dr asmaa faden treatment planning concepts the dentist’s goal is to provide the best dental...
TRANSCRIPT
TREATMENT PLANNING
Dr Asmaa Faden
Treatment Planning ConceptsThe Dentist’s goal is to
provide the best dental treatment for each patient
individually
- Gathering of Information
- Diagnosis
Treatment Planning ConceptsTreatment Plan is a strategy
that may be changed OR adjusted according to the patients needs.
Time is needed for a successful treatment Prognosis
Format of Treatment Plans
Treatment Plans
General Format
Flexible Format
Format of Treatment Plans I-General Format
Phase I(Priority Tx)
Phase II(Disease Control)
Phase III(Restoring Function & Aesthetic)
Phase IV(Re-evaluation & Re-Call)
Format of Treatment Plans
II- Flexible Format
- A rigid Tx. Plan is not suitable for All Patients
- New information during Tx.
-Tx. Plan needs modification or changes
Format of Treatment Plans
Phase I (Priority Care)- Eliminate Pain and manage acute infections.
- If possible manage C.C.
Format of Treatment Plans
Phase II (Disease Control)- To control all disease processes BUT not to eradicate
All diseases.
Format of Treatment PlansPhase III (Restoration of Function &
Aesthetics)- Eliminate the remaining areas of decay.
- Restore the mouth to full function and aesthetics through restorative & prosthodontics procedures.
Format of Treatment Plans
Phase IV (Re-evaluation & Re-call)
Factors that influence treatment plans:1- The patient’s Health
2- The patient’s Age
3- The patient’s expectations
4- Psychological Factors
5- Existing Dental Conditions
6- The Operator’s philosophy
7- The Prognosis
8- Emergency Treatment
9- Financial Considerations
Factors that influence treatment plans
1- The patient’s Health
• The medical health status of a patient may necessitate
modifications, e.g., prophylactic antibiotics.
• Precautions may include necessary medications prior to
the dental treatment, e.g., diabetic patient or patient
with heart problem.
• Modifications of treatment planned, e.g., one quadrant
per appointment.
Factors that influence treatment plans
2- The patient’s Age
• Chronologic age is a rough indicator of physiologic age,
considering the physical & emotional maturity of the
patient.
• Age can indicate the relative size of the pulp chamber.
Factors that influence treatment plans
3- The patient’s expectations
• Many factors influence the patient's expectations
regarding the dental care (Attitudes, past experiences,
financial concerns).
• Sometimes, the patients desires may be attainable or
unrealistic
• As the patient ages, list of priorities may differ.
Factors that influence treatment plans
4- Psychological Factors
• Modifications to the treatment plans according to the
patients personality may be needed.
• Treatment plan must be designed and presented to
motivate the patient to accept optimal care.
• The Chief Complaint should be managed first, to help
establish that the dentist is listening and cares.
Factors that influence treatment plans
5- Existing Dental Conditions
• The dentist should first determine a diagnosis, which
includes factors such as, the presence and absence of
caries and periodontal diseases, the location and
numbers of missing teeth.
• The dentist should consider what possible treatment
for the existing condition.
• Finally, the dentist decides which treatment option
will provide the best long-term prognosis.
Factors that influence treatment plans
6- The Operator’s philosophy
• In a situation when the dentist is given the choice
between 2 treatment alternatives, he/she is most likely
to choose the option that is consistent with her/his
philosophy of dental care with which he/she has the
most successful outcomes.
• In other cases, when treatment is beyond the ability of
the dentist the case is usually referred to a dental
specialty practice (Ortho, Endo…….)
Factors that influence treatment plans
7- The Prognosis of Proposed Dental Treatment
• The dental treatment plan should be designed with a
definitive goal concerning the longevity of the care
(Timing).
• The amount of time needed to provide comprehensive
care for one patient may not be acceptable to another.
• Generally, the prognosis for any dental reconstruction
should be at least 5 years (with the exception of
transitional dental appliances).
Factors that influence treatment plans
* Four levels of prognosis can be identified to make an accurate predictions
concerning the longevity of treatment plans
1- Teeth with Stable Prognosis: have
no major problems, can be maintained
by Pt. indefinitely
2- Teeth with Guarded Prognosis :
have problems that may render them
poor candidates for indefinite retention,
but can rely on them for an adequate
length of time.
7- The Prognosis of Proposed Dental Treatment, cont’d
Factors that influence treatment plans
* Four levels of prognosis can be identified to make an accurate predictions
concerning the longevity of treatment plans
3- Teeth with Diminished Prognosis:
have predictive longevities of
approximately 1 to 5 years or they are
incapable of contributing a
dependable amount of support for
dental appliances.4- Teeth with Hopeless Prognosis :
are defined as teeth that cannot be
maintained and are indicated for
removal.
7- The Prognosis of Proposed Dental Treatment, cont’d
Factors that influence treatment plans
8- Emergency Treatment
• Emergency patients may have severe pain and may
insist on extraction of teeth rather than other
alternatives such as RCT, which may result in loss of
useful tooth.
• To avoid this, many dentists recommended conservative
treatment to relieve pain and to delay definitive care.
• Decisions can then be decided by the patient after a
thorough diagnosis and formulation of treatment
alternatives
Factors that influence treatment plans
9- Financial Considerations
• Financial factors should not affect the dentist’s
formulation of the best dental treatment plan.
• Modifications may be made to the plan to make it less
expensive, or to deliver only the initial phase of care
and to postponed other phases.
Alternative & Tentative Treatment Plans
Treatment plan for the patient is an OPINION of what the dentist thinks is best for the patient.
This is because:
• The formulation of a professional opinion is the
“service“ dentists provider patients.
• The dentist should not be offended if patients seek a
second opinion.
• More than one way exists to plan treatment for a
patient, many of them are acceptable.
Alternative Treatment Plans
- Alternative treatment plans are developed mainly to provide the patient with options
when finances are a concern.
- Alternatives to treatment may be limited to elimination of diseases, or use of different
types of treatment.
- The dentist should present the plan that is in the patients best interest regardless to
financial cost.
Alternative Treatment Plans
- Alternative treatment plans are sometimes a
necessity, but the dentist should develop
other treatment options that provide the
patient with the highest level of possible care
and the best long-term dental health
potential.
Tentative Treatment Plans
- Some dental diagnosis are so complex that no definitive treatment can be planned until the result of intermediate therapy is determined.
-These require a tentative treatment plan, which are vague but crucial in situations since they determine whether the patient chooses sophisticated or expensive treatment.
Tentative Treatment Plans-Simple tentative plans that involve only one
or two areas of questionable treatment are
much like definitive plans and are easily
explained to the patient.
-Complex tentative plans require a great deal
of explanation (advanced periodontitis with
questionable prognosis on several potential
abutment teeth) fixed, partial or
complete dentures????
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