(1) Date: 4/23/14 - Cristina

Background: Cristina is a 22 year old who will be finishing her Masters degree in social work in the
Spring of 2014.
Completed in one appointment
Assessment:
Medical/Dental history: No health concerns; last dental appointment was more than 3 years ago and her
vitals were normal.
Intra/extra oral exam: I found a 4mm x 4mm red and white patch on her palate by the lingual of tooth
#3 and a 2 mm granule posterior to tooth # 14 on the buccal mucosa.
Dental: Her teeth were in excellent shape with no restorations. Dr. Kelly recommended to have a sealant
prepped with a bur by a dentist. No x-rays were taken at this appointment.
Assessment (Perio): There was generalized slight marginal and papillary inflammation with no bleeding
upon pocket measurements. The plaque was slight interproximal and at the gingival margin. The deposit
evaluation was 1/1.
Diagnosis:
DHD- Generalized recession, with localized slight periodontitis; Perio Case type I, localized II. I Explained
to Christina that she had slight clinical attachment loss on her posteriors. She already knew about the
areas of recession, I explained to her the importance of keeping those areas clean to avoid further bone
loss. Cristinas biggest concern coming into the appointment was the granule on inside of her cheek,
Dr. Kelley confirmed that this was salivary duct stone, and should go away in a few days.
Plan:
Cristina was very interested in preventing any cavities and any additional bone loss. She already did a
very good job with her toothbrush; however, after I explained to her the importance of flossing, she
plans to increase the amount that she flosses per week. After I explained the dental hygiene diagnosis
and the dental plan to Cristina, we planned our treatment. I started scaling her maxillary arch, then I
continued on to complete scaling the mandibular arch. Once the scaling was completed, I selectively
polished her entire dentition and applied 5% topical fluoride varnish.
OHI:
I demonstrated sulcular brushing as well as showed her the proper technique for using her electric
toothbrush, and also demonstrated C-shaped flossing.
Personal reflection:
I was very pleased to be able to clean Cristinas teeth. Her appointment was the first appointment I was
successfully able to complete in one session (including the periodontal assessment). This appointment
made me feel more confident in myself, feeling very knowledgeable about the information I have

learned in the first few terms of the program. She was a great patient and seemed to absorb the
information that I had given to her, I believe I was able to give enough information to make the OHI
successful without completely overloading her. I look forward to being able to help complete the sealant
with Dr. Kelley at some point this term. I look forward to being able to be more skilled and able to
complete more appointments in an initial appointment.

(2) Date: 4/29/14 - Payton

Background: Payton is 11 years old and was one of the students who came to one of our pedo clinic.
Completed in one appointment
Assessment:
Medical/Dental history: Payton was taking methylphenidate- and had not taken her medication because
she ran out of it at home. This medication is taken for ADHD. Vitals were all normal and she was an ASA
class I.
Intra/extra oral exam: Everything in her Intra/Extra oral exam was within normal limits.
Dental: Payton had mixed a mixed dentition, she did have a distal caries on tooth # S; however, Dr.
Kelley did not recommend any treatment on that tooth because it was going to exfoliate soon. Dr. Kelley
did recommend sealants on #3 and #14 which we completed at the appointment. Four indirect digital xrays were taken at this appointment.
Assessment (Perio): There was generalized slight marginal and papillary inflammation with generalized
bleeding upon pocket measurements. The plaque was slight interproximal and at the gingival margin.
The deposit evaluation was 1/1.
Diagnosis:
DHD- Generalized gingivitis; Perio Case type I. I Explained to Payton that her gums were inflamed due to
bacteria on her teeth, we completed home care instructions and I had her show me the proper ways to
floss and brush her teeth after I gave her instructions.
Plan:
I began the day looking over Paytons medical history and asking about her medication, this is when she
explained to me that she was out of her medications. We took radiographs and I explained to her how I
was going to complete treatment. After checking in with Tammy S. I started scaling her maxillary arch,
then I continued on to complete scaling the mandibular arch. Once the scaling was completed, I polished
her entire dentition and applied 5% topical fluoride varnish.
OHI:
After disclosing Paytons entire dentition, I showed her the areas that she was not cleaning. We
completed very in depth home care instructions because she was only 33% plaque free, I demonstrated
sulcular brushing and C-shaped flossing.

