New guidelines case discussions: Case 2

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Hi All,

Thanks a lot for participating in the last case.. Here's the outline for the

next case..

25yr old Patient complains of tooth becoming short with time(6mnths) and ulcers

that come and go(10 yrs). Patient is a bruxer, takes a lot of fizzy drinks and

has a stressful life style. Asthmatic on steroid inhalors

As per the new guidelines some information will be provided before history

taking: (so for this case)

photographs of the patient showing front teeth .

BPE score (212/211),

all teeth except third molars are present,

no visible caries.

History Taking:

Name: Ms Martha s

DOB: 12th Jan 1986

Occupation: Law Student

Address: #ab Street, London

Marital Status; Unmarried, No partner

C/o : 1. patient complains of tooth becoming short over last 6 mnths

2. Pt complains of ulcers that come and go for lat 10 yrs.

HOPI: 1. Pt complains of tooth wear, noticed since 6mths, mand. ant region,

sensitivity to hot and cold, no pain on biting, no change in colour of teeth, no

recent resto. on opposing teeth, +ve PFH - Bruxism, Lifestyle - stressful, h/o

high intake of fizzy drinks, no h/o eating disorder/acidic regurg.,

2. 3 ulcers +nt, painful, all small 1-2mm, all on tongue, stay for 1wk, heal

sponta, no scar on healing, freq- 5-6mths since last 10yrs, FH/o recurrent

ulcers +nt, no boil before ulcer, no h/o trauma/accidental biting, not +nt

anywhere else mouth or otherwise, no bleeding/discharge, used bonjela

PDH: Regular attender, Brushes 2/day, no m/w, floss.. No dental treatment except

scaling/polishing.

PMH: H/o Asthma (10yrs) / controlled/ never hospitalised/ Taking steroid

inhalers – 10 yrs, no known latex/dental products allergy, no known medicine

allergy, no other medication

SH: Non Smoker, h/o smoking (5yrs- 5cig/day, stopped 7mnths ago),

Alc- Social drinker- Red wine 4-5units/wk

Fizzy drink/citrus fruits/juice intake- high

Carbo/sugary intake- low

What would be your provisional diagnosis, which radiographic views will you ask

for and why and what special investigations would you want to be done for this

patient?

Hoping for your active participation..

Thanks and Regards,