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Case profile: While waiting on your next patient, an emergency patient arrives. The patient called this morning complaining of pain in the lingual area of the tongue and reported some previous bleeding. The patient is a 65-year-old male who is not a patient of record at your office. You have been asked to seat the patient, take a medical history, determine what is visible in the mouth, and report your findings to the dentist, who is currently with another patient.
The new patient is Mr. Saunders and his wife accompanied him to the appointment. As you question Mr. Saunders, you receive a great amount of information from his wife during the conversation. Mr. Saunders is on multiple medications for high blood pressure and high cholesterol, and is a borderline diabetic. He is able to control the diabetic problem with diet and says that he does well by watching his lifestyle factors. Although he reports that he is controlling his diabetes, you suggest that his physician clear him for further treatment.
He has a partial denture to replace missing teeth on the mandible and tells you that the appliance was fabricated at least 15 years ago. Since the initial partial was made many years ago, he has lost some teeth (Nos. 28 and 29), which leads you to his main problem and why he is in your office today. His wife tells you that they were driving on the interstate last night and his partial became dislodged and "stuck in his tongue," bleeding profusely. It became necessary for them to pull off the highway and he was able to dislodge the partial from his tongue (Figure 1).
The bleeding began to subside and they were able...