Phases of treatment planing ppt

Phases of treatment planing

1. Phases of Treatment planning Department of Oral Medicine and Radiology BPKIHS , CODS Resource faculties: Prof. Dr. Jyotsna Rimal Dr. Ichha Kumar Maharjan Dr. Pragya Regmi Presenter: Amrit Raj Jaishi (662)

2. Content Introduction Basic principles Phases Comprehensive treatment plan Modification Treatment planning in our context Merits of treatment planning Summary.

3. TREATMENT PLAN Development of a treatment plan is the most critical step in the successful future management of the patient DIAGNOSIS----Provisional diagnosis Final Diagnosis

4. Formulate Treatment Options Treatment Plan The golden rule of treatment planning is that a diagnosis should be made before treatment begins. Caries Risk Assessment Patient’s Preferences/factors (Subjective Findings ) Problem Lists (Objective findings from oral and radiograph exam) Patient’s Preferences Informed Consent

5. “ The sequential guide for the patient’s care as determined by the dentist’s diagnosis and is used by the dentist for the restoration to and/or maintenance of optimal oral health” -American Dental Association

6. Treatment plan is their required treatment that our plan is based upon Basic Principles involved… Afford patient opportunity to make well informed decisions Educate and advise patients Medical risk assessment should be done

7. Phases of treatment plan

8. Acute Phase :Preliminary phase

9. Preliminary phase Emergency phase includes the chief complain along with those dental problems producing acute symptoms and their potential sources.

10. . Soft tissue lesion Painful , infected and hopeless teeth Bad oral habits like, chewing paan tobacco Stoppage of bleeding

11. Non-Surgical phase Plaque control and patient education

12. Patient Education In patient with rampant caries advices such as diet controlling can be a preventive measure. Awareness regarding oral hygiene –practices like type of brush, materials used, techniques and frequency of brushing.

13. Dietary instruction: Balