Event 4: Dental Assessment and Treatment

Joe Took Margaret to the Dentist

Joe, Margaret’s grandson, was able to take Margaret to the dentist for a dental examination and treatment. Having a family member take Margaret to the appointment allowed for communication of her health status, provide answers to questions, and to reassure Margaret with a familiar face in an unfamiliar situation.

Components of Dental Exam

During a dental exam, the dentist will:

  1. Evaluate your overall health and oral hygiene
  2. Evaluate your risk of tooth decay, root decay, and gum or bone disease - Look for plaque and calculus. Check for bleeding and swollen gums; Check for dry mouth.
  3. Evaluate your need for tooth restoration or tooth replacement; review bridges or dentures - Look for enamel wear, fractured teeth, denture fit at rest and with movement.
  4. Check your bite and jaw for problems - Check temporal mandibular joint for crepitation with open/close or mandible glide, or clicking of joint with chewing.
  5. Assess your need for fluoride.
  6. Take dental X-rays or, if necessary, do other diagnostic procedures.

Dental Examination Results

Patient is wearing an upper removable partial denture. Oral hygiene was poor with gross soft deposits.

Image
Dental examination showing Margaret's teeth with her dentures in.
Upper removable partial denture

Soft tissue underneath the denture was inflamed. Two broken teeth with decay were found underneath the denture.

Image
Dental examination showing Margaret's teeth with her dentures removed.
Inflamed denture

The last tooth had a deep cavity, and the nerve was exposed. There was a large painful ulcer on the buccal gum tissue, which may be painful while chewing.

Image
Dental examination showing cavity in tooth with bleeding gum.
Ulcer on buccal gum tissue

The denture had large amount soft deposits covering the denture base, indicating the denture had not been clean for a long time.

Image
Margaret's denture shows large amounts of soft deposits over the denture base.
Denture showing soft deposits on denture base.

Dental Treatment Plans for Margaret

The dentist recommends the following for dental treatment plan for Margaret:

  • Improve oral hygiene
  • Prevent dental caries
  • Treat fungal infection
  • Extract hopeless teeth
  • Replace missing teeth to improve chewing function
  • Remake the denture
  • Provide guidance for Oral Health at Meadow Lane Nursing Facility

Elements of Good Oral Health

The World Health Organization (WHO) lists the following characteristics for the elements of good oral health:

  • Free from mouth and facial pain
  • Free from oral and throat cancer
  • Free from oral infection
  • Free from tooth and gum disorders
  • Free from oral functional limitations

Test Your Knowledge: Recommendation for Treatment

To promote dental health by non-dental providers in long term care an important tool is being able to recognize what action should be taken when examining the residents’ oral and dental health. Look at the picture, and make a recommendation for a treatment plan.

Image
Teeth and gums show inflammation around gumline.
Recommend treatment based on photo
Correct. This picture shows no cavities, but gums are slightly inflamed by change in color, which can be improved through better mouth care.
Incorrect
Incorrect

Test Your Knowledge: Recommendation for Treatment

To promote dental health by non-dental providers in long term care an important tool is being able to recognize what action should be taken when examining the residents’ oral and dental health. Look at the picture, and make a recommendation for a treatment plan.

Image
Teeth and gums show multiple broken teeth and severely inflamed gums.
Recommend treatment based on photo
Incorrect
Incorrect
Correct. This picture shows multiple broken teeth. Gums are also severely inflamed with darker red color. Refer to dentist for further assessment and treatment.

Test Your Knowledge: Recommendation for Treatment

To promote dental health by non-dental providers in long term care an important tool is being able to recognize what action should be taken when examining the residents’ oral and dental health. Look at the picture, and make a recommendation for a treatment plan.

Image
Teeth and gums show multiple broken teeth.
Recommend treatment based on photo
Incorrect
Incorrect
Correct. This picture shows multiple broken teeth, which may be sensitive. Refer to dentist for further assessment and treatment.

Test Your Knowledge: Recommendation for Treatment

To promote dental health by non-dental providers in long term care an important tool is being able to recognize what action should be taken when examining the residents’ oral and dental health. Look at the picture, and make a recommendation for a treatment plan.

Image
Teeth and gums show good oral hygiene
Recommend treatment based on photo
Incorrect
Correct. This picture shows good oral hygiene. No cavities. No inflammation on the gums. Continue oral care.
Incorrect

 

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