BY JENNIFER HELLING NOV 11 TH 2014 OHI Presentation

Patient Background 29 year old female, college student History of regular care (annual cleanings) Patient using manual soft bristle tooth brush twice a day, and flosses on occasion.

1 st appointment 46% plaque free Patient was missing large area on right side while brushing. She stated she usually begins on the left side. Most of her plaque was on the cervical 1/3 of the teeth, or interproximally. Patient states she does not floss often. Completed adult prophy and fluoride varnish. Patient had generalized inflammation from plaque

1 st. Appointment Continued  Patient said she has never been shown how to properly brush (or may not remember), even though she has had regular cleanings for the past several years.  I focused on taking the time to make sure she understood the techniques, and had her demonstrate them in front of the mirror.

1 St Plaque Index-46% Plaque Free

Interventions Discussed sulcular brushing at 45 degree angle “C” shaped flossing to contour the tooth anatomy Advised patient to brush for equal amounts of time in all areas of the mouth, for a minimum of 2 minutes. Recommended patient get a Sonicare toothbrush. Used tell, show, do method to demonstrate techniques.

2 nd Appointment  Patient brushed and flossed, and then I disclosed entire dentition.  Plaque index- 85% plaque free  Patient states she has been using her new Sonicare toothbrush twice a day for a longer duration (3 min) and is flossing daily as recommended.  Patients gingiva were less inflamed.

2nd. Plaque Index-85% Plaque Free

Revised Recommendations Most of the remaining plaque was seen interproximally. Reviewed with patient once again how to floss with a “C” shape technique. She admitted she had forgotten this piece of the instructions. Once again used the tell, show, do method with a mirror. Patient seems to understand well and is motivated to try this at home. Other than that patient is doing a great job removing plaque!

Motivation Patient told me that after our visit she was motivated to help others with their oral health, and handed out toothbrushes instead of candy on Halloween.

Reflections This OHI patient made me realize that even though the patient may be seen regularly for cleanings, they may not be receiving or retaining thorough homecare instructions. This is an example of the importance of reiterating home care methods and instructions at each visit. This patient had great results and I feel like I was able to motivate her to change her behaviors long term.

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