Treatment Planning Flashcards
Treatment plan definition
“Blue print” for case management
How we will go from disease to health
Where treatment will end
What are requirements for Treatment Planning
Data collection
Diagnosis
Data collection
Patient exam - chief complaint, med hx, dental hx, exam
Diagnosis
Can have multiple treatment plans for one disease
What are the different treatment goals?
Primary goal Short-term goals Long-term goals Specific goals of perio treatment Eliminate furcations Satisfactory function/esthetics Control Risk Factors
Primary goal of treatment
Establish/maintain overall health of periodontium
Short term goals of treatment
Return to health
Eliminate infection/inflammation
Long-term goals of treatment
Reconstruct a healthy definition both functionally and esthetically
Specific goals of Perio treatment
Pain control (immediate issue - shouldn’t leave with pain)
Reduce/resolve inflammation
Reduce probe depths to ≤ 4mm
What is considered a healthy BOP level and what is ideal?
Health = ≤25%
Ideal =
What level do we want furcations to be?
≤ 3mm
anything greater than 3 is hard to maintain
Why is it important to have satisfactory function/esthetics?
That’s what the patient wants - otherwise they won’t be satisfied
Controlling risk factors
Can do great work, but if the patient doesn’t care/want to remove risk factors (smoking or diabetes control, proper plaque control) then you fail in the eyes of the pt
What are the phases of Perio therapy?
Systemic Phase
Initial (Hygiene) phase
Corrective Phase
Maintenance Phase
Systemic Phase of therapy
Eliminate/descrease the influence of systemic conditions/protect from infectious hazards
Review med hx
Lab screenings - med consult if needed
Identify/modulate risk factors (smoking)
Assess hypertension (Stress-reduction protocol during therapy)
Initial (Hygiene) phase of therapy
"Cause-related" therapy Emergency treatment if needed Removal of hard and soft deposits + retentive factors Pt motivation (via OHI) and education Initial phase is over when re-evaluation is favorable Dental consultations Extraction of hopeless teeth Re-evaluation
Corrective Phase of therapy
Perio surgery
Implants
Endo/Restorative/Prosthetic Therapy
Pt cooperation determines therapy options
Maintenance Phase
The most important phase - any chronic disease will come back without maintenance
Prevent recurrence - assess deep/BOP sites - caries control
Control prosthetic restorations (subject to breakdown)
Assessment of PD, CAL, hygience, risk factor changes, radiographs
When is increased frequency of maintenance therapy is helpful?
Initially and with patients at greater risk
Re-evaluation
During initial phase
Re-assess prognosis
Re-assess need for consultations and tests
Assessment of risk factor modulation
Patient motivation
What should be done when explaining the treatment plan to the patient?
Be specific (so they understand) Always begin with a positive statement (help motivate) Present the entire Tx plan as a unit - so they have a good idea of what to expect (let them know it can change) Dentist has the responsibility of stressing the importance of perio treatment and health
