A 56-year-old male complains of bad breath and bleeding gums when brushing his teeth.
Clear medical history.
Former smoker (quit 6 months ago, smoked 20 cigarettes per day for 15 years before this).
Irregular dental attender, with no previous history of periodontal treatment. Manual toothbrush user, twice per day, for at most 1 minute each time Generalized probing depths of 5–8 mm with bleeding on probing (BOP score 70%).
Generalized alveolar bone loss (> 50% root length) throughout the dentition, with more advanced bone loss (>80%) at maxillary molars Mobility of upper and lower incisors (grade I) and upper right and left molars (grade 2)

A 56-year-old male complains of bad breath and bleeding gums when brushing his teeth.
Clear medical history.
Former smoker (quit 6 months ago, smoked 20 cigarettes per day for 15 years before this).
Irregular dental attender, with no previous history of periodontal treatment. Manual toothbrush user, twice per day, for at most 1 minute each time Generalized probing depths of 5–8 mm with bleeding on probing (BOP score 70%).
Generalized alveolar bone loss (> 50% root length) throughout the dentition, with more advanced bone loss (>80%) at maxillary molars Mobility of upper and lower incisors (grade I) and upper right and left molars (grade 2)

A 56-year-old male complains of bad breath and bleeding gums when brushing his teeth.
Clear medical history.
Former smoker (quit 6 months ago, smoked 20 cigarettes per day for 15 years before this).
Irregular dental attender, with no previous history of periodontal treatment. Manual toothbrush user, twice per day, for at most 1 minute each time Generalized probing depths of 5–8 mm with bleeding on probing (BOP score 70%).
Generalized alveolar bone loss (> 50% root length) throughout the dentition, with more advanced bone loss (>80%) at maxillary molars Mobility of upper and lower incisors (grade I) and upper right and left molars (grade 2)

A 56-year-old male complains of bad breath and bleeding gums when brushing his teeth.
Clear medical history.
Former smoker (quit 6 months ago, smoked 20 cigarettes per day for 15 years before this).
Irregular dental attender, with no previous history of periodontal treatment. Manual toothbrush user, twice per day, for at most 1 minute each time Generalized probing depths of 5–8 mm with bleeding on probing (BOP score 70%).
Generalized alveolar bone loss (> 50% root length) throughout the dentition, with more advanced bone loss (>80%) at maxillary molars Mobility of upper and lower incisors (grade I) and upper right and left molars (grade 2)

A 56-year-old male complains of bad breath and bleeding gums when brushing his teeth.
Clear medical history.
Former smoker (quit 6 months ago, smoked 20 cigarettes per day for 15 years before this).
Irregular dental attender, with no previous history of periodontal treatment. Manual toothbrush user, twice per day, for at most 1 minute each time Generalized probing depths of 5–8 mm with bleeding on probing (BOP score 70%).
Generalized alveolar bone loss (> 50% root length) throughout the dentition, with more advanced bone loss (>80%) at maxillary molars Mobility of upper and lower incisors (grade I) and upper right and left molars (grade 2)

A 56-year-old male complains of bad breath and bleeding gums when brushing his teeth.
Clear medical history.
Former smoker (quit 6 months ago, smoked 20 cigarettes per day for 15 years before this).
Irregular dental attender, with no previous history of periodontal treatment. Manual toothbrush user, twice per day, for at most 1 minute each time Generalized probing depths of 5–8 mm with bleeding on probing (BOP score 70%).
Generalized alveolar bone loss (> 50% root length) throughout the dentition, with more advanced bone loss (>80%) at maxillary molars Mobility of upper and lower incisors (grade I) and upper right and left molars (grade 2)

A 56-year-old male complains of bad breath and bleeding gums when brushing his teeth.
Clear medical history.
Former smoker (quit 6 months ago, smoked 20 cigarettes per day for 15 years before this).
Irregular dental attender, with no previous history of periodontal treatment. Manual toothbrush user, twice per day, for at most 1 minute each time Generalized probing depths of 5–8 mm with bleeding on probing (BOP score 70%).
Generalized alveolar bone loss (> 50% root length) throughout the dentition, with more advanced bone loss (>80%) at maxillary molars Mobility of upper and lower incisors (grade I) and upper right and left molars (grade 2)

A 35-year-old male tells you my gums are inflamed.
Diabetic patient with crowding, presents with localized plaque and generalized inflammation. Patient is a graduate student and has reported stress affecting his sleep.
Patient Oral Hygiene is average. Patient avoids brushing where inflammation and bleeding persists. He would like his gums to be “healthy” prior to orthodontic treatment.
Probing depths were in the range of 2 to 3 mm, BOP was 42%. Recession noted in the mandibular left canine, lateral incisor, and central incisors.

A 35-year-old male tells you my gums are inflamed.
Diabetic patient with crowding, presents with localized plaque and generalized inflammation. Patient is a graduate student and has reported stress affecting his sleep.
Patient Oral Hygiene is average. Patient avoids brushing where inflammation and bleeding persists. He would like his gums to be “healthy” prior to orthodontic treatment.
Probing depths were in the range of 2 to 3 mm, BOP was 42%. Recession noted in the mandibular left canine, lateral incisor, and central incisors.

