Methamphetamines
Patient: Erica
Gender: Female
Age: 24
Height: 5 Feet 5 Inches
Weight: 110 pounds
Home: Modesto, Ca
Physical Assessment
Patient appears malnourished and pale. Has red eyes as well as open sores on face and arms.
Mental Assessment
Patient is depressed
Seems aggravated and nervous
Acts paranoid
Social Assessment
Patient lives in a house with several roommates
Roommates also use meth recreationally
works as a bar tender
Medical Assessment
Patient admits to using methamphetamine for about 3 years
Has a family history of drug use
Has continuous bronchitis
Complains of severe muscle cramping
Dental History
Patient has severe attrition
Rampant carries at the gum line and tooth surfaces
Has had restorative work in the past that have since fallen out
Has severe dry mouth
Extra Oral Assessment
Head is symmetrical
Has generalized lesions around mouth and forehead
Glossy eyes, but very alert
Intra Oral Assessment
Has severe attrition on mandibular and maxillary anterior
Bilateral hyperkeritinization on buccal mucosa
Gum tissue appears red and inflamed and bleeds upon touch
Communication
After reviewing Erica’s health history, we discussed her addiction problem and willingness to quit. Some of the questions that came up were:
> What steps does she want to take to stop?
> What effects her addiction is having on her teeth, along with the fate of her teeth if she didn’t seek help?
> What kind of support does she have at home, or is she able to change her environment?
Erica seems very interested in wanting to get her life together. She wants to take the proper steps to be healthy and break the cycle that has consumed so many of her family members already. She has asked for some places she could reach out to and wants to start a plan to get her teeth restored and in better shape so she doesn’t loose them.
Appointment Planning
Multiple short appointments that last about 20 minutes
Nutritional counseling
Remind patient that if she doesn’t make her appointments or is continuously late then we will cancel all appointments thereafter
Three month re-care intervals
Client Positioning
To assure the patient stays comfortable keep in a semi-supine position
Avoid any bright lights in operatory and directed toward the patients face
Safety Precautions
Anesthetic without epinephrine
Non-steroidal anti-inflammatory drugs (NSAIDs) for pain relief as needed
Dismiss patient if they appear high, and inform the front desk to get back up if needed.
Patient Recommendations/OHI
After discussing the effects that drug addiction has made on her oral condition, we went over proper oral hygiene. Keeping instruction short, I recommended the patient try an electric toothbrush for a start and we will discuss more options at the next appointment. I also suggested fluoride mouthwash that does not contain alcohol, and recommended an antimicrobial rinse. I told the patient we were here to support her and help her to achieve optimal oral health.
Personal Reflection
I choose to do this study on meth, because I feel like it going to be something I see more and more of as my career builds. It is a terrible addiction and I want to be sure my patients know that I can be a supporting hand in them trying to turn their life around. What intrigued me most about this topic is it hit close to home for me. I have had some friends fall into this addiction and it is very sad to watch their health be the first thing to go, especially their teeth. If I can help them to understand the negative effects this drug has on their mouth, they may be more inclined to understand the negative effects it has on their body.
Gender: Female
Age: 24
Height: 5 Feet 5 Inches
Weight: 110 pounds
Home: Modesto, Ca
Physical Assessment
Patient appears malnourished and pale. Has red eyes as well as open sores on face and arms.
Mental Assessment
Patient is depressed
Seems aggravated and nervous
Acts paranoid
Social Assessment
Patient lives in a house with several roommates
Roommates also use meth recreationally
works as a bar tender
Medical Assessment
Patient admits to using methamphetamine for about 3 years
Has a family history of drug use
Has continuous bronchitis
Complains of severe muscle cramping
Dental History
Patient has severe attrition
Rampant carries at the gum line and tooth surfaces
Has had restorative work in the past that have since fallen out
Has severe dry mouth
Extra Oral Assessment
Head is symmetrical
Has generalized lesions around mouth and forehead
Glossy eyes, but very alert
Intra Oral Assessment
Has severe attrition on mandibular and maxillary anterior
Bilateral hyperkeritinization on buccal mucosa
Gum tissue appears red and inflamed and bleeds upon touch
Communication
After reviewing Erica’s health history, we discussed her addiction problem and willingness to quit. Some of the questions that came up were:
> What steps does she want to take to stop?
> What effects her addiction is having on her teeth, along with the fate of her teeth if she didn’t seek help?
> What kind of support does she have at home, or is she able to change her environment?
Erica seems very interested in wanting to get her life together. She wants to take the proper steps to be healthy and break the cycle that has consumed so many of her family members already. She has asked for some places she could reach out to and wants to start a plan to get her teeth restored and in better shape so she doesn’t loose them.
Appointment Planning
Multiple short appointments that last about 20 minutes
Nutritional counseling
Remind patient that if she doesn’t make her appointments or is continuously late then we will cancel all appointments thereafter
Three month re-care intervals
Client Positioning
To assure the patient stays comfortable keep in a semi-supine position
Avoid any bright lights in operatory and directed toward the patients face
Safety Precautions
Anesthetic without epinephrine
Non-steroidal anti-inflammatory drugs (NSAIDs) for pain relief as needed
Dismiss patient if they appear high, and inform the front desk to get back up if needed.
Patient Recommendations/OHI
After discussing the effects that drug addiction has made on her oral condition, we went over proper oral hygiene. Keeping instruction short, I recommended the patient try an electric toothbrush for a start and we will discuss more options at the next appointment. I also suggested fluoride mouthwash that does not contain alcohol, and recommended an antimicrobial rinse. I told the patient we were here to support her and help her to achieve optimal oral health.
Personal Reflection
I choose to do this study on meth, because I feel like it going to be something I see more and more of as my career builds. It is a terrible addiction and I want to be sure my patients know that I can be a supporting hand in them trying to turn their life around. What intrigued me most about this topic is it hit close to home for me. I have had some friends fall into this addiction and it is very sad to watch their health be the first thing to go, especially their teeth. If I can help them to understand the negative effects this drug has on their mouth, they may be more inclined to understand the negative effects it has on their body.