props
Dental Hygiene Procedures:
-Patients who are experiencing a relapse should not have elective procedures.
-Emergency care may be provided
-May need to consult physician
Safety Precautions:
-To help facilitate treatment, restraint or support devices, pillows, or help from the caregiver may be used
-Nitrous Oxide should NOT be used on patients experiencing numbness or tingling in their extremeties
Oral Hygiene Instructions:
-Recommend biotene products for dry mouth
-Recommend interdental aids for implant and restorations
-Praise patient for keeping up with tooth brushing, but recommend trying a power toothbrush
-Caregiver is also given these take home instructions as well as pamphlets
Personal Reflection:
I chose Multiple Sclerosis for my mock case study because it is the most common autoimmune disease of the nervous system and it is very important to be aware of this disease. I learned a lot about MS in my prerequisite classes and I find it very interesting how it progresses. It's frustrating knowing what this disease does to your brain while the cause is unknown. It is so important for the dental field to learn about all of the possible diseases patients may have and to manage our treatment accordingly.
Additional Information:
www.msassociation.org
www.nationalmssociety.org