Oral Health

Report 1: case study:
Introduction:

An 11 years old girl has been referred to an oral health adviser by the dentist for providing her with an effective oral health advise on prevention and effectives management of periodontal abscess. The dentist diagnoses that the girl has signs and symptoms of the periodontal abscess. The analysis of patient’s personal history shows that the girl lived with her parents in a small flat. Both her parents work in the private organisation and the busy in their daily office schedule. Her mother has to manage her office and household works which make her unable to take proper care of her daughter’s oral health and oral hygiene. The personal history assessment shows that the patient (the girl) never smoke or drink alcohol. The soft tissue cheek, periodontal screening and gum screening show that there are clear traces of pus accumulation in the supporting tissues associated with the gumline.

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From this assessment it is clear that the girl suffers from periodontal abscess. On the other hand, the extra periodontal examination shows that the gum areas of the patient also show the symptoms of gingival recession which can contribute to the deteriorating condition of gum infection (Antipovienė et al. 2021). The girl experiences various symptoms such as swelling of periodontium, redness in the gumline, pus secretion from gum, pus accumulation in the supporting tissues, bad smell from mouth and pain in the gum areas while chewing or biting foods. Along with the dental health assessment other routine physical tests are also performed in this case for checking whether the patient has any additional physical health condition that can deteriorate the periodontal abscess condition (Demiriz and Bodrumlu, 2018). The complete blood counts (CBC), fasting sugar level test, post prandial sugar level test, temperature check, oxygen saturation level and pulse check and BMI check. From the test results it is clear that girl has no additional physical health condition excerpt obesity and high BMI due to her sedentary lifestyles and high condition of junk foods.

Clinical intervention suggest that the paradental abscess is a common dental health condition in children (Gasoyan et al. 2019). This dental health condition develops due to the bacterial infection which attacks the gum thereby secreting pus which is then collected to the supporting tissues associated with the gum areas, the periodontium (Đuričković and Ivanović, 2020). Periodontal abscess is the advanced gum disease which is also called as periodontitis. Evidence suggest that poor oral hygiene associated with this oral health condition that not only pose adverse implication on the physical wellbeing about also on the mental and social wellbeing of children.

While cheeking the social general circumstances of the patient, it is seen that the girl belongs to the South Asian Community in an interior area of England. She has reported that, due to belonging to the ethnic minority community she faces severe bully, harassment and insult by her peers at her schools. These maltreatments have been increased from the last two weeks as she suffers from periodontal abscess (Gao et al. 2020). Nobody in the class wants to sit beside her as her mouth smells very bad and there is frequent secretion of pus from her gum. From the last three days she quits to go to school as her pain in the gumline increases with increasing pus secretion. She also feels hesitation as well as shame while talking to any neighbour or relative due to her poor oral health condition. This poor oral health condition interferes not only with the physical wellbeing of the girl, but also impacts on her social, and emotional well-being. The girl suffers from severe depression anxiety, loneliness and lack of self-confidence due to her deteriorating gum infection.

Methods:

The second occasion of this oral health check-up is to determining patients’ needs based on the analysis of the above-mentioned health assessment report. The aim of this second session of the oral health check-up is to provides the proper oral health guidelines to that patients about the prevention and effective management of the periodontal abscess. This session also aims to provides the immediate treatment ad clinical support to the patient to care the gum infection thereby assisting the patents to get rid of periodontitis.

Patient’s needs:

While it comes to analyse the health needs of patients who suffers from periodontal abscess, it is important for the dental practitioners to determine the clinical features of the periodontal abscess. What types treatment and clinical support the patients’ needs is entirely dependent on the types and symptoms of the periodontal abscess (Gasoyan et al. 2019). From the above-mentioned health assessment, it is seen that girl in the case study suffers from different oral health implication of the periodontal abscess such as redness in the gumline, oedema in infected site, swelling in the infected area, enhanced mobility of teeth, increased probing depth with severe bleeding and presence of draining sinus. Base on all these symptoms that the girl shows, it is stated the gurl needs immediate surgery at the gumlines for safe drainage of pus. Additionally, it is also stated by the dental health practitioner that as inflammation at the infected areas in the gum is severe the girl needs to take antibiotics and regular dressing of the infected areas. Through performing periodontal surgery, it is possible to improve the gum condition by removing the infected areas and drain the pus from supporting tissues. In addition to this physical treatment the girl needs emotional and social support that can improves her self-confidences and reduces her depression as well as anxiety. She needs proper care, love and guidelines from her parents which provide the oral health information to this girl. The girls need the support and care from her peers, school teachers and educators in term s if motivating her to maintain a healthy and effective oral health routine on regular wise.

