Professional Documents
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COH Patient
COH Patient
What makes this case interesting is that the patient presented twice in pain, which had to be
treated as an emergence. The patient also requires a variety of different treatments. This
meant that I was able to see the patient for many appointments and improve my skills in
paediatric dentistry. The patient was also in a mixed dentition which meant I had the
responsibility of ensuring we preserve his permanent dentition and enforce prevenative
measures in order to so. On the first appointment the patient was quiet and reserved so I had
to use my communication skills effectively to build the patients trust and confidence in me.
Also this case outlined to me despite offering patient the best treatment or treatment which
advised the patient to brush last thing at night and continue using fluoridated toothpaste (1350
ppm), and that he should spit out after brushing instead of rinsing The patient has a mixed
dentition so it is essential he keeps these teeth clean and develops good oral hygiene habits.
The patients sugar consumption was a cause for concern, a diet sheet was given but is yet to
be completed. However I have, advised the mother that the frequency and amount of sugary
foods and drinks should be limited to meal times. Next we planned to fissure seal or place
preventive resin restorations on all four permanent first molars. Multiple restorations were
also planned these included, URED, LRE,ULE and a pulpotomy was to be done on the LLD
a stainless steel crown to be placed if asymptomatic. As mentioned above on his 3rd visit, he
had presented with pain again, the plan had to be altered, and a pulpotomy was done of the
URE and a IRM temporary restoration placed to relieve the patient of pain.
What difficulties did you encounter and how did you overcome them?
In my first consultation with patient the patient did not really co-operate and
was slightly anxious. To compound to this anxiety the patient presented with
pain. While taking the history I ensured I engaged my patient as much as
possible. I asked about his school life, his siblings , the sports he likes and what
cartoons he likes. Once the patient was eased into the new surroundings there
was a change in theco-operation levels.
release which is incorporated in the apatitie crystal structure of enamel to form fluorapatite
which is less soluble in acid and hence inhibits demineralisation. This is fluoride uptake has
been shown to resuce the risk of caries. It is also aesthetic and the thermal expansion
coefficient is similar to enamel, meaning there is no shrinkage. IRMIRM
Ferric Sulphate was also used whilst performing a pulpotomy. Ferric sulphate is
the preffered mode of medicament for pulp therapy. It is a haemostatic agent
which allows for the sealing of blood vessels. Ferric sulphate
Ferric Sulphate
(15.5%, Astringedent)
liquid/gel
haemostatic agent
During the course of treatment my patient became more compliant and helped me gain the
trust of the patient and his mother. My patient also has a greater understanding of the
importance of oral hygiene and is determined to ensure he never gets a toothache with his
permanent dentition.