Personal reflection:
I was very grateful to be able to work with Payton, It gave me experience to work with someone that
was a little more active and I had to make some adjustments in order to keep her occupied during the
cleaning. Not only was she young, but she had not taken her medications so she was a little more
inclined to look around and not sit still. She did seem to pay attention to detail while completing OHI,
and was very detailed when showing me how to properly clean her teeth. I look forward to help children
when possible understand the importance of their oral health.

(3) Date: 4/14/14 (1st appointment) - Trisha

Background: Trisha is 33 and is in the dental assisting program. She had not had her teeth cleaned in
about 10 years.
Completed in two appointments
Assessment:
Medical/Dental history: No health concerns; last dental appointment was more than 10 years ago and
her vitals were normal.
Intra/extra oral exam: I found a 2 mm superficial petechial on the patients left check adjacent to tooth
#14. Was not verified by the dentist because there was no exam completed because she previously had
an exam completed with Clock Tower. This was annotated in her record so we could keep track of it.
Dental: Trishas teeth were in very good shape, she had two restorations completed before her cleaning.
She had heavy tobacco staining on her teeth and was very interested in getting that removed and
becoming more regular with her dental visits. No x-rays were taken at this appointment.
Assessment (Perio): There was generalized slight marginal and papillary inflammation with localized
slight bleeding upon pocket measurements. The plaque was slight interproximal and at the gingival
margin with generalized heavy staining. The deposit evaluation was 1.5/1.5.
Diagnosis:
DHD- Generalized slight gingivitis with localized recession; Perio case type I with localized Perio case
type III. Trisha had moderate CAL on the facial of #11, and the lingual of #12. Trisha and I discussed the
areas of recession/ CAL, we talked about the risk factors of occasional tobacco used and thumb sucking.
Trisha already knew about the areas of recession and we talked about the importance of keeping that
area clean to help avoid further bone loss. Trishas chief concern at the first appointment was a lesion
on the left mucosa adjacent to tooth #14, we discussed that this was most likely caused by eating
Sugary/sour foods, and should go away in a few days.
Plan:
Trisha was very interested in preventing additional cavities along with further bone loss. She already
did a very good job with her toothbrush. After I explained the dental hygiene diagnosis and the dental
plan to Trisha, we planned our treatment. I started by scaling her maxillary arch and scheduled her to
complete her cleaning in a few weeks.

OHI:
At Trishas first appointment, I demonstrated sulcular brushing and C-shaped flossing, and also discussed
the importance of being very gentle while using her toothbrush, especially in the areas with recession.
Date: 4/28/14 (2nd appointment) - Trisha
Assessment:
Medical/Dental history: No additional health concerns.
Intra/extra oral exam: The 2 mm superficial petechial on the patients left check adjacent to tooth #14,
was no longer visible at her second appointment.
Dental: On her second visit, Trisha commented that her maxillary arch was so clean and white and she
was very excited to get the rest of her dentition completed. No x-rays were taken at this appointment.
Diagnosis:
DHD- After evaluating on the previously debrided areas, I noted that the patient was compliant with her
OHI, there was no bleeding in the area, and there was very little plaque. There were a few areas with
plaque on the maxillary arch on the interproximal surfaces of the anterior teeth with generalized slight
inflammation.
Plan:
Trisha and I continued her second appointment by making modifications to her home care and
completed a pre-polish and continued to hand scale her mandibular arch, and completed the cleaning
by polishing her entire dentition and applying 5% topical varnish.
OHI:
During Trishas second appointment I showed her how to use the gum stimulator on the areas with
recession.
Personal reflection:
I was very excited to be able to complete Trishas cleaning, she was very self-conscious of her teeth due
to the tobacco staining. This was the first cleaning where I was dealing with heavy staining. It was a
great experience to see how much more effort goes into removing the stain and to immediately see the
difference in the dentition. Trisha was a great patient and I loved to see the expression on her face once
her teeth were pearly white. I look forward to being able to work with patients that I make a difference
in their teeth and are truly grateful and excited to have a difference in their oral health.
(4) Date: 6/4/14 - Gene
Background: Gene is a 43 year old male who was evaluated by Beth and I was able to see as my last
patient before the end of the term. He had traveled a lot, was in the military and previously had
cleanings completed at Chemeketa Community Colleges dental hygiene clinic.
Completed in one appointment