Assessment of patient’s knowledge and attitude:

In this second session of the oral health check-up, an assessment of the patient’s knowledge, skill and attitude had been done. Though carrying this assessment, the dental health practitioners able to determine the health implication of the periodontal abscess on the mental, behavioural ad emotional wellbeing of the girl (Gasoyan et al. 2019). In additional to this, assessment had been done to check whether the patient has any knowledge on periodontal abscess, its adverse effected on the oral health prevention of this health condition.

During this assessment process the dental health adviser makes a clinical conversation with the girl to assess the knowledge, perspective and understanding of the patient about the periodontal abscess. In the discussion, the oral health adviser asks the girl what she thinks and feel about the periodontal abbess and how this oral health condition poses adverse impact of her physical and mental wellbeing. In this clinical discussion, the girl is asked about her pain in the gum, the impacts the infection has on her oral health and any previous measures and treatment that she has done to prevent the further infection. As mentioned by Rezazadeh et al. (2018), the effective oral health advises and treatment is associated with not only curing the oral health condition of the patient but also provide the patient with the knowledge and understanding regarding the prevention and effective management of the dental disease. The oral health adviser observes the behaviour and attitude of the girl towards her periodontal abscess and it impacts in health and wellbeing. As mentioned by Ligade and Pandya (2020), observing; patients’ behaviour regarding oral health is important to analyse how much the patient is concern with his or her oral health. The oral health adviser uses the denial screening checklist to ask questions on the periodontitis to the girl to determine that whether she has any understanding on prevention and, management of periodontitis. Throughout assessment it is seen that the girl has no ideas on what is periodontitis, what are risk factors of periodontitis and how to maintain effective oral hygiene to prevent occurrence of periodontal abbesses.

Resources:

Resources that are used in this oral health advise session by the oral health adviser are the demonstration teeth and gum structure, a laptop, notebook, pointer light, hard copy of different poster and leaflets that contains comprehensive discussion on periodontal abscess (Ruff and Niederman, 2018). These resources are proved to be highly helpful in terms of developing the patient’s understanding on what the periodontal abscess is and how it can be prevented. The demonstration teeth and gum structure are used to explain the normal teeth structure in front of the patients which will assist the patients to have an in-depth concept on the different element of teeth, the normal gun structure (Sabogal et al. 2019). Thet posters and leaflets are handed over to the patient to make her aware about the oral health guidelines that she needs to be followed for having healthy teeth and gum. The laptop and notebook are used to open online videos on the occurrence of the periodontal abscess, its types, its health implications, and its prevention process (Oliveira et al. 2018). The pointer light is used by the oral health adviser to highlight the particulate areas on the screen when the videos on oral health are played through projectors

Planning and advice:

Based on the above-mentioned oral health assessment the girl is provided with effective oral health advise. The girl is advised to brush her teeth twice in each day as she neds this to protect her gum as well as teeth from the further infection (Ruff and Niederman, 2018). Her mother is advised to take care of the oral health of her daughter by ensuring that that girl follows all the given oral health advise. The girl is advised to brush her teeth at morning after leaving bed and at night before going to bed.

A recommendation for using the fluoride toothpaste had been done for the girl. The fluoride toothpaste is best option of children in terms of protecting their teeth from any kind of infection. Here the girl is also advised to use fluoride mouth wash that she needs to use after meal (Mlenga and Mumghamba, 2021). She can use the mouth wash before and after taking meal, which will protect her gum from the further infection and fasten the cure of periodontal abscess. Thet girl is also recommended to use Salcabrush and oral B interdental floss which will keep her teeth and gum clean and free from any further infection.

