2021 Volume 63 Issue 3 Pages 158-169
We report a 15-year follow-up case of periodontal treatment of an elderly patient with moderate to severe chronic periodontitis, focusing on the changes in her living environment and systemic condition.
The patient was a 63-year-old woman who was diagnosed as having moderate to severe periodontitis based on a clinical interview and clinical examinations at the first visit, was counseled on the necessity for periodontal therapy, and received basic periodontal therapy.
The patient was very fearful of dental treatment, so that treatment was first administered for thorough removal of the source of infection, which led to significant improvement of the periodontal condition. That is, percentage of teeth with a PPD of less than 3 mm improved from 38% at the first visit to 96.8% after the treatment, the positivity rate of bleeding on probing decreased from 94.3% to 5.7%, the O'Leary's plaque control record score improved from 100% to 15.7%, and symptom stabilization and occlusion were obtained. The nutritional status also improved, with improvement of the asthma and allergic symptoms seen at the first visit, and the patient herself realized that the periodontal condition exerted great influence on her general health.
For 12 years after shifting to supportive periodontal therapy (SPT), we continued SPT according to the changes in the patient's living environment and maintained a stable periodontal condition, but after she developed Alzheimer's disease, her periodontal condition worsened transiently. However, at present, we are trying to support self-care for maintenance of the oral hygiene of the patient in cooperation with various occupations, and we have been able to maintain a good periodontal condition in the patient.
In this case, patient education and thorough removal of the source of infection in consideration of the patient's living environment and general condition led to improvement of her periodontal condition. In addition, we believe that we were able to contribute to the health of the patient by adopting measures in consideration of the situation without overlooking changes in the living environment and the general condition while performing SPT.
