treatment planning Flashcards
what are we aiming for with treatment planning
we are aiming to address those problems
and we can make the dentition functional and aesthetically pleasing
what makes a good treamtment plan
logical
the more info you have form the exam- accurate diagnosis
can we deliver in the timing
can we deliver in the skills i have
take into account patient preference- timing and costs
followed carefully and only changed after discussion
how to we form a diagnosis
by history taking
examinations-EO,IO
special tests-vitality and x rays
what can we form from the diagnosis
prognosis and speak to the patient
after speaking to the patient we can form a
treatment plan
what does C/O mean
complaining of- eg pain aesthetics function or factors
what does HPC mean
history of presenting complaint
what can history of presenting complaint contain
site radiation onset character radiation timing associated factors exacerbating/relieving factors severity
what is the HPC of reversible pulpitis
site:localised
onset:set off by stimulus
character:sharp
radiation:none
timing:short
exacerbating/relieving factors:removal of stimulus
severity:mild to moderate severity
what is the HPC of irreversible pulpitis:
site: not well localised
onset: spontaneous
PDH
past dental history
what does past dental history include
attendance
previous dental treatment
LA
oral hygiene regime
how can we tell if someone is a low risk for dental caries
regular visits to the dentist
they brush twice a day with floss
they use fluoride toothpaste
and they use interdental aids
how do we tell if someones medium risk for caries
irregular dental visits
might forget to brush x2
irregular use of floss or aids
how do we tell if someones a high risk for caries
infrequent visits
hardly brushes
no use of interdental brushes
what does social history contain
smoking- current status and history of smoking or alternatives such as vaping alcohol diet personal habits grinding teeth stress occupation availability to attend
how long does it take for the body to get to pre smoking health
around 10 years
how much of a higher risk can you have of getting oral cancer when you smoke and drink
x40
why might people get erosion
due to excess acid found in alcohol
what do we ask about relating to the diet
sugar- type and amount
acid
frequency
what questions will be asked in relation to alcohol
type
amount
frequency
personal habits also need to be included
such as nail biting habits and chewing pens
and life style such as working hours and stress
what questions do we ask in the medical history
are they fit and well
are the on any medications- dosage and usage
hospitalised in the past
any allergies
when do we ask about the medical history
before every appointment
what medications makes it difficult to remove teeth
bisphosphonates due to the fact it makes it difficult to heal
what diseases can be shown in the dental clinic in patients
heart problems-eg angina cannot put patient very supine
asthmatic patients- can cause drying of the mouth, acidic and cause toothwear
high BP- gingival hyperplasia leading to fibrous ginigva
gastric problem- bullimic and tooth wear
why might patients experience dry mouth
due to sjrogrens syndrome
polypharmacy
radiotherapy
diabetes
what is sjrogrens syndrome
where the salivary glands do not produce enough saliva and the patient has xerophthalmia
if it is a BPE score of 0 what does that mean
healthy gums
BPE of 1 means
bleeding on probing
BPE of 2 means
calculus or PRF
BPE of 3 means
OHI, RSD and the band is partially visible and the pocket is 3.5mm-5.5mm
BPE of 4 means
further testing and definitely needs radiographs
what do we look at in EO exam
swelling asymmetry ulcer gait obesity we also look at the lymph nodes-infection TMJ-dislocation or bruxism
in the IO exam what do we look for
the hard palette the tongue dorsal surface of the tongue floor of the mouth ventral surface of the tongue lateral border of the tongue gingiva mucosa buccal mucosa posterior gingiva vestibule
special tests include:
vitality tests such as EPT(electronic pulp testing) and ethyl chloride
disadvantages od ethyl chloride
icy spray which can go to the tooth next door
what are the two types of occlusion
static
dynamic
why is it hard to do a vitality test on a crown
as the crown is in the way
what are the stages of the treatment plan
emergency
stabilisation
corrective therapy
reconstructive therapy
what does the emergency stage include
pain relief \
restore function or aesthetic
stabilisation phase
ohi-modified bass technique preventative advice smoking cessation plaque free score fluoride toothpaste brushing twice is 14% more effective
how much % is more effective brushing twice a day
14%
what is high fluoride toothpaste called
durophat which has 5000ppm of fluoride
not for life but the first few months
who should durophat be used for
exposed root surfaces extensive restorations reduced salivary flow orthodontic appliance wear elderly patients oral cancer only over 16+
mouthwash rinse
POOR DEXTERITY
ORAL APPLIANCES
root caries
what is the other type of fluoride
durophat varnish
22600ppm fluoride
how can we stabilise the dentition
diet advice
reduce frequency
do not have before bed
what does a diet sheet include
type amount and timing of foods
includes three days two weekdays and 1 weekend day
depends high patient cooperation and truth
what options can we offer people with a dietsheet
realistic offer alternatives sugar free gum drink water limit frequency of sugar/cariogenic
