1. Modification of Dental Hygiene Care Plan in a Dementia Patient K. Lamping, J. Janoski*, A. Reed Indiana University School of Dentistry, Indianapolis Indiana ABSTRACT Objective: The objective of this clinical case presentation is to establish effective communication between the patient with dementia, as well as the caregiver, and identify necessary modifications throughout the dental hygiene appointment. Assessment: An 81-year old, Caucasian male patient presented with caregiver who stated the chief complaint of “my husband needs a cleaning.” The patient’s wife explained that his last cleaning was over 24 years ago. The patient presents with dementia, Type II Diabetes, hypertension, prostate enlargement and cardiovascular disease, in addition to polypharmacy. Because of the patient’s mental health disorder, the patient is unable to adequately communicate with the clinician, so the caregiver is present at all times. The caregiver stated that the patient brushes at least once per day, never flosses but rinses with Listerine everyday. The patient’s Type II Diabetes is controlled with a healthy, low carbohydrate diet. This is especially important, not only for the diabetes control, but also because of his high risk for dental caries. The patient is at high risk for dental caries due to active decay, no dental home, medication-induced xerostomia and inadequate home care due to mental health disorder. He presented clinically with generalized moderate plaque-induced, diffuse gingivitisas evidenced by light pink, soft, rolled gingiva with moderate bleeding on probing and generalized chronic periodontitis as evidenced by 4-6 mm clinical attachment levels. Radiographically, the patient presented with generalized mild horizontal bone loss as evidenced by 3-4 mm measured from the cementoenamel junction to the crest of the alveolar bone. DH Care Plan: Four quadrants of scaling and root planing with extensive oral hygiene instructions, and periodontal tissue re-evaluation were performed. Evaluation: Upon re-evaluation, no improvement was seen with the patient’s oral hygiene or periodontal status. The dental hygiene care plan was adapted by implicating aggressive prevention, such as shorter recall intervals for periodontal maintenance, application of professional topical fluoride and extensive oral hygiene instruction modified towards the caregiver. Multiple auxillary aids were introduced to the caregiver, specific to the patient’s needs. Verbal and nonverbal communication techniques were utilized. Conclusion: Concluding this clinical case, it was apparent that many modifications must be made when managing a patient with dementia. When the patient is unable to perform basic oral hygiene care on his or her own, the responsibility of home care lies in the hands of the caregiver. Hence, the focus of oral hygiene instruction becomes more about educating the caregiver. RESULTS RESULTS TABLE RESULTS GRAPH SUMMARY REFERENCE CONCLUSIONS RESULTS BLOCK 2 Insert Abstract Here…Arial 18 pt. Justify left. Insert text here…….18 pt. Justify left. Insert Abstract Here…Arial 18 pt. Justify left.