An interesting case A 63yr old female... Hb 11.8 Wbc 5600 N 60 L 32 E 4 M 2 B 0 LFT KFT are WNL... C reactive protein is wnl.. Height 5.1ft Weight 45kg Appetite good but fear of eating as it is painful if slightly spicy.. Sleep poor.. Systemic NAD Having oral thrush since about last 2 years.. Treated with candid mouthpaint, multivitamins , analgesics, fluconazole pulse therapy, betadine gargles from various practitioners... but not getting results... it is recurring in a week and patient becomes restless and coping with anxiety... feels death will get rid of it at last... She has no any comorbidity.. no htn, no dm Hiv, vdrl hbsag is non reactive... No history of any major illness in last 5 yrs except Jaundice 10yrs ago... No history of any steroid intake at all... Non tobacco chewer but pawn chewer.. since last 25 yrs and stopped chewing pawn since abt 6 months.. But dental and oral hygiene is poor... No any lymphadenitis... No any dysphagia or laryngitis pharyngitis... What nxt should be done...?? Thank you..... No signs of gingivitis or pulpitis.. as if now..

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Most effective way of treatment in this patient is extractions of rest of the teeth and roots ( source of chronic oral thrush due to poor oral hygiene ) if any, followed by upper and lower artificial dentures, under guidance of a Dentistry.

Ch gen periodontitis is aggravating the condition.. Missing teeth.. Sharp edges.. No brushing.. Treatment should be Extraction of all teeth and CD If not ready, then oral prophylaxis, Sharp edges reduction, RPD.. Medicines, Tab Rebagen, Lexanox ointment + dologel ct, fluconazole 150 mg 8tab(1st day BD then OD), candid mouth paint, Turmix tab tid, syp polybion, tab azithral 500

Wow sir What a Rx agree
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Dr.parshuran agarwal To treat this pt. Her dental and mouth Hygiene needs to be brought back to normal , i am not a dentist but in my openion she needs total dental extraction. Can she afford present Day dental treatment as it has become Very expensive. You do that and pt. Will improve dramatically.

Suggest dental extraction and artificial dentures

A case of total extraction... or of those who are severely affected.... trimming of the sharp edges .....

Tab.rebagen. bd for 1month With tab laycostar od .......

Dental hygiene is her real treatment

Dental hygiene be must ...its the best treatment for her..that's brought back to normal ...

It is suggestive to do first complete SRP properly .. extract tooth with grade 3 mobile and do localized flap sugery for rest.. selective coronoplasty for sharp cusps..candid ointment for topical app..pt generally have no compliance for full mouth extraction..if she agrees then u knw what to do..

Agree with @Dr. Arvind Khatri ......

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