In this advice session the mother is also advised to take proper care of her daughter’s daily diet routine. Diet and food habits of children are strongly associated with their oral health. Here the mother of the girl is advised to make sure that the girl is provided with the homemade foods which are low in oil and fats and rich in protein and carbs. On the other hand, the mother is advised to ensure that her daughter must avoid the junk foods. Junk foods are the reason of oral heath infection in case of children. Finally, the mother and the patient are provided with hardcopy of the leaflets as well as poster on oral health guidelines which will provide them with the guidance for maintaining proper oral hygiene and prevent teeth and gum from any infection.

Evaluation (Follow up):

The third occasion is the follow up of the oral health advised and the treatment that are provided to the patient (the girl) in her first and second session (Oliveira et al. 2018). Throughout this follow up session, it is determined that whether there is any improvement in the gum condition of the girl and whether here is reduction in the pus secretion from gum. Thet follow up session starts with performing some dental tests such as periodontal screening, gum screening and soft tissue check. The test results show that, although there is improvement in the gum condition of the girl, this is not as per the expectations (Gao et al. 2020). By checking the dental Xray and the dental screening report it is seen that there is sign of reduction of bacterial colonisation in the gumline and reduced secretion as well as accumulatio of pus in the soft tissues.

Apart from this above-mentioned improvement, there are some signs and symptom of oor oral health on the gum, which show that the patient does not follow all the oral health guidelines that are given to her in her second visit (Gasoyan et al. 2019). The patient has still redness on the gumline, the swollen area, pain the in gum and tissue structure, oedema at the infection area and frequent secretion of pus. All these symptoms show that oral health advise and treatment that are provided to the gurl during her last visits are not properly effective in terms of preventing periodontal abscess.

Based on this follow up session, the patient is strictly advised to follow all the oral health advise that are given to her in the last visit otherwise there may be chronic infection at the gumline that cannot be cured through treatment (Haque et al. 2019). This follow up shows that that, there is also negligence to the avoidance of junk food by the patient. This is why still the girl has redness and swollen patches on her gum and pus secretion. The mother also fails to take proper care of her daughter’s oral health routine which has been recommended to the patient to follow in her last visit. Thet mother is advised to become stricter to her daughter’ food habits and dietary routine which are important for the patients to reduces the chances of further infection in periodontium. The mother report that as per the oral health advise in their last visit, her daughter uses the fluoride toothpaste but it makes severe irritation and pain in her gum on the other hand, the girl also experiences difficulties in using the fluoride mouth wash which causes sight burn on here gum thereby increasing her pain in the gumline.

Based on this report, the girl is proscribed to use the normal toothpaste and make sure that she brushes her teeth twice a day. Same antibiotics that are recommenced in the last visit are prescribed by changing the dose for preventing the further infection in the gum.

Report 2: Exhibition:
Target group:

Children belonging to the age group 4-11 years who suffer from periodontal abscess at any of their life stage and belong to the ethnic monitory community in England are targeted for exhibition.

The reason behind selecting these children for conducting this exhibition is that, the children belonging to 4-11 years and ethnic monitory community are morel likely to suffer from oral health disease in the UK. Evidence suggests that more than 24% of children of 4-12 years who reside in the South Asian and black ethnic community in England are more likely to develop oral health illness such as root carries, gingival recession and periodontitis [PHE, 2018].

PHE (20918) mentioned that, in this UK there are many cases in which the children ethnic monitory community suffers from the periodontal abscess and root carries because of their high consumption of junk foods and lack of systematic lifestyle [PHE, 2018]. The report from the World Health Organisation shows that in the England many cases of childhood periodontitis have been registered in the NHS hospital out of which many children are at the risk of the chronic infection at the gumline due to the poor oral health [NHS, 2019]. Reasons behind this increasing rate of oral illness in case of children residing in the ethnic minority community in the England are considered as the lack of knowledges on oral highness, lack of healthy diet and systematic lifestyle and poor parental guidance. In this context, the selection of this target group is highly relevant which will raise the pubis awareness regarding the prevention and management of the periodontitis.

