1. OHI Case Study Maluhia Farr-DH II DH 220 A

2. First Appointment: 11/3/14 Patient presents with generalized heavy plaque. Plaque index shows that patient is 36% plaque-free.

3. Patient Motivation: Patient did not seem motivated to keep a regular home care routine. During previous maintenance appointment (4 months prior), heavy plaque was also noted, which showed there had been no improvement. Lack of attention and enthusiasm during OHI, lead me to believe that there would not be much improvement at second appointment.

4. Oral Hygiene Instruction: Patient was determined to be a Perio-Case Type II. I showed patient the intraoral photos so that he could see the extent of the plaque. Used the “tell-show-do” method to demonstrate. Two components: – Sulcular brushing – C-shaped flossing

5. Intraoral Photos:

6. Second Appointment: 11/7/14 Upon initial visual exam, it was evident that there was an improvement. Chart notes indicate, “Great improvement”. “Very slight IP plaque” compared to the “Gen. heavy plaque”, noted during the first appointment. Not sure if patient was motivated for himself or due to the fact that this assignment was being done on him. Even after congratulating him on doing such a great job, he still seemed unexcited about the situation and seeing his progress.

7. Intraoral Photos:

8. OHI Modifications: Because my patient showed such great improvement with his condition, I didn’t make any modifications to home care. I made this decision, because 1) he was successful with the routine he was using, and 2) I didn’t want to overwhelm him to the point where he would revert to old behaviors.

9. Observations and Reflections: I am always surprised when I have a patient with heavy, visible plaque on their teeth. I wonder why there is no concern on their part to take care of this basic hygiene need. My patient’s lack of interest in the topic of home care, had me concerned that there would be no improvement in his condition. I was pleased, however, to see a great improvement. It feels great to know that my patient utilized the skills learned in our first appointment, and was able to see the improvement for himself (only assessments were performed at the first appointment, so all changes were due to his efforts!).

10. continued Things I would do the same: I would keep things simple. Basic sulcular brushing technique and one means of cleaning interproximally. If patient had not been successful with flossing, I would have recommended another method. Things I would do differently: I would have performed a microscope exam with the patient, if I could do it over again. I believe that the microscope would have been a great way to motivate him.