CLINICAL FEATURE
Systematic, individual prevention concept for a cigarette smoker with dental erosions: Case report By Dr Romana Krapf , MSc
INTRODUCTION The bidirectional relationship between oral and general medical health is very well known. It is no longer sufficient — and arguably even old-fashioned — to consider intraoral conditions in isolation. In order to create a personalised, case-specific preventive and patient profile, it is essential to take a detailed medical history and perform diligent examination of the general medical and intraoral health, as well as considering the two in combination (Fig. 1). 1-3 Careful consideration of individual patient parameters facilitates the creation of a risk profile that optimally supports the maintenance of good health and patient quality of life. Moreover, the risk profile offers dentists a sense of assurance during planning. This case presentation highlights the usefulness of a systematic, individual prevention concept when creating a case-specific patient profile and implementing the resulting treatment measures. MEDICAL HISTORY The subject of the following case report is a 28-year-old patient. Based on his own account, the patient was a competitive athlete in his youth. He states that he used to drink up to 3-4L of isotonic beverages throughout the
The patient brushes his teeth twice a day with an electric toothbrush and uses interdental brushes once a day. He prioritises the maintenance of good dental health. He currently engaged in preventive follow-up and visits the practice three times a year. EXTRAORAL AND INTRAORAL FINDINGS There were no pathological extraoral findings. During intraoral examination, inspection of the frontal view revealed brownish discolouration near the keratinised gingiva and at the transition to the moveable mucosa (Fig. 2), which could be attributed to nicotine consumption. Whitish mucosal lesions were observed on the palate, particularly near the maxillary molar palatal surfaces, indicating increased keratinisation and can also be attributed to nicotine consumption. The tongue was covered with a removable white and brownish coating.
Fig. 1: Schematic representation of the case-specific patient profile created by considering both general medical and intraoral health. According to Lang & Tonetti day. He has no longer been doing this for the past year. Instead, he now drinks water and black tea. The general medical history revealed no underlying disorders. He reports suffering from hay fever in spring and takes antihistamines on a seasonal basis if needed. The patient does not suffer from asthma. However, he has been smoking up to 10 cigarettes per day for the past eight years.
Fig. 3: Occlusal view of the maxilla
Fig. 2: Frontal view
38 DENTAL ASIA SEPTEMBER / OCTOBER 2024
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