I had an older patient who was regularly seen by a graduated dental hygiene student. From

Radiolucency found on 37 perapical region in 2011

my initial dental hygiene assessment, I found a perapical radiograph that revealed a periapical radiolucency on tooth 16. I looked for a referral or any intervention that has been done on the area but could not found any. My periodontal exam revealed a deeper pocketing and worsened

Larger radiolucency found at the same area in 2013

clinical measurements on the area compared to the time the graduated dental hygiene student measured.

I took a new perioapical radiograph for the area and identified the remaining periapical radiolucency, which was bigger and spreading to other areas. I immediately refereed the patient for an emergency clinic for a possible periapical abscess. Later, the emergency dentist’s report identified periodontal abscess with root necrosis which resulted in tooth extraction. One of the major concerns for the patient was too keep his remaining teeth; however, the practitioner ignorance on follow-up with identified lesion cost the patient to suffer much more serious infection than he initially had and a tooth. This case reminded me of the importance of ethical and moral duties of dental hygienists who are striving to provide holistic care as primary care providers.