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)
Format of Treatment Plans
II- Flexible Format
- A rigid Tx. Plan is not suitable for All Patients
- New information during Tx.
-Tx. Plan needs modification or changes
Format of Treatment Plans
Phase I (Priority Care)- Eliminate Pain and manage acute infections.
- If possible manage C.C.
Format of Treatment Plans
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.
Format of Treatment Plans
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.
Factors that influence treatment plans
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.
Factors that influence treatment plans
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.
Factors that influence treatment plans
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.
Factors that influence treatment plans
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.
Factors that influence treatment plans
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…….)
Factors that influence treatment plans
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).
Factors that influence treatment plans
* 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
Factors that influence treatment plans
* 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
Factors that influence treatment plans
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
Factors that influence treatment plans
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????
طيبين انتم و سنة كل و