Vignette 4

Isabella does not have a problem with oral hygiene.

Isabella reports she has "excellent oral hygiene." She brushes and flosses her teeth daily regardless of whether she is "upbeat", "down" or "normal". Her commitment to maintaining oral health is long-standing - over 20 years. She visits a dentist annually accessing information and arranging for transportation. When in a severe manic or depressive phase, Isabella may cancel or miss her dental appointments but always follows up and reschedules when she reaches "balance".