Treatment planning 1 Flashcards
describe properties of a good treatment plan
- logical series of steps
- based on good information, carefully gathered
- takes many factors into account
- realistic (consider long term prognosis and time scales needed)
- deliverable ( available resources)
- agreed upon by patient considering timing and costs
- followed carefully and only changed after discussion
- dynamic
- timing and costs
describe the different processes in a treatment plan
- history
- examination
- special tests
- diagnoses
- discuss options with patient
- treatment plan
in history taking what should we note down
- patient complaint of (C/O)
pain
aesthetics
function
caries, aesthetics, pain - history of presenting complaint (HPC)
- site, onset,chracter,radatioation,associated factors, timing, excearbating /relieving factors and severity
- 1-10 scale of pain - Past dental history (PDH)
- attendance, previous dental treatment, local anaesthesia, oral hygiene regimen - Social history
- smoking, alcohol,diet, personal habits, clenching/grinding, stress, occupation,availability for appointments
frequency , sugar tax
personal habits, lifestyle - Medical history
- fit and well
- undergoing treatment with GP
- hospitalised in the past
- prescribed medications?
- do you have allergies
describe the difference between reversible pulpit its and irreversible pulpits
Reversible pulpit its
- localised
- set off by stimulus
- sharp
- no radiation
- short timing
- removal of stimuli
- mild to moderate severity
Irreversible pulpitis
- not well localised
-spontanous
- sharp/throbbing
- radiation to other teeth
- last long
- hot/cold may sooth it
- moderate to severe
what questions would you ask in PDH
- how often do you attend the dentist?
- how often do you brush your teeth?
- Do you use a fluoride toothpaste?
- Do you use any interdental aids?
why is it important to diagnose dry mouth?
- side effects of medications
- patients that have radiotherapy will suffer form dry mouth
- dry mouth due to underlying syndrome
- dry mouth and dry eyes
- usually patients with dry mouth have higher risk of dental caries
what Is followed by history taking and what does it consist of?
- start examination
- examine patient teeth, have right equipment
- surface mirror
-BPE probe - Good elimination
- Isolated teeth for dry teeth to examine the surfaces carefully
- BPE - black band visible
black band disappears within pocket
code* furcation involvement - extraoral and intra oral examination
(assymetry)
examination by pulpating the muscles of mastication. - intraoral - soft and hard tissues, lateral border of tongues, floor of mouth, lips and soft tissues and mucosa for lumps and swellings
- occlusion
- special tests - vitality tests: electronic pulp testing, ethyl chloride
describe special tests in detail in examination
- vitality tests - if pulp is vital, electronic supply current to tooth and if response gained then it is alive
- radiographs are useful and important aspect of assessment of patient
- intra oral give idea of tooth form shape and area of tooth\
- infection on apex of tooth
what follows examination in treatment planning
diagnosis
- key to have
what can be some of the treatment options
- extraction/ RCT
- Amalgam, composite, GIC restoration
- Denture bridge implant
what are the stages of treatment plan?
- emergency
- stabilisation
- corrective therapy
- reconstruction
not all patients need to go through all 4 stages
when is emergency phase used
- pain relife
- usually root canal or extraction
- Patient is traumatised soft tissues
- large swelling
- describe painkillers
- fallen over and chipped tooth
restore form/function
what does the stabilisation phase do?
- cause related therapy
- establish healthy oral environment
- pass through emergency phase
- move onto stabilisation phase
- preventative advice
-OHI, smoking cessation advice - Plaque free score
- Oral hygiene instructions- understadning patinet technique of brushing/ modifying if not bushing right way - interdental/fluroide toothpaste
what are the benefits of using fluoride toothpaste?
- use twice a day
- 14% more effective to use twice daily than once per day
- spit, don’t rinse
- Duraphat - higher fluoride toothpaste - prescribed for epithets with an increased caries risk
what are indications for prescribed fluoride toothpaste?
- exposed root surfaces
- extensive restorations
- reduced salivary flow
- orthodontic appliance wearers
- elderly patients
- oral cancer patients
- only for over 16 years old