Objectives:

To improve public awareness regarding the occurrence, type and prevention of periodontal abscess

To provide the health information to parents of the target group regarding how to guide their children to maintain a good oral health

To promote healthy habits in children to protect the teeth and gum from any infection

To provides proper information to the dental health practitioners regarding effectives prevention and management of periodontist

To recommend suitable evidence-based strategies that the dental health practitioners can use to treat the periodontitis in children thereby promoting goof oral health in children

Methods and planning:

In this exhibition three sessions have been arranged for target children. A total of 10 children from the South Asian community of England are selected for this exhibition. Among these three sessions, the first session is about to perform the effective dental assessment of each children to see what issue they are facing in the teeth and gum structure (Haque et al. 2019). On this first session, the oral health adviser and dentist together perform different dental test such as periodontal screening test, extra periodontal screening test, soft tissues check and the screening of the gumline (Đuričković and Ivanović, 2020). All these tests are performed to check the teeth structure and gumline. After the conducting dental assessment, the dental health adviser would analyse the test reports thereby determining the health needs of each child. Based on these needs the oral health advise is developed.

In the second session, each child along with his or her parents is provided with the valuable oral health advise regrind the prevention of periodontal abscess and other gum infection. Thet oral health advise would be specially based in each health needs of each child.

The third session is about the follow up, in which the dental health practitioners will evaluate the usefulness of the treatment ad oral health advise that are provided to the patients and his or her parents in the second visit, throughout this third session, the dental health practitioner determine that whether there is any improvement in the oral health condition of the patient (Demiriz and Bodrumlu, 2018). If these is no significant improvement in the child’s teeth and gum, then the dental practitioner must change the dose of antibiotics and will provide effective oral health advise.

Method of evaluation:

The evaluation method is about to cheek and determine whether there is any improvement in the gum and teeth condition of each of the selected child. In this process, the dental health practitioner has performed the periodontal screening and soft tissues check to determine whether there is still secretion of pus from the gum and whether there is any risk of further infection at the gumline which can cause chronic infection (Gao et al. 2020). In this process, the dental health practitioners will use dental screening check list to ask each of the 10 children about his or her current feeling about the oral health condition, the pain on gum and teeth, the frequency of pus secretion and usefulness of the oral health advise are given in the last visit.

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Reflective practice:

The entire exhibition and the case study analyses are highly informative and effective to me that enable me to develop my knowledge in dental health. Through working on this exhibition, I have gathered good understanding on what is periodontal abscess, how it developed, what are its risk facts and how this oral health condition can be prevented and managed. This exhibition also assisted to gain good understanding on the oral health guidelines that needs to be followed for protecting the gum and teeth from any kind of infection. Throughout the exhibition, I am able to work in different team which not only improve my team work skill about but also assisted me to develop my resilience and adaptability to any healthcare condition. Moreover, I also develop good understanding on how to behave with children while providing them with effective oral health advise.

Reference list:

Antipovienė, A., Narbutaitė, J. and Virtanen, J.I., 2021. Traumatic dental injuries, treatment and complications in children and adolescents: a register-based study. European journal of dentistry.

Demiriz, L. and Bodrumlu, E.H., 2018. Reasons for the Extraction of Primary Teeth in Primary School-age Children in Zonguldak, Turkey: A Retrospective Study. Meandros Medical and Dental Journal, 19(1), p.32.

Đuričković, M. and Ivanović, M., 2020. Dental health status in children with type 1 diabetes mellitus in Montenegro. Vojnosanitetski pregled, (00), pp.50-50.

Gao, S.S., Chen, K.J., Duangthip, D., Wong, M.C.M., Lo, E.C.M. and Chu, C.H., 2020. Preventing early childhood caries with silver diamine fluoride: study protocol for a randomised clinical trial. Trials, 21(1), pp.1-7.

Gasoyan, H., Safaryan, A., Sahakyan, L., Gasoyan, N., Aaronson, W.E. and Bagramian, R.A., 2019. School-based preventive dental program in rural communities of the republic of Armenia. Frontiers in public health, 7, p.243.

Gavriilidou, N.N. and Belibasakis, G.N., 2019. Root caries: the intersection between periodontal disease and dental caries in the course of ageing. British dental journal, 227(12), pp.1063-1067.

