Documente Academic
Documente Profesional
Documente Cultură
Treatment Planning
a. Chief Complaint
the problem that initiated the
patients visit
record the complaint verbatim in the dental record
the patient should be encouraged and guided to discuss
all aspects of the current problem: a) onset; b) duration;
c) symptoms; d) related factors
Information is vital to establish the need for specific
diagnostic tests and to determine the cause and
treatment of the complaint
I. Patient Assessment
b. Medical Condition and History
Helps to identify conditions that could alter, complicate or
contraindicate the proposed dental procedures
Communicable diseases which require special precautions ,
procedures, or referral. Affects patient management and may
contribute potential transmission hazards within the dental practice
Allergies or medications that may contraindicate the use of
certain drugs
Systemic diseases and cardiac
abnormalities which demands less
strenuous procedures or prophylactic
antibiotic coverage
Physiologic changes associated with
aging which may alter clinical presentation
and influence treatment
I. Patient Assessment
b. Teeth
Visual changes in tooth surface texture and color
Tactile sensation when an explorer is used judiciously
Radiographs
Transillumination
- for Caries Diagnosis
II. Examination / Diagnosis
Caries Diagnosis:
1. Amalgam blues
bluish hue results from 1) leaching of corrosion products of
amalgam into dentinal tubules: 2) colors of underlying amalgam as
seen through enamel (occurs when the enamel has no dentin
support e.g. undermined cusps, marginal ridges)
- For replacement: 1) elective improvement of esthetics, 2) areas
under heavy functional stress rearing cusp capping
2. Proximal overhang
diagnosed visually, tactilely and radiographically
- amalgam-tooth junction; evaluated by: 1) moving explorer back &
forth across it confirmed by catching or 2) tearing of dental floss
- effect: plaque trap
II. Examination / Diagnosis
3. Marginal gap or ditching
deterioration of the amalgam-tooth interface as a result of wear,
fracture or improper tooth preparation
- explorer dropping into an opening as it crosses the margin
- shallow ditching of less 0.5mm deep may not a reason for
replacement because of the eventual self sealing property of
amalgam allows the restoration to serve adequately.
- if the ditch is too deep needs replacement
- Why? 1) it jeopardizes the integrity of the remaining restoration;
2) secondary caries frequently found around marginal gaps
near the gingival wall
II. Examination / Diagnosis
4. Voids
other than ditching at the margins of the restoration
- If void is at least 0.3mm deep and is located in the gingival third of
the tooth crown the restoration is defective and should be repaired
or replaced
5. Fracture line
across the occlusal portion of the amalgam restoration specifically
isthmus region
General Considerations:
1. Infection Control
2. Charting and Records
a. Uncomplicated easily understood by dentist and
staff
b. Comprehensive noting all normal and abnormal
dental conditions; including a detailed representation
and location, nature, and size of all restorations.
c. Accessible
d. Current / Updated
Treatment Plan Sequencing
The exact location and condition of all teeth, restorations,
defects, caries, and soft and hard tissues are necessary for many
reasons, including the following:
Proper care: thorough charting provides basic information for an
accurate, comprehensive treatment plan.
Third-party communication: accurate records of the patients
conditions are useful in communicating with third-party payment
agencies.
Practice audits and quality assessment
Legal proceedings: the dental record is considered legal,
admissible, evidence in arbitration of contended negligence or
malpractice.
Forensic uses: the dental record is the only means of
identifying a deceased person.
3. Tooth denotation system
Thank you