Treatment Planning

Question 1

Treatment plan definition

Answer 1

“Blue print” for case management
How we will go from disease to health
Where treatment will end

Question 2

What are requirements for Treatment Planning

Answer 2

Data collection

Diagnosis

Question 3

Data collection

Answer 3

Patient exam - chief complaint, med hx, dental hx, exam

Question 4

Diagnosis

Answer 4

Can have multiple treatment plans for one disease

Question 5

What are the different treatment goals?

Answer 5

Primary goal
Short-term goals
Long-term goals
Specific goals of perio treatment
Eliminate furcations
Satisfactory function/esthetics
Control Risk Factors

Question 6

Primary goal of treatment

Answer 6

Establish/maintain overall health of periodontium

Question 7

Short term goals of treatment

Answer 7

Return to health

Eliminate infection/inflammation

Question 8

Long-term goals of treatment

Answer 8

Reconstruct a healthy definition both functionally and esthetically

Question 9

Specific goals of Perio treatment

Answer 9

Pain control (immediate issue - shouldn’t leave with pain)
Reduce/resolve inflammation
Reduce probe depths to ≤ 4mm

Question 10

What is considered a healthy BOP level and what is ideal?

Answer 10

Health = ≤25%

Ideal =

Question 11

What level do we want furcations to be?

Answer 11

≤ 3mm

anything greater than 3 is hard to maintain

Question 12

Why is it important to have satisfactory function/esthetics?

Answer 12

That’s what the patient wants - otherwise they won’t be satisfied

Question 13

Controlling risk factors

Answer 13

Can do great work, but if the patient doesn’t care/want to remove risk factors (smoking or diabetes control, proper plaque control) then you fail in the eyes of the pt

Question 14

What are the phases of Perio therapy?

Answer 14

Systemic Phase
Initial (Hygiene) phase
Corrective Phase
Maintenance Phase

Question 15

Systemic Phase of therapy

Answer 15

Eliminate/descrease the influence of systemic conditions/protect from infectious hazards
Review med hx
Lab screenings - med consult if needed
Identify/modulate risk factors (smoking)
Assess hypertension (Stress-reduction protocol during therapy)

Question 16

Initial (Hygiene) phase of therapy

Answer 16

"Cause-related" therapy
Emergency treatment if needed
Removal of hard and soft deposits + retentive factors
Pt motivation (via OHI) and education
Initial phase is over when re-evaluation is favorable
Dental consultations
Extraction of hopeless teeth
Re-evaluation

Question 17

Corrective Phase of therapy

Answer 17

Perio surgery
Implants
Endo/Restorative/Prosthetic Therapy
Pt cooperation determines therapy options

Question 18

Maintenance Phase

Answer 18

The most important phase - any chronic disease will come back without maintenance
Prevent recurrence - assess deep/BOP sites - caries control
Control prosthetic restorations (subject to breakdown)
Assessment of PD, CAL, hygience, risk factor changes, radiographs

Question 19

When is increased frequency of maintenance therapy is helpful?

Answer 19

Initially and with patients at greater risk

Question 20

Re-evaluation

Answer 20

During initial phase

Re-assess prognosis
Re-assess need for consultations and tests
Assessment of risk factor modulation
Patient motivation

Question 21

What should be done when explaining the treatment plan to the patient?

Answer 21

Be specific (so they understand)
Always begin with a positive statement (help motivate)
Present the entire Tx plan as a unit - so they have a good idea of what to expect (let them know it can change)
Dentist has the responsibility of stressing the importance of perio treatment and health