Treatment Planning Flashcards
what should be included in the treatment plan
a patient’s disease
goal of treatment
treatment options for the disease
possible side effects
expected length of treatment and likelihood of success
what are some clinical tests for teeth and tooth health
is the tooth sensitive to the air from the 3 in 1
tender to percussion
mobility
presence of sinus
pocket depth
what are radiographs used for
aiding with dental or periodontal diagnosis, screening assessment
what is a diet diary used for
caries risk assessment
what are photographs used for
pre treatment record, evidence of the disease, referrral aid
what is a sensibility testing use dfor
determing the vitality of the pulp
what are study models used for
reviewing occlusion, monitoring non carious tooth surface loss, and planning treatment and referral aid
what are composite vs amalgam
caries risk assessment
size of cavity
moisture control
aesthetics
cost
patient reference
describe SOCRATES
site
onset
character
radiates
associated symptoms
time/duration
exacerbating factors
severity
how to carry out sensitivity tests
indirectly determine the state of pulpal health by assessing the reaction of the nerves within the dental pulp
what are some sensitivity tests
electric pulp testing
ethyl chloride
warm gutta percha
describe the pros and cons of extraction
cheaper
done in a single visit
risk of post op complications
left with a gap
drifting/tilting/overeruption of adjacent teeth
restorative options for space
describe the pros and cons of root canal treatment
more expensive
multiple visits
success rate
what to restore the tooth with - direct filling or indirect filling
what is a direct filling
composite or amalgam
what is an indirect filling
crown or an onlay
what are some treatments that cannot wait
pain management, management of present complaint
how can a present complaint be managed
recement a lost crown, replace a lost restoration in an aesthetic area
how can you identify the source of caries for caries management
review diet
review oral hygiene
provide preventative advice
fluride prescription
what is included under disease control
direct restorations
extractions
prevention
hygiene based therapy
what is included in the reconstructive phase
more complex restorative work such as crowns, bridges, root canal treatment or dentures
good foundations needed to provide complex treatment
what are the pros and cons of acrylic removable partial dentures
cheap
instant fit
doesnt involve prepartion of adjacent teeth
easy to add to
describe the pros and cons of cobal chrome
more expensive than acrylic
period of healing required
may need to prep teeth for the rest of the seats
cannot always add
what are the pros and cons of bridges
utilises adjacent teeth, delayed placement following extractions
will fail if preventative measures are not taken
what are the procs and cons of implants
cost
patient selection
no preparation of adjacent teeth
invasive procedure
failure rate
describe the treatment plan workflow
History Taking
Extra-Intra Oral examination
Dental charting & BPE scoring
Provisional diagnosis
Special investigations
Final diagnosis
Treatment planning & Disease management
Clinical intervention
Re-evaluation
Rehabilitation phase
Maintenance
elements of history taking
- main complaint
- history of the present complaint
- dental history
- medical history
- social history
- family history
elements to examination
- extra oral exam
- intra oral exam
- basic periodontal examination
- dental charting
elements to special investigation
study model
radiograph
photograph
pulp testing
diet diary
diagnosis examples
caries
gingivitis
periodontal disease
apical periodontitis
toothwear
problem examples
poor aesthetics
missing teeth
loose dentures
fractured restorations
sequence of treatment: immediate
what cannot wait until tomorrow
pain relief mainly
sequence of treatment: initial
what diseases do we need to treat
sometimes called the disease control phase
sequence of treatment: re evaluation
checking if treatment is successful
is more treatment of initial disease required
can we progress to more difficult treatment
sequence of treatment: reconstructive
more complex restorative work
good foundations needed to provide complex treatment
initial treatment complete
sequence of treatment: maintenance
supporting patient to continue care at home
maintaining a health after your treatment plan is complete
monitoring for further disease or failure of restorations
treatment options for missing teeth
denture
- cobalt chrome
- acrylic
- upper or lower only
bridgework
- conventional
- resin bonded
dental implants
- implant supported crowns
- implant supported bridge
treatments for a lost crown
crown
- post crown with root canal treatment
- metal
- metal ceramic
- lithium disilicate
- alumina
extraction
- overdenture
- precision attachment for denture
- dental implant
what is gout
inflammatory arthritis characterised by recurrent attacks of a red, tender, hot and swollen joint
raised uric acid level in the blood and the deposition of urate crystals
ideal diet diary
should include 3 consecutive days including 2 working days and 1 weekend
comply fully and assess diet honestly
diet should not be changed because it is being recorded
caries prevention diet advice
- reduce snacks containing sugar
- replace it with healthy snacks
- avoid adding sugars
- look for hidden sugars
erosion prevention
best time to do have fruit drinks when saliva flow is highest at meal times
drinking with a straw
what needs to be recorded by the mother in the diet sheet
time
the content
the amount of food and drink consumed
drugs that cause gingival hyperplasia
cyclosporin for preventing organ transplant rejection
epilepsy seizure treatment - phenytoin
PPE rules
gloves used for all procedures
aprons for blood and bodily fluids
visors for all procedures
face mask for aerosols, ultrasonic cleaning and high speed cleaning
when should gloves not be worn
- when opening cupboards or drawers
- when touching hair, adjusting chair or using pen
- when dispensing oral hygiene aids
patient PPE
disposable bib
safety glasses
bowl
sharps bin
small yellow tub with orange lid
sharps containing medicinal waste bin
local anaesthetic cartridges
vials
medicine/cement bottles
all go into small columnar bin with yellow body and blue lid
amalgam bin
small white with red lid
healthcare waste bin
patient bibs
mouthwash cup
denture bowls
gauze
drapes
globes
plastic apron
domestic waste
cardboard, packaging and empty containers
black bin bags
process for wiping down a bay after a patient
start at the top, light handles, arm, headrest, back of chair and arm rests
replace wipes
worktop, bracket table, motors, cables
replace wipes
suction tubing, partition between the units
how to clean goggle
detergent wipes
how to clean visor
decontaminate with detergent wipes or discard
non verbal signals to convey interest and attention
- eye contact
- body orientation toward the speaker
- posture; lean forward, arms relaxed
- silence
- follow cues
- distance, 3-4 metres from speaker
- distractions - avoid distracting behaviour and movements
- position at same height as patient
- be in the line of sight of the patient
question types to ask patients when interviewing them
open questions - allows patient to engage in conversation, bringing in as much or as little information as they want to
focused questions - what do you do when the pain starts - check if patient understands information
closed questions - clarifying important points
leading questions - avoid as patients can agree to things they do not understand
