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1. FORMULATING A
DENTAL TREATMENT
PLAN

2. INTRODUCTION
BEING A DIAGNOSTICIAN IS PART OF
THE SKILL OF A GOOD CLINICIAN!
THE CLINICIAN SHOULD ACQUIRE
THE FUNDAMENTALS IN
GATHERING & INTERPRETING
CLINICAL INFORMATION.

3. DENTAL TREATMENT AND
PLANNING
AN ART
DEVELOP TALENT
A SCIENCE
TAUGHT

4. HISTORY
MAIN COMPLAINT –M/C
HISTORY OF MAIN COMPLAINT -HMC
PAST DENTAL HISTORY -PDH
GENERAL MEDICAL HISTORY -GMH

5. HISTORY(CONT)
SOCIO-ECONOMIC
HABITS
CULTURAL / CUSTOMS

6. B) EXAMINATION
1) EXTRA ORAL EXAMINATION –EOE
 SYMMETRY ( Facial )
 LIPS
 LYMPH NODES
 TMJ

7. B) EXAMINATION
2) INTRA ORAL EXAMINATION -IOE
Oral mucosa –colour , texture , DMS
Tongue
Periodontium
Teeth
Occlusion
Prosthesis (if any)

8. C) SPECIAL INVESTIGATIONS
RADIOGRAPHS
VITALITY TESTS
STUDY MODELS
DIET ANALYSIS
OTHER ( Blood Tests )

9. C) SPECIAL INVESTIGATIONS
RADIOGRAPHS -panelipse X-ray
bitewing radiographs
periapical radiographs
•VITALITY TESTS -electric pulp testing
thermal tests
percussion
palpation
colour
presence of a sinus
test cavity prep

10. DENTAL CHARTING
A) PERIODONTAL CHARTING
-plaque indices
-probing depths
-bleeding points
-gingival level
-tooth mobility

11. DENTAL CHARTING (cont)
B) CONSERVATION CHARTING –
( Tooth )
-caries
-existing restorations

12. DENTAL CHARTING (cont)
TOOTH NOTATION SYSTEMS
1) Palmer System
2) FDI System-(Federation Dentaire
Internationale)

13. Dental Charting(cont)
TOOTH NOTATION (cont)
3) US Tooth Notation System
4) Letters & Numbers Tooth Notation
System

14. Treatment Planning
“Treatment planning is the key factor which
separates a technician from a professional.
It can be the stimulating challenge which changes
the drudgery of a patchwork practice into an
orderly and logical progression of
comprehensive treatment.”
Hocott 1984

15. TREATMENT PLANNING(cont)
Basic Principles
-educate and advise patients
-be open and honest
-afford patient opportunity to make
well informed decisions —Importantly,
it’s their required Rx your plan is based
upon!

16. TREATMENT PLANNING (cont)
REMEMBER!!
KEEP YOUR TREATMENT PLAN
S-SIMPLE
A -AFFORDABLE
A -ADAPTABLE

17. GOD GIVEN TEETH
DESTRUCTION
RESTORATION
SUCCESS FAILURE
RISKS vs BENEFITS!

18. TREATMENT
PLANNING(cont)
DATA COLLECTION
ORGANISATION & VISUALISATION
TREATMENT OPTION
IDEAL Rx REALISTIC Rx
PLAN PLAN

19. TREATMENT PLANNING
(cont)
IDEAL Rx PLAN
-attitude
-desire
-finances
-health
-other modifying factors
WILL THE END JUSTIFY
THE MEANS?
?should Rx be undertaken?
?chance of success over a
long period?
REALISTIC Rx PLAN
Rx sequencing
Treatment
Maintenance
NB!!continued reassessment
at EACH stage!

20. MODIFYING FACTORS IN Rx
PLANNING PROCESS
1. Quality of life
2. Prognosis without Rx
3. Patient attitude
4. Iatrogenic potential
5. Expected duration & prognosis
6. Possibility for repair
7. Dentist and lab limitations
8. Flexibility
9. Benefits vs Costs+Risks
10.Primary complaint
11. Referral Possibility

21. TREATMENT PLANNING (cont)
TREATMENT SEQUENCING
1. EMERGENCY Rx
-m/c
-drainage & Rx of dental abscess
2. HIGH PRIORITY Rx
-extraction of hopelessly involved teeth
-caries control
-coronal scaling & polishing+OHI
-pulpotomies and pulp extirpations

22. TREATMENT SEQUENCING
(cont)
3. LOW PRIORITY TREATMENT
-Endodontic therapy
-restoration of carious lesions
-temporary splinting
-re-evaluation

23. TREATMENT SEQUENCING
(cont)
4. MAINTENANCE
-3/12
-6/12
* CONTINUED REASSESSMENT AND RE -EVALUATION!

24. TREATMENT PLAN(TX)
“TX” SHOULD TAKE THE PATIENT AND
DENTIST TO THE POINT WHERE
DISEASE IS CONTROLLED AND THE
DENTITION IS FUNCTIONAL , STABLE
AND ACCEPTABLY AESTHETIC !

25. TREATMENT SEQUENCING
SEQUENCE OF “TX” CAN BE BROKEN
INTO STAGES…

26. TX SEQUENCING
1.STABILIZATION
•RELIEVE PAIN –
TEMPORARY RX
•PERMANENT RX
•EXTRACTION
2. REASSESSMENT 1
* ORAL HYGIENE
* ASSESS TEMPORARY
RX –IS IT
RESPONDING-EG.
REVERSIBLE
PULPITIS ( ?
INDIRECT PULP CAP
/ OR RCT )

27. TX SEQUENCING
3. PRELIMINARY
RESTORATIVE
PHASE
PERFORM URGENT RX
FIRST.
* COMPLETE ALL
PROCEDURES THAT
ARE NECESSARY.
* WAIT FOR HEALING.
4. REASSESSMENT 2
•ORAL HYGIENE
•CHECK FOR NEW
DISEASE –EG
BROKEN
RESTORATIONS

28. TX SEQUENCING
5. DEFINITIVE
RESTORATIVE PHASE
* SCALE AND POLISH
* FLUORIDE RX
* FISSURE SEALANTS ETC
* COMPLETE ALL
RESTORATIONS
6. REASSESSMENT 3
•CHECK ORAL
HYGIENE
•POLISH AMALGAMS

29. TX SEQUENCING
7. MAINTENANCE
RECALLS –EVERY 6
WEEKS
3 MONTHS
6 MONTHS ETC…

30. TX SEQUENCING
STABILIZATION
REASSESSMENT 1
PRELIMINARY RESTORATIVE PHASE
REASSESSMENT 2
DEFINITIVE RESTORATIVE PHASE
REASSESSMENT 3
MAINTENANCE

31. TREATMENT OPTIONS
ORTHODONTICS
PERIO /
MFOS OCCLUSION RESTORATIVE
& TMJ
PROSTHODONTICS
ENDODONTICS