Assessment:
Medical/Dental history: No health concerns; he mentioned that he had some sensitivity on his maxillary
arch, and last dental appointment was in 2013 and his vitals were normal.
Intra/extra oral exam: The intra/extra oral examination was within normal limits.
Dental: His teeth were in excellent shape with no restorations. He had localized attrition and recession.
The dentist (Dr. Larson) recommended for him to have a free gingival graft completed on tooth #5. A
full-mouth digital set of x-rays were sent from Chemeketa Community College dated 1/15/13, five direct
digital bitewing x-rays were taken at this appointment.
Assessment (Perio): There was generalized slight marginal and papillary inflammation with slight
generalized bleeding upon pocket measurements. He had very tenacious calculus on the lingual
mandibular anterior teeth and a 6 mm pocket on both the lingual and buccal distal of tooth # 31. He had
2-4 mm of CAL on the maxillary premolars and canines on both the right and left quadrant. The deposit
evaluation was 2/1.5.
Diagnosis:
DHD- Generalized recession, with localized slight to moderate periodontitis; Perio Case type II, localized
III. I explained to Gene that he had attrition on his canines and recession on his molars and mandibular
anterior teeth. He already knew about the areas of recession, I explained to him the importance of
keeping those areas clean and to be sure to use gentle sulcular brushing to avoid further bone loss and
attrition.
Plan:
Gene had a lingual bar on his mandibular anterior teeth, he was very interested in preventing additional
attrition and bone loss and using soft pics to keep the lingual bar clean. After I explained the dental
hygiene diagnosis and the dental plan to him, we started treatment. I started by using the ultrasonic
scaler on his maxillary arch, exploring the arch and returning to any areas that had remaining deposits
with my Gracey curettes. I then I continued by using the ultrasonic to complete the mandibular arch,
after using the ultrasonic along the mandibular arch paying close attention and extra time on the lingual
bar, I explored and removed all remaining deposits using my Gracey curettes and sickle. Once the
scaling was completed, I used the prophy jet on his entire dentition and applied 5% topical fluoride
varnish.
OHI:
I demonstrated sulcular brushing and C-shaped flossing. After completing the cleaning exposing the
lingual bar I also showed him how to use the soft pics to help keep the mandibular anterior teeth clean
and help to avoid as much accumulation of plaque.
Personal reflection:
Gene was a very great patient and was very excited to be able to get his teeth cleaned before the end of
the term. He was very anxious about getting his mandibular anterior teeth cleaned and to learn ways to
keep that area clean of debris. I used the ultrasonic on his entire dentition he had some areas of
sensitivity which I made a point to avoid using the ultrasonic scaler around, he was very helpful in

