Bill S. is a longtime patient in your practice and has been inand out of rehabilitative treatment centers for the past 10 yearsfor alcoholism. He tells you that he has been “on the wagon†forthe past 3 months, and he is taking Antabuse. He also tells youthat he is smoking more to deal with the stress of giving upalcohol. When you perform the intraoral and extraoral examinations,you notice that his parotid glands seem enlarged and that he has ared, beefy tongue with an ulcerated area on the lateral border ofthe left side. Once you start periodontal probing, the bleeding isexcessive and continues long after it should have stopped.
2. Which factors could be responsible for the excessivebleeding?
a. Adverse reaction to the Antabuse
b. Poor oral hygiene
c. Liver failure caused by alcohol abuse
d. Squamous cell carcinoma
3. Which is the most likely cause of the ulcerated area on thelateral border of Bill’s tongue?
a. Trauma
b. Aphthous ulcer
c. Adverse reaction to the Antabuse
d. Squamous cell carcinoma
4. Noting that Bill is taking Antabuse, you use an alcohol-freepre-procedural rinse. Which would explain this use?
a. Fear of triggering alcohol cravings
b. Better efficacy than alcohol-based rinses
c. Adverse reaction to the Antabuse
d. Drying of oral mucosa with alcohol mouth rinses
5. Which modifications to the dose level of local anestheticshould be made for Bill’s dental treatment?
a. The dose should be reduced.
b. The dose should be increased.
c. No modification to the dose is necessary.
d. Local anesthetic is contraindicated completely.