Haque, M., Sartelli, M. and Haque, S.Z., 2019. Dental infection and resistance—global health consequences. Dentistry journal, 7(1), p.22.

Karki, S., Laitala, M.L., Humagain, M., Seppänen, M., Päkkila, J. and Anttonen, V., 2018. Oral health status associated with sociodemographic factors of Nepalese schoolchildren: A population-based study. International dental journal, 68(5), pp.348-358.

Ligade, S.S. and Pandya, S., 2020. Assessment of awareness of periodontal disease among dental undergraduates: A questionnaire study. Journal of Dental Research and Review, 7(4), p.171.

Milgrom, P., Horst, J.A., Ludwig, S., Rothen, M., Chaffee, B.W., Lyalina, S., Pollard, K.S., DeRisi, J.L. and Mancl, L., 2018. Topical silver diamine fluoride for dental caries arrest in preschool children: A randomized controlled trial and microbiological analysis of caries associated microbes and resistance gene expression. Journal of dentistry, 68, pp.72-78.

Mlenga, F. and Mumghamba, E.G., 2021. Oral Hygiene Practices, Knowledge, and Self-Reported Dental and Gingival Problems with Rural-Urban Disparities among Primary School children in Lilongwe, Malawi. International Journal of Dentistry, 2021.

Oliveira, B.H., Cunha-Cruz, J., Rajendra, A. and Niederman, R., 2018. Controlling caries in exposed root surfaces with silver diamine fluoride: A systematic review with meta-analysis. The Journal of the American Dental Association, 149(8), pp.671-679.

Rezazadeh, F., Vahabi, S. and Shirinbak, I., 2018. The prevalence of inappropriate prescription of antibiotics and mouthwash in periodontal disease among general dentists. Iranian Journal of Pediatric Dentistry, 13(2), pp.43-52.

Ruff, R.R. and Niederman, R., 2018. Comparative effectiveness of treatments to prevent dental caries given to rural children in school-based settings: protocol for a cluster randomised controlled trial. BMJ open, 8(4).

Sabogal, Á., Asencios, J., Robles, A., Gamboa, E., Rosas, J., Ríos, J. and Mayta-Tovalino, F., 2019. Epidemiological profile of the pathologies of the oral cavity in a Peruvian population: A 9-year retrospective study of 18,639 patients. The Scientific World Journal, 2019.

Scarfe, W.C., Azevedo, B., Pinheiro, L.R., Priaminiarti, M. and Sales, M.A., 2017. The emerging role of maxillofacial radiology in the diagnosis and management of patients with complex periodontitis. Periodontology 2000, 74(1), pp.116-139.

Schwendicke, F., Krois, J., Schiffner, U., Micheelis, W. and Jordan, R.A., 2018. Root caries experience in Germany 1997 to 2014: analysis of trends and identification of risk factors. Journal of dentistry, 78, pp.100-105.

Süt, Z. and Çekim, D., Reasons for the Extraction of Primary Teeth in Primary School-Age Children in Zonguldak, Turkey: A Retrospective Study.

Tampi, M.P., Pilcher, L., Urquhart, O., Kennedy, E., O’Brien, K.K., Lockhart, P.B., Abt, E., Aminoshariae, A., Durkin, M.J., Fouad, A.F. and Gopal, P., 2019. Antibiotics for the urgent management of symptomatic irreversible pulpitis, symptomatic apical periodontitis, and localized acute apical abscess: Systematic review and meta-analysis—a report of the American Dental Association. The Journal of the American Dental Association, 150(12), pp.e179-e216.

Tan, H., Richards, L., Walsh, T., Worthington, H.V., Clarkson, J.E., Wang, L. and Velo, M.M.D.A.C., 2017. Interventions for managing root caries. The Cochrane Database of Systematic Reviews, 2017(8).

Wu, X., Chen, J., Xu, M., Zhu, D., Wang, X., Chen, Y., Wu, J., Cui, C., Zhang, W. and Yu, L., 2017. 16S rDNA analysis of periodontal plaque in chronic obstructive pulmonary disease and periodontitis patients. Journal of oral microbiology, 9(1), p.1324725.


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