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Name: Matthew
19-year-old male

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Patient is complaining that his front teeth are very sensitive to temperature, touch and acidic foods and drinks. He says they are so sensitive that he has been unable to brush them for the last few months.

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Diagnosed with depression

Taking antidepressants

Patient is a smoker

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Matthew is currently employed as a factory worker.

Left home at age 17 and since then has been moving frequently, in and out of work, sharing accommodation with other young people in similar circumstances.

He tells you that he has not been looking after himself and has been living on soft drinks and junk foods for the past couple of years.

He said he wants to 'get himself together'

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He says he is very keen for his front teeth to be saved, but he said he could not stand injections.

Four restorations were placed when he was at primary school and the patient reports that he experienced a lot of pain during the procedure. The local aesthetic given before the procedure had not worked and was very painful.

He has avoided dental visits since, and has developed an extreme fear of injections and dental work.

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Currently a very unbalanced diet

Matthew reports drinking over three liters of sugared soft drink that he sips throughout the day.

His meals are irregular

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Cavitated carious lesions into dentine present on some anterior and posterior teeth.

All teeth are vital, and exhibiting a strong reaction to cold

Teeth are stained and covered in plaque

Gingiva are inflamed, but no evidence of any loss of attachment.