Decision making-Treatment Plan Flashcards
what is clinical decision making
process whereby the dentist and dental hygienist use the information gathered during clincical PA to identify treatment strategies that meet the patients individual needs
It is the legal responsibility of the ______ to make a periodontal diagnosis
dentist
responsibility of who to plan nonsurgical therapy?
dentist and dental hygienist
responsibility of patient to _____ fully in treatment decisions and goals
participate
does an individuals periodontal care needs change over time? due to what?
yes due to the intermittent theory
the decision between health or disease is based on what?
signs of inflammation
T/F: patients are aware of the disease
false; they are unaware and we must inform the patient
purpose of the diagnosis
determine the prognosis, aid in establishing a treatment plan, and state the etiology of the disease (type of gingivitis or perio)
clinical parameters to assist in making the diagnosis
age, attachment level, bone level, plaque level, and pattern of disease
prognosis is a _____. It is a prediction of the probable course of disease and of the chances of the patients recovery
forecast
three meanings of dentistry
- diagnostic
- therapeutic
- prosthetic
what is a diagnostic prognosis:
what is the main status now without treatment and what is the future of the dentition
what is a therapeutic prognosis:
what will treatment have on the course of the disease
what is a prosthetic prognosis:
what will be the success of prosthetic restoration
purpose of the prognosis
- inform the patient
2. establishes treatment plan
characteristics of an excellent prognosis
- no bone loss
- excellent gingival conditions
- good patient cooperation
- no systemic or local factors
characteristics of a good prognosis
one or more of the following:
- adequate remaining bone support
- possible to control local and systemic factors
- adequate patient cooperation
characteristics of a fair prognosis
one or more of the following:
- less than adequate remaining bone
- some tooth mobility
- class 1 furcation
- adequate maintenance by patient
- limited local and systemic factors
characteristics of a poor prognosis
one or more of following:
- moderate to advanced bone loss
- tooth mobility
- class 1 or 2 furcation involvements
- difficult to maintain areas
- doubtful patient cooperation
- presence of local and systemic factors
characteristics of a questionable prognosis
- advanced bone loss
- class 2 or 3 furcation involvements
- tooth mobility
- inaccessible areas
- presence of systemic or local factors
characteristics of a hopeless prognosis
non-maintainable areas
- extractions included
- presence of local factors
- the dentist will inform the patient of hopeless teeth
is the hygienist qualified to tell the patient that a tooth needs to be extracted?
no; that is the dentists’ job
individual tooth prognosis depends on what factors?
- %age of tooth loss
- probing depths
- distribution and type of bone loss
- mobility
- crown to root ratio
- pulpal involvement
- presence and severity of furcas
overall prognosis depends on what factors?
- age
- medical status
- individual tooth prognosis
- degree of involvement, duration, and history of the disease
- economic considerations
What significance does documentation have on periodontal diagnosis
- critical skill for dental team
- use case type system
- use correct terms
T/F: bleeding doesn’t indicate bone loss
True
master treatment plan does what for the patient?
- coordinates and sequences all treatment and education
- estimates length of time required for comprehensive treatment
- communication with patient is vital
5 phases of perio treatment plan
- assessment phase and preliminary therapy
- nonsurgical periodontal therapy
- surgical therapy
- restorative therapy
- periodontal maintenance
features of assessment and preliminary therapy
- Periodontal assessment
- stage is also referred to as emergency therapy
features of nonsurgical phase
- all nonsurgical measures used to help control gingivitis and perio
- dental hygiene care and educational measures
- also called bacterial control and anti-infective therapy
features of surgical phase
- periodontal surgery
- placement of implants
- root canal therapy
features of restorative phase
- splinting of teeth
- restorations
- replacement of missing teeth by fixed or removal prostheses
features of perio maintenance phase
- all measures used to keep perio under control
- maintain teeth functioning throughout life
- goal is to prevent recurrence of disease
what should documentation in patient record include
assessment data, all educational instructions, and treatment services provided
what is informed consent
patient’s voluntary agreement to proposed treatment after achieving an understanding of relevant facts, benefits of treatment, risks involved
what is the most vital about informed consent?
communication with the patient about the treatment plan
informed consent is only possible if the patient has been advised of what?
- recommended treatment
- alternate treatment options
- benefits and risks of treatment
what does the informed consent originate from
a persons legal right to direct what happens to his or her body
the ethical duty of the dental healthcare provider to involve the patient in his or her own dental care
what is important for the patient to understand about the scope of information?
the patient’s role and responsibilities during and after perio treatment
- discuss prognosis if no treatment is provided
- reinforce the right to refuse treatment
never ______ the outcome of proposed treatment? why?
guarantee because the perio disease is intermittent
