Treatment Planning Flashcards
When listening to a patients chief complaints, what should you allow?
- allow patient time to explain in his or her own words their:
- problems
- expectations about possible treatment options and treatment outcomes
It is important to do so without any interruptions
What are the two most important aspects of the patient assessment process?
- History taking
- Clinical examination
What are the two functions of special tests/investigations?
- screening tool to pick up unanticipated conditions
- provide confirmation of a provisional diagnosis
What are the steps required to follow the evidence based dentistry (EBD) process?
- define a clinically relevant and focussed question
- search for systematic reviews that may answer the question asked, such as the Cochrane Oral Health Group Reviews
- evaluate the relevance of the evidence to indivdual patient needs
What is the problem with the normative need approach?
Presenatation of a single “ideal” option by the dentist
- fails to take into account the patients dental healthcare wishes, beliefs and attitudes or behaviours
- fails to recognise that all treatment options possess both advantages and disadvantages
Give examples of some considerations that must be made for young patients when treatment planning
- tooth eruption
- large pulp chambers which can impact decision on whether or not to use a particular type of restoration
Give examples of some considerations you may make for older patients when treatment planning
- risk of periodontal disease
- risk of root caries
Give an example of a treatment option that is contraindicated for a patient with a neuromuscular condition and thus has issues with their dexterity. Briefly state your reasoning behind this
- complex bridge work /fixed partial denturs
- cleaning around these areas that require more attention may be more difficult for a patient with dexterity difficulties
Give specific dental considerations for a dentist before designing a treatment plan
- oral hygiene status/motivation/cooperation of the patient
- control of dental caries, tooth wear and periodontal disease
- pulpal and endodontic status of individual teeth
- functional occlusal relationships and occlusal forces or stresses
- appearance of the dentition
- restoration retention- crown height, enamel available for bonding
What is the overarching aim of dental treatment?
provide a masticatory system that is:
* functionally adequate
* free from disease and discomfort
* aesthetically pleasing to the patient
What are the advantages of a well thought-out and documented treatment plan?
- smooth and logical progression through the various treatment phases
- reduced stress for the patient, dentist and staff
- more effective use of clinical time
- less incovenience for the patient
- greater likelihood of achieving the patients expectations
- provision of essential information for the patient such as time involved, cost, expected treatment outcomes and anticipated prognosis
- reduced risk of non-payment of fees and dento-legal problems
- anticipation of any complications and provision of any contingency plans
- ability of a colleague to continue, without difficulty, the treatment in your stead if required
Outline the phases of a treatment plan for complex restorative work
- emergency and stabilisatoon
- preventive and disease control
- initial restorative, and consultations
- review and occlusal analysis
- definitive complex restorative
- maintenance and monitoring
What treatment items are involved in the emergency and stabilisation phase
- control of acute pain, infection, tooth fracture gingival bleeding
- medical consultations if required
- extraction of non-strategic hopeless teeth and retained roots
- caries and erosion control
What treatment items are involved in the preventive and disease control phase of a treatment plan?
- OHI
- scaling and prophylaxis
- fluorides
- chlorhexidine mouthrinses
- casein derived pastes
- dietary analysis
- splint construction
What treatment items are involved in the initial restorative and consultations phase of a treatment plan?
- simple restorative work
- placement of cores
- endodontic, periodontic, prosthodontic, orthodontic etc consultations
