Please fix and check my report! (Please

Please fix and check my report! (Please also check the grammar.) and can you add more conclusion parts??***** The 58-year-old Asian male patient’s medical history included hypertension, gastroesophageal reflux disease (GRED), and smoking. The patient has suffered from the periodontal disease for decades, and the current AAP Classification is Generalized Periodontitis Stage IV. Due to a lack of knowledge of oral health and dental, the patient did not take care of his teeth until now. The patient reported that he had smoked for 15 years, then been smoke-free for 4 years, and had recently started smoking again. The patient mainly vapes one cartridge with 5% nicotine daily, and occasionally smokes 3-4 cigarettes when meeting people on weekends (1 cartridge with 5% nicotine = 20 cigarettes). The patient is unaware of how their medical condition and smoking relate to each other and affect their periodontal status. According to the journal article from the National Center for Biotechnology Information (NCBI), “This study shows that smoking cigarettes and vaping nicotine is a risk factor for periodontal diseases, including periodontitis, and can lead to worse gum health.” (Figueredo et al., 2021). This conclusion is supported by evidence from the study that shows that smoking and vaping are both associated with an increased risk of periodontal diseases. Additionally, the study found that smoking and vaping had a synergistic effect, meaning that their combined effect was greater than the effects of either one alone. Therefore, this study provides evidence to support the conclusion that smoking cigarettes and vaping nicotine has a negative impact on gum health and is a risk factor for periodontal diseases. The researchers also discovered that smoking and using electronic cigarettes were linked to deteriorating gum health throughout the course of the trial, as determined by the periodontal probing depth and clinical attachment level measurements. This suggests that smoking and using electronic cigarettes can have a detrimental effect on gum health, even before the onset of periodontal disorders (Figueredo et al., 2021). These findings are backed up by additional pieces of research that demonstrate the negative impact that smoking and vaping have on the oral cavity. For instance, research has shown that smoking is associated with an increased risk of oral cancer as well as greater levels of bacteria that are found in the mouth. Inflammation and injury to the tissue of the mouth cavity can also be a consequence of vaping. It is crucial for dental hygienists to be aware of the possible dangers that are linked with smoking and vaping, and they should advise their patients of the significance of avoiding these activities in order to keep their oral health in good condition. The patient has had hypertension for 15 years and has been taking daily medications to control his blood pressure. “People with high blood pressure had higher levels of inflammatory periodontal biomarkers and lower levels of periodontal clinical attachment than people without high blood pressure.” (Machado, et al., 2020). High blood pressure affects periodontal health and can easily cause inflammation. Smoking also causes an acute increase in blood pressure and heart rate and has been found to be associated with malignant hypertension. Additionally, “quitting smoking reduced the risk of hypertension, and the effect was more pronounced among smokers who quit smoking at an earlier age and with a longer duration of quitting.” (Fan, H., & Zhang, X. 2022). They also discovered that the number of years since quitting was strongly connected with a lower risk of hypertension, and that risk declined with time. The results of this study have significant health-related ramifications since they imply that quitting smoking can immediately lower the incidence of hypertension. The findings of this study also imply that programs designed to lower the risk of hypertension should concentrate on aiding smokers in quitting rather than just reducing how much they smoke. This is due to the fact that smoking intensity trajectory and cumulative exposure to smoking had stronger short-term impacts on the risk of hypertension than long-term effects. From the first patient visit, the patient was informed of the dangers of smoking and asked to quit smoking throughout the treatment period. And I continued to motivate quitting smoking by explaining how smoking has a great effect on oral health and overall health at every appointment. The patient indeed abstained from smoking during the treatment period, and as a result, his blood pressure slowly began to decrease. During re-evaluation time, the patient presented improvement with a BOP index of 20.8%, a significant reduction of more than 40%. At the same time as the BOP index greatly improved, the condition of the patient’s gingiva also improved differently from the initial visit. Overall, the gingiva, which had been swollen from inflammation, was pink and much healthier than before. Lastly, the relationship between Gastroesophageal Reflux Disease (GERD) and Periodontitis is an important one to consider. The illness known as gastroesophageal reflux disease (GERD) is a long-term disorder that causes acid from the stomach to flow backward into the esophagus, where it can cause damage to the lining of the esophagus. Inflammatory gum disease, also known as periodontitis, is brought on by a bacterial infection. If it is not treated, periodontitis can result in the loss of teeth. It is essential to keep in mind that GERD is not in and of itself the cause of periodontal disease; nonetheless, the acid reflux that is linked with it can make a periodontal disease that already exists worse. According to the research, people who suffer from GERD have an increased likelihood of developing periodontal disease, higher levels of periodontal bacteria, and an increased number of periodontal pockets (Li, et al., 2022). This shows that the existence of GERD can make an existing periodontal condition worse, and it is important to keep this in mind when treating periodontitis. In conclusion, Throughout the appointments, the patient has gained a deeper understanding of the periodontal disease, including the disease process and the importance of daily oral hygiene. The patient still needs to improve their home care, but they are making progress in quitting smoking. Through several consultations, they have learned about the risks associated with smoking and the correlation between smoking and periodontal disease, and I will continue to motivate them in their efforts to quit.

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