Non-surgical periodontal therapy and home-care support for a patient with aggressive periodontitis

Abstract

We report the case of a patient with severe aggressive periodontitis and intellectual disability who underwent intensive non-surgical periodontal therapy under general anesthesia and received oral home-care support. The patient was a 25-year-old woman who visited our clinic with the chief complaint of swollen gums. Periodontal examination revealed dental plaque deposits and deep periodontal pockets, with easy bleeding, in all the teeth. Although the patient had difficulty brushing her own teeth because of intellectual disability, she was not only instructed on the method of brushing but was also supervised by caregivers. We assessed that usual dental treatment would be difficult, because she refused probing. Periodontal treatment combined with full-mouth scaling and root planing (SRP) was undertaken under general anesthesia, with antimicrobial therapy. Thereafter, the patient's periodontal condition stabilized, and we moved to monthly supportive periodontal therapy (SPT). During the SPT period, we continued to provide oral self-care support to the patient and brushing instructions to the caregivers. The results showed that both the instructions provided to both patient and the caregivers led to brushing habits and plaque control, and the periodontal condition improved. Furthermore, we found that the patient also adapted to the dental treatment at the same time as the periodontal condition improved. Currently, about 3 years have passed since the start of the SPT, and the periodontal condition remains stable.

This case suggests that oral home-care support, non-surgical periodontal therapy, and short-term SPT are effective for the control of severe aggressive periodontitis and adaptation to dental treatment of patients with intellectual disability.