Alcoholism Case Study
Brett
Demographics:
Race: Caucasian
Gender: Male
Age:30
Height: 5 ft 11 in
Weight: 195
Home: Santa Barbara, CA
Physical Assessment:
Patient appears tired
He has a bandage on his left elbow
slight limp
Mental Assessment:
Slow
Depressed
Anxious
Social Assessment:
Withdrawn from family and friends
Hanging out with a new crowd at the local bar
Medical Assessment:
Frequent injuries
Abdominal pain
Vomiting
Diarrhea
Headaches
Erectile dysfunction
Dental Assessment:
Broken teeth #4,5,8,9,12,13
Buccal caries on #2,3,14,15
Signs of bruxism
Extra Oral Exam:
Angular cheilitis
Dandruff
4x2mm ulceration on left side of upper lip
Intra-oral Exam:
Smell of alcohol on breath
Enlargement of parotid glands
Xerostomia
Coated tongue
Gingival bleeding
Petichiae on both sides of buccal mucosa
Communication:
Q: Have you ever felt the need to cut down on your drinking?
A: No, not really.
Q: Have you ever felt annoyed by criticism of your drinking?
A: Yes. That's the main reason I don't talk to my family anymore.
Q: Have you often been under the influence of alcohol in a situation where it increased your chances of getting hurt?
A: Yes. My two front teeth are broken from a bar fight that I got into.
Q: Have you ever felt guilty about your drinking?
A: Yes.
Q: Have you ever had a drink first thing in the morning?
A: Yes.
Appointment Planning:
Patient should have morning appointments
Short (20 min)
2-3 month continued care appointments
Cancelled appointments should not be accepted
Client Positioning:
Make sure patient is comfortable
DH Procedures:
Avoid alcohol based mouth washes (Listerine)
Safety Precautions:
If there is a need for a mood altering drug you should contact the physician, have the doctor prescribe only the amount needed without refills.
Be sure they do not have significant liver dysfunction before administration of amide local anesthetic drugs.
OHI:
Saliva substitutes
Alcohol free mouthrinse
Bass brushing method
"C" shaped flossing
Personal Reflection:
I chose to do this assignment on alcoholism because my mom is a recovering alcoholic, so the information in here really hits close to home. I remember the struggles we went through and how her physical, oral, and emotional health all suffered from the disease. It is so important for people to know just how quickly it can get out of control and how many people are effected by alcoholism. I think in the dental profession it is very important for us to know that sometimes the patients that we least expect are the ones who suffer from alcoholism. If you saw my mom out on the street or how she is with her family you would never know that she had an alcohol problem. For that very reason I always make sure to ask my patients if they would prefer a non-alcoholic mouth rinse prior to my appointments. I am very happy to say that my mom has a year and 4 months sober now and plans to continue a sober lifestyle. AA has been a very helpful organization for her to be a part of and something that I would encourage any willing patient to check out.
Additional Information:
This is a great website with a lot of useful information about getting help.
http://www.aa.org
Demographics:
Race: Caucasian
Gender: Male
Age:30
Height: 5 ft 11 in
Weight: 195
Home: Santa Barbara, CA
Physical Assessment:
Patient appears tired
He has a bandage on his left elbow
slight limp
Mental Assessment:
Slow
Depressed
Anxious
Social Assessment:
Withdrawn from family and friends
Hanging out with a new crowd at the local bar
Medical Assessment:
Frequent injuries
Abdominal pain
Vomiting
Diarrhea
Headaches
Erectile dysfunction
Dental Assessment:
Broken teeth #4,5,8,9,12,13
Buccal caries on #2,3,14,15
Signs of bruxism
Extra Oral Exam:
Angular cheilitis
Dandruff
4x2mm ulceration on left side of upper lip
Intra-oral Exam:
Smell of alcohol on breath
Enlargement of parotid glands
Xerostomia
Coated tongue
Gingival bleeding
Petichiae on both sides of buccal mucosa
Communication:
Q: Have you ever felt the need to cut down on your drinking?
A: No, not really.
Q: Have you ever felt annoyed by criticism of your drinking?
A: Yes. That's the main reason I don't talk to my family anymore.
Q: Have you often been under the influence of alcohol in a situation where it increased your chances of getting hurt?
A: Yes. My two front teeth are broken from a bar fight that I got into.
Q: Have you ever felt guilty about your drinking?
A: Yes.
Q: Have you ever had a drink first thing in the morning?
A: Yes.
Appointment Planning:
Patient should have morning appointments
Short (20 min)
2-3 month continued care appointments
Cancelled appointments should not be accepted
Client Positioning:
Make sure patient is comfortable
DH Procedures:
Avoid alcohol based mouth washes (Listerine)
Safety Precautions:
If there is a need for a mood altering drug you should contact the physician, have the doctor prescribe only the amount needed without refills.
Be sure they do not have significant liver dysfunction before administration of amide local anesthetic drugs.
OHI:
Saliva substitutes
Alcohol free mouthrinse
Bass brushing method
"C" shaped flossing
Personal Reflection:
I chose to do this assignment on alcoholism because my mom is a recovering alcoholic, so the information in here really hits close to home. I remember the struggles we went through and how her physical, oral, and emotional health all suffered from the disease. It is so important for people to know just how quickly it can get out of control and how many people are effected by alcoholism. I think in the dental profession it is very important for us to know that sometimes the patients that we least expect are the ones who suffer from alcoholism. If you saw my mom out on the street or how she is with her family you would never know that she had an alcohol problem. For that very reason I always make sure to ask my patients if they would prefer a non-alcoholic mouth rinse prior to my appointments. I am very happy to say that my mom has a year and 4 months sober now and plans to continue a sober lifestyle. AA has been a very helpful organization for her to be a part of and something that I would encourage any willing patient to check out.
Additional Information:
This is a great website with a lot of useful information about getting help.
http://www.aa.org