Module 3 Flashcards
What are the 5 steps in the Treatment Planning Process
1) Collecting the information
2) Forming the Diagnosis
3) Formulating the TP
4) Determining the prognosis
5) Presenting the Case
Describe the Diagnosis
A condition that requires treatment
Formed from a problem list
Pt always has the option to refuse treatment
Includes factors such as caries, perio disease, location of teeth, missing teeth
What are the four “Phases” of a treatment
Phase I - Urgent/Priority Treatment
Phase II - Disease Control
Phase III - Restoration of Function and Esthetics
Phase IV - Recall
Phase I - Urgent Treatment
Procedures that eliminate pain and manage infection
Pt’s chief complain should be addressed in this phase - if it can’t be done, explain that to the pt
What procedures are part of Phase I?
Endo Oral surgery Restorative Periodontics Pathology
Phase II - Disease Control
Procedures that control all disease process
Final Tx plan may not be completed until the end of Phase II
Before moving to phase III, the student and faculty must fill out “Phase II Completed Tx” Form
What are some examples of procedures done during Phase II?
Perio procedures Management of CC if it wasn't addressed in Phase I Most oral surgery extractions (like non-restorable teeth or 3rd molar extractions) Restorative of carious lesions Endo Ortho records Occlusal Analysis Complex D&T
Phase III - Restoration of Funciton and Esthetics
Restore the mouth to full function and esthetics through restorative and prosthodontics procedures
It is important to maintain vertical stops at all times when crowns are involved throughout the dentition
What is done first, Fixed (Crowns) or Removable (RPDs, Dentures) Restorations?
Fixed, then removable
What are some examples of procedures done during Phase III?
Post and core MCC, CVC, ACC Veneers FPD, RPD, Dentures Implants
Phase IV - Recall
Check that all procedures have been completed
Make sure no other treatment is needed
(Re-evaluate pt at completion)
Establish follow-up exams and time interval
Must fill out “Completed Treatment Forms” at the end of treatment
What must be signed off before beginning phase III?
Phase II Completed Treatment Form
It must be signed off before beginning Phase III
If doing an RPD, what must be done before beginning Phase III of Treatment?
Surveying
Crowns opposing one another in a situation with an acceptable occlusal plane and vertical stop should be…
Fabricated at the same time
What are the factors that influence treatment plans?
Patient's Health Patient's Age Patient's Expectations Psychological Factors Existing Dental Conditions Dentist's Philosophy and Experience Emergency Treatment Financial Considerations Prognosis
How does Patient’s Health influence treatment plans?
Prophylactic antibiotics
Limiting the amount of treatment that can be done for each apt
Special appointment times
Patients recovering from heart attack should not be stressed by dental procedures that aren’t urgent
Pregnant pts should be limited to necessary procedures during the 2nd trimester
Terminal pts should have pain eliminated and maintain quality of life
How does the pt’s age influence the treatment plan?
Age can indicate the pulp chamber size
18 reflects the age when sufficient pulpal shrinkage has occured
How do patient’s expectations effect the treatment plan?
Financial concerns
Esthetics
Realistic v unrealistic
What can form a patient’s expectations?
Attitude
Experience
Current Life Situation
Pts own self image
How can psychological factors influence the TP?
aka the Personality of the Pt
Addressing the pt’s chief complaint first may help establish a good relationship
How can existing dental conditions influence the TP?
Helps determine the prognosis
How can the Dentist’s Philosophy and experience effect the TP?
Dentists will most often chose a TP that they have had successful outcomes
As the dentists experiences change, so may the TP
How can Emergency Treatment influence the TP?
Pt’s who desire “emergency only? care even after discussion of options should be treated quickly to treat the emergency
How can Financial Considerations influence the TP?
Should not affect the formulation and presentation of the ‘best’ TP as an option
If the ‘best’ is not feasible, modifications can be made to make it less expensive
Prognosis
The estimation of the likely course of the disease
The long-term outlook of the probable result of treatment
What areas are evaluated in the prognosis determination?
Patient Desires and Capabilities Systemic Health Status of Supporting Structures Condition of Teeth Matching of the TP with the Pts desires Other individual considerations
How can systemic health effect prognosis?
May contraindicate certain procedures
What things are considered when looking at the status of supporting structures?
Crown:Root ratio
Tooth mobility
Current level of Oral Hygiene
What are the 4 levels of prognosis
Teeth with Stable Prognosis
Teeth with Guarded Prognosis
Teeth with Diminished Prognosis
Teeth with Hopeless Prognosis
Stable Prognosis
Teeth have no major problems and can be maintained by pt
Guarded Prognosis
Teeth have problems that may render them poor candidates for indefinite retention but the teeth can be depended on for an adequate length of time to support the TP
Diminished Prognosis
Teeth have longevities of 1-5 years or are incapable of contributing dependable support for dental appliances
eg 2nd molars with furcation involvement
Hopeless Prognosis
Teeth cannot be maintained and are indicated for removal
What is the importance of alternative treatment plans?
Often more than one way to treat a pt
Alternative TPs give the pt options
T/F - Assumptions about the pt help make alternative TPs
False - In making alternatives, the dentist should not make assumptions about the pt’s commitment or finances
Dentist has an obligation to present TP in the pt’s best interest
