Dr Asmaa Faden Treatment Planning Concepts The Dentist’s goal is to provide the best dental...

TREATMENT PLANNING

Dr Asmaa Faden

Treatment Planning ConceptsThe Dentist’s goal is to

provide the best dental treatment for each patient

individually

- Gathering of Information

- Diagnosis

Treatment Planning ConceptsTreatment Plan is a strategy

that may be changed OR adjusted according to the patients needs.

Time is needed for a successful treatment Prognosis

Format of Treatment Plans

Treatment Plans

General Format

Flexible Format

Format of Treatment Plans I-General Format

Phase I(Priority Tx)

Phase II(Disease Control)

Phase III(Restoring Function & Aesthetic)

Phase IV(Re-evaluation & Re-Call)


II- Flexible Format

- A rigid Tx. Plan is not suitable for All Patients

- New information during Tx.

-Tx. Plan needs modification or changes


Phase I (Priority Care)- Eliminate Pain and manage acute infections.

- If possible manage C.C.


Phase II (Disease Control)- To control all disease processes BUT not to eradicate

All diseases.

Format of Treatment PlansPhase III (Restoration of Function &

Aesthetics)- Eliminate the remaining areas of decay.

- Restore the mouth to full function and aesthetics through restorative & prosthodontics procedures.


Phase IV (Re-evaluation & Re-call)

Factors that influence treatment plans:1- The patient’s Health

2- The patient’s Age

3- The patient’s expectations

4- Psychological Factors

5- Existing Dental Conditions

6- The Operator’s philosophy

7- The Prognosis

8- Emergency Treatment

9- Financial Considerations

Factors that influence treatment plans

1- The patient’s Health

• The medical health status of a patient may necessitate

modifications, e.g., prophylactic antibiotics.

• Precautions may include necessary medications prior to

the dental treatment, e.g., diabetic patient or patient

with heart problem.

• Modifications of treatment planned, e.g., one quadrant

per appointment.


2- The patient’s Age

• Chronologic age is a rough indicator of physiologic age,

considering the physical & emotional maturity of the

patient.

• Age can indicate the relative size of the pulp chamber.


3- The patient’s expectations

• Many factors influence the patient's expectations

regarding the dental care (Attitudes, past experiences,

financial concerns).

• Sometimes, the patients desires may be attainable or

unrealistic

• As the patient ages, list of priorities may differ.


4- Psychological Factors

• Modifications to the treatment plans according to the

patients personality may be needed.

• Treatment plan must be designed and presented to

motivate the patient to accept optimal care.

• The Chief Complaint should be managed first, to help

establish that the dentist is listening and cares.


5- Existing Dental Conditions

• The dentist should first determine a diagnosis, which

includes factors such as, the presence and absence of

caries and periodontal diseases, the location and

numbers of missing teeth.

• The dentist should consider what possible treatment

for the existing condition.

• Finally, the dentist decides which treatment option

will provide the best long-term prognosis.


6- The Operator’s philosophy

• In a situation when the dentist is given the choice

between 2 treatment alternatives, he/she is most likely

to choose the option that is consistent with her/his

philosophy of dental care with which he/she has the

most successful outcomes.

• In other cases, when treatment is beyond the ability of

the dentist the case is usually referred to a dental

specialty practice (Ortho, Endo…….)


7- The Prognosis of Proposed Dental Treatment

• The dental treatment plan should be designed with a

definitive goal concerning the longevity of the care

(Timing).

• The amount of time needed to provide comprehensive

care for one patient may not be acceptable to another.

• Generally, the prognosis for any dental reconstruction

should be at least 5 years (with the exception of

transitional dental appliances).


* Four levels of prognosis can be identified to make an accurate predictions

concerning the longevity of treatment plans

1- Teeth with Stable Prognosis: have

no major problems, can be maintained

by Pt. indefinitely

2- Teeth with Guarded Prognosis :

have problems that may render them

poor candidates for indefinite retention,

but can rely on them for an adequate

length of time.

7- The Prognosis of Proposed Dental Treatment, cont’d


* Four levels of prognosis can be identified to make an accurate predictions

concerning the longevity of treatment plans

3- Teeth with Diminished Prognosis:

have predictive longevities of

approximately 1 to 5 years or they are

incapable of contributing a

dependable amount of support for

dental appliances.4- Teeth with Hopeless Prognosis :

are defined as teeth that cannot be

maintained and are indicated for

removal.

7- The Prognosis of Proposed Dental Treatment, cont’d


8- Emergency Treatment

• Emergency patients may have severe pain and may

insist on extraction of teeth rather than other

alternatives such as RCT, which may result in loss of

useful tooth.

• To avoid this, many dentists recommended conservative

treatment to relieve pain and to delay definitive care.

• Decisions can then be decided by the patient after a

thorough diagnosis and formulation of treatment

alternatives


9- Financial Considerations

• Financial factors should not affect the dentist’s

formulation of the best dental treatment plan.

• Modifications may be made to the plan to make it less

expensive, or to deliver only the initial phase of care

and to postponed other phases.

Alternative & Tentative Treatment Plans

Treatment plan for the patient is an OPINION of what the dentist thinks is best for the patient.

This is because:

• The formulation of a professional opinion is the

“service“ dentists provider patients.

• The dentist should not be offended if patients seek a

second opinion.

• More than one way exists to plan treatment for a

patient, many of them are acceptable.

Alternative Treatment Plans

- Alternative treatment plans are developed mainly to provide the patient with options

when finances are a concern.

- Alternatives to treatment may be limited to elimination of diseases, or use of different

types of treatment.

- The dentist should present the plan that is in the patients best interest regardless to

financial cost.

Alternative Treatment Plans

- Alternative treatment plans are sometimes a

necessity, but the dentist should develop

other treatment options that provide the

patient with the highest level of possible care

and the best long-term dental health

potential.

Tentative Treatment Plans

- Some dental diagnosis are so complex that no definitive treatment can be planned until the result of intermediate therapy is determined.

-These require a tentative treatment plan, which are vague but crucial in situations since they determine whether the patient chooses sophisticated or expensive treatment.

Tentative Treatment Plans-Simple tentative plans that involve only one

or two areas of questionable treatment are

much like definitive plans and are easily

explained to the patient.

-Complex tentative plans require a great deal

of explanation (advanced periodontitis with

questionable prognosis on several potential

abutment teeth) fixed, partial or

complete dentures????

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