Medical Emergencies · patient case question
Based on the information given, what is this patient's ASA physical status classification?
Patient case: Deep pockets on molars and incisors only
Patient: Female, 22 years old
Chief Complaint: “My front teeth feel like they are moving.”
Background: Healthy. No medications, no allergies, non-smoker. No family history recorded.
Vital Signs: BP 112/70 mmHg · HR 72 bpm · RR 15 · T 98.4°F
Findings: Probing depths 8–9 mm at first molars and 5–6 mm at incisors. Other sites are 2–3 mm. Plaque and calculus deposits are minimal relative to the destruction. Dark, hard subgingival deposits are visible after retraction.
Show answer and explanation
Correct answer: D. ASA I
- A. ASA II requires a mild systemic disease with no functional limitation — controlled hypertension, well-controlled diabetes, pregnancy, active smoking, obesity with BMI 30–40. Nothing in the history meets that.
- B. ASA IV is severe systemic disease that is a constant threat to life — recent MI or stroke, unstable angina, severe valve dysfunction.
- C. ASA III means severe systemic disease with functional limitation, such as poorly controlled diabetes, a myocardial infarction more than three months ago, or dialysis dependence.
- D. CORRECT. The ASA scale grades SYSTEMIC physical status, not oral disease. This patient has no systemic illness, takes no medications, does not smoke and has normal vital signs — she is ASA I. Periodontitis, however severe, is a local condition and does not by itself move a patient up the scale.
Note: The recall offered no key. Some study sources reflexively assign ASA II to any patient with periodontal disease; that is wrong. ASA is a systemic scale. Expect the exam to test exactly this distinction.
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