Treatment Planning Flashcards
What grading is used to determine whether a person/child is medically fit for treatment in clinic, on which part of the scale are they treatable?
-ASA score (american society of anaesthiology)
Class I: no organic, physiological, biochemical, or psychiatric disturbance
Class II: mild to moderate systemic disturbance, e.g. mild diabetes, moderate anaemia, mild asthma, not disabling
(class I and II can be treated, goes up to class V in terms of condition severity)
What is generally the age at which you can do treatment in the chair?
3 years old, below this refer for GA
What should you try to test a child’s ability to receive treatment?
Take B/W’s
T/F you can start treatment on children without x-rays?
F
What factors should be taken into account for treatment planning?
- MHx
- SE status
- Co-operation levels
What should you do to determine how aggressively you want to treat a child?
- Take into account patient factors
- e.g. if irregular attender, frequent FTA’s, place stainless steel crown over enamel lesion (in 6 months time that lesion could hit pulp)
- if regular attender, motivated, follows instructions, then duraphat and monitor
T/F School dental service will not allow RA in the x-ray room
T
What is dental fatigue, and how many appointments does it take to start being significant?
- Decrease in cooperation as the appointments go on due to child getting tired of visiting/sick of treatment
- Usually starts become significant at the 4th appointment
- Especially prevalent if child is already struggling at the first appointment to take B/W’s
- If child is already struggling at the beginning, put patient on waiting list for GA even if you are going to do a second appointment attempt–>they can always get taken off later but reduced waiting time by 2 months
- Keep in mind that in private practice if need to come back several time for RA appointments, cheaper to do GA (in public government covers it so not an issue), especially with time taken off work
What are some predictors for a child being unable to cope with treatment?
- Unable to take radiographs
- Multiple extensive treatment
- Multiple visits for treatment
- Possibility of behaviour deterioration from child’s demeanour
T/F you should continuously talk about prevention even as you are donig treatment
T
Which appointments should you keep the simple procedures for?
First: introduce atraumatic experience
Last: leave pleasant memory
In what order should you do impressions on children?
- Older: Lower (comfortable) first
- Younger: Upper (uncomfortable) first, so finish on something that is not as bad
What are some ways to deal with dental fatigue?
- Book for non-invasive appointment in between (e.g. on 3rd appointment book for 15 minute prophy)
- Schedule longer appointemnt intervals (e.g. once every 3 weeks rather than once a week)
What are the recall periods for SADS?
- Low risk: 24 months
- Medium risk: 18 months
- High risk: 12 months (if necessary, 3-6 month fluoride recalls e.g. while waiting for GA)
What are the advantages and disadvantages of having parents in the waiting room?
adv:
-Increases coping effect of child + feeling of security
dis:
- May increase management problems
- may disrupt procedure
- may project anxiety onto child