letting me know if there were any additional areas to avoid using the ultrasonic scaler on. He was very
willing to have the prophy jet used on him, and interested to have it used since he had never had it used
before. He gave me wonderful feedback about how clean his teeth felt and he did feel that the prophy
jet did make his teeth very smooth; however, some areas that over-sprayed onto the tongue were a
little uncomfortable.
(5) Date: 5/7/14 - Allie
Background: Allie is 10 years old and had to leave a little early to get to dance practice the day of the
appointment.
Completed in one appointment
Assessment:
Medical/Dental history: No health concerns; she does grind her teeth at night and her last dental
appointment was about 6 months ago and her vitals were normal.
Intra/extra oral exam: Allies intra/extra oral exam was within normal limits.
Dental: Her teeth were in excellent shape with no restorations. Dr. Kelly recommended to have a sealant
placed on teeth #3 and #14. Four indirect digital bitewing x-rays were taken at this appointment.
Assessment (Perio): There was generalized slight marginal and papillary inflammation with no bleeding
upon pocket measurements. She had some interproximal calculus on her mandibular anterior teeth
along with sticky plaque on both her maxillary and mandibular dentition. The deposit evaluation was
1/.5.
Diagnosis:
DHD- Generalized gingivitis; Perio case type I. I explained to Allie that there were some areas that were
more inflamed and sensitive due to areas that were not being cleaned that plaque and bacteria was able
to irritate.
Plan:
Allie was very interested in preventing cavities and keeping her teeth healthy and white. She did a
very good job with her toothbrush, and explained to her the importance of flossing, she plans to start
flossing and continue brushing her teeth at least two times per day. After I explained the dental hygiene
diagnosis and the dental plan to Allie, I started treatment. I began by pre-polishing her entire dentition
then continued on to hand scale her maxillary and mandibular arches. Once the scaling was completed, I
polished her entire dentition and had her use a 2% topical fluoride tray.
OHI:
I demonstrated sulcular brushing as well as showed her the proper technique for using her electric
toothbrush, and also demonstrated C-shaped flossing.
Personal reflection:

Allie was very excited to come in and have her teeth cleaned by me. She asked lots of questions about
what we were going to be doing and was very interested in learning how to keep her teeth clean and
free from any caries. I was very excited to be able to show Allie what I do on at school as well as the
interest she has taken in making sure that her teeth are as clean as possible. She was a great patient
and seemed to absorb the information that I had given to her.
(6) Date: 5/20/14 - Cristian
Background: Cristian is a 15 year old student at North Eugene High school, He spoke primarily Spanish
and very little English.
Completed in one appointment
Assessment:
Medical/Dental history: No health concerns; his vitals were normal and I was unable to verify the last
time he had a dental cleaning.
Intra/extra oral exam: Cristians intra/extra oral exam was within normal limits.
Dental: His teeth were very clean with no restorations on any teeth. He did have hyper fluorosis on his
entire dentition. Four indirect digital bitewing x-rays were taken at this appointment.
Assessment (Perio): There was generalized moderate marginal and papillary inflammation with
generalized slight bleeding upon pocket measurements. He had some heavy calculus on his lower
mandibular anterior teeth, along with sticky plaque on both his maxillary and mandibular dentition. The
deposit evaluation was 1.5/1.
Diagnosis:
DHD- Generalized moderate gingivitis; Perio case type I. I explained as best as I could to Cristian the
importance of keeping his teeth clean to help reduce the inflammation.
Plan:
Cristian was a little nervous to have his teeth cleaned, I believe even more so because there was not
access to communicate very well. I was unable to talk to him in depth about how often he brushed.
After exposing radiographs and completing the check in process, I started treatment. I began by prepolishing his entire dentition then continued on to hand scale his maxillary and mandibular arches. Once
the scaling was completed, I polished his entire dentition. I then completed sealants on teeth #2 and #3,
Natasha completed sealants on teeth #14, #15, #18, and #19 and Dawn completed sealants on teeth #30
and #31. I then applied 5% topical fluoride varnish.
OHI:
I demonstrated sulcular brushing and C-shaped flossing. I then had him demonstrate the techniques to
me and complimented him on using the tooth brush and floss correctly.
Personal reflection:

Cristian was a very great patient, I was very happy to have taken some Spanish classes and to
understand and be able to speak to him a little; however, I definitely realized that I need to work on
information that is specific to dental hygiene. I was able to make a working relationship with Cristian
and I believe was able to help reduce some of the anxiety that he seemed to have at the beginning of
the appointment. This was a very great opportunity that will help to further my ability to work with
different cultures. I believe it is very important to make your patient as comfortable as possible and
believe I was able to do that successfully with this appointment.