A 35-year-old male tells you my gums are inflamed.
Diabetic patient with crowding, presents with localized plaque and generalized inflammation. Patient is a graduate student and has reported stress affecting his sleep.
Patient Oral Hygiene is average. Patient avoids brushing where inflammation and bleeding persists. He would like his gums to be “healthy” prior to orthodontic treatment.
Probing depths were in the range of 2 to 3 mm, BOP was 42%. Recession noted in the mandibular left canine, lateral incisor, and central incisors.

A 35-year-old male tells you my gums are inflamed.
Diabetic patient with crowding, presents with localized plaque and generalized inflammation. Patient is a graduate student and has reported stress affecting his sleep.
Patient Oral Hygiene is average. Patient avoids brushing where inflammation and bleeding persists. He would like his gums to be “healthy” prior to orthodontic treatment.
Probing depths were in the range of 2 to 3 mm, BOP was 42%. Recession noted in the mandibular left canine, lateral incisor, and central incisors.

A 35-year-old male tells you my gums are inflamed.
Diabetic patient with crowding, presents with localized plaque and generalized inflammation. Patient is a graduate student and has reported stress affecting his sleep.
Patient Oral Hygiene is average. Patient avoids brushing where inflammation and bleeding persists. He would like his gums to be “healthy” prior to orthodontic treatment.
Probing depths were in the range of 2 to 3 mm, BOP was 42%. Recession noted in the mandibular left canine, lateral incisor, and central incisors.

A 35-year-old male tells you my gums are inflamed.
Diabetic patient with crowding, presents with localized plaque and generalized inflammation. Patient is a graduate student and has reported stress affecting his sleep.
Patient Oral Hygiene is average. Patient avoids brushing where inflammation and bleeding persists. He would like his gums to be “healthy” prior to orthodontic treatment.
Probing depths were in the range of 2 to 3 mm, BOP was 42%. Recession noted in the mandibular left canine, lateral incisor, and central incisors.

A 35-year-old male tells you my gums are inflamed.
Diabetic patient with crowding, presents with localized plaque and generalized inflammation. Patient is a graduate student and has reported stress affecting his sleep.
Patient Oral Hygiene is average. Patient avoids brushing where inflammation and bleeding persists. He would like his gums to be “healthy” prior to orthodontic treatment.
Probing depths were in the range of 2 to 3 mm, BOP was 42%. Recession noted in the mandibular left canine, lateral incisor, and central incisors.

A 35-year-old male tells you my gums are inflamed.
Diabetic patient with crowding, presents with localized plaque and generalized inflammation. Patient is a graduate student and has reported stress affecting his sleep.
Patient Oral Hygiene is average. Patient avoids brushing where inflammation and bleeding persists. He would like his gums to be “healthy” prior to orthodontic treatment.
Probing depths were in the range of 2 to 3 mm, BOP was 42%. Recession noted in the mandibular left canine, lateral incisor, and central incisors.

A 35-year-old male tells you my gums are inflamed.
Diabetic patient with crowding, presents with localized plaque and generalized inflammation. Patient is a graduate student and has reported stress affecting his sleep.
Patient Oral Hygiene is average. Patient avoids brushing where inflammation and bleeding persists. He would like his gums to be “healthy” prior to orthodontic treatment.
Probing depths were in the range of 2 to 3 mm, BOP was 42%. Recession noted in the mandibular left canine, lateral incisor, and central incisors.

A 35-year-old male tells you my gums are inflamed.
Diabetic patient with crowding, presents with localized plaque and generalized inflammation. Patient is a graduate student and has reported stress affecting his sleep.
Patient Oral Hygiene is average. Patient avoids brushing where inflammation and bleeding persists. He would like his gums to be “healthy” prior to orthodontic treatment.
Probing depths were in the range of 2 to 3 mm, BOP was 42%. Recession noted in the mandibular left canine, lateral incisor, and central incisors.

2nd patient-
A 6-year-old female complains “My daughter has extreme pain in her mouth
and cannot eat or drink anything.”
Child has a noncontributory medical history and no history of drug allergies. She had comprehensive restorative treatment performed 14 months earlier and is here today for an emergency appointment.
• Body temperature of 101.8° F and malaise
• Bilateral neck lymphadenopathy
• Swollen, inflamed, and erythematous gingiva
• Multiple ulcers on the marginal gingiva, mucosa, and soft palate

2nd patient-
A 6-year-old female complains “My daughter has extreme pain in her mouth
and cannot eat or drink anything.”
Child has a noncontributory medical history and no history of drug allergies. She had comprehensive restorative treatment performed 14 months earlier and is here today for an emergency appointment.
• Body temperature of 101.8° F and malaise
• Bilateral neck lymphadenopathy
• Swollen, inflamed, and erythematous gingiva
• Multiple ulcers on the marginal gingiva, mucosa, and soft palate