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The evidence-based decision making process starts with a patient question or concern. Here are three examples below of how to format your case that you will use for this course. Use your patient information and chief complaint or concern to write a case that allows you to answer a question that the patient has. The question that the patient has might be about a dental technique, a product for oral health, or about how their systemic health might affect their oral health. You might have discovered a lesion or oral disease that the patient may have questions about treating.
1. Case: Mrs. Spencer Mrs. Spencer presented for examination in the UDM School of Dentistry Clinic. During the examination she told me that she was unhappy with the color of her front teeth. Mrs. Spencer does not have any caries or faulty restorations and there is very little gingival inflammation. She does have gingival recession with exposure of 1-2 mm of root surface on several incisors and premolars. She has no other complaints. She asked me if she could use teeth whitening trays that she saw at Walgreens for $24.99 to bleach her front teeth. I think that patients with gingival recession have root sensitivity following bleaching, and so I am not sure what to tell her. Mrs. Spender was rescheduled for a prophylaxis in one week and I told her that I would talk to her about the bleaching at that appointment.
2. Case: Mr. Tomkins Mr. Tomkins is 38 years old and works at the McNichols campus. He has four teeth with caries but no periodontal disease. He smokes two packs of cigarettes every day and has smoked for 20 years. He told me that the last dental hygienist he had an appointment with one year ago told him that he must floss every day to remove plaque. Mr. Tomkins told me that he uses toothpicks to clean in between his teeth after he eats lunch and dinner. Mr. Tomkins asked me if it was OK to keep using toothpicks every day or if he really should switch to daily flossing. I told him I would answer his question at his next appointment.
3. Case: Martin Martin is a 30 year old male who works as a bartender in Troy. He drinks a few beers a day and also uses Skoal chewing tobacco several times a week, especially after he has had a few beers. At his last examination I saw what may be a pre-cancerous lesion in the left side mandibular vestibular area. Martin says that that is where he usually keeps the plug of tobacco in his mouth. This news is making Martin want to quit using smokeless tobacco. He doesn't know how to stop, and he asked me if he should use a nicotine patch or a drug like Chantix. I told him I would help him make a decision.
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