14/10/2025
Case Summary
Patient: 17-year-old male�Chief Complaint: Pain in the right lower third molar area�Clinical Findings:
* Localized: Inflammation and bleeding on probing of the right mandibular third molar area
* Generalized: Gingival hyperplasia noted throughout the oral cavity
* Mobility: 1st degree mobility of the third molar
* History: Recent use of NSAIDs and 1st generation antibiotics (for 1 week, prescribed by his physician), with no improvement in symptoms
* Social History: Chronic va**ng, identified as a likely contributing factor to both localized and generalized oral symptoms
Diagnosis:
* Localized: Pericoronitis (with possible early periodontal involvement due to 1st molar mobility)
* Generalized: Gingival hyperplasia, likely aggravated by va**ng, combined with possible plaque-induced inflammation.
Treatment Plan:
1. Oral Prophylaxis:
* Deep scaling and root planing
2. Symptomatic Relief:
* NSAID alternative is acetaminophen (if not contraindicated), or a topical anesthetic gel for localized pain relief.
*Chlorhexidine mouth rinse.
3. Addressing Gingival Hyperplasia:
* OHI (Oral Hygiene Instruction): Reinforce good brushing and flossing techniques, especially focusing on areas with gingival overgrowth.
* Va**ng cessation advice: This is crucial, as continued va**ng may exacerbate both the localized and generalized oral health issues. Providing educational resources on va**ng’s effects on oral health may improve compliance.
photos are just for reference and awareness. Photo credit to the owner. I cannot post the actual photo of the patient’s oral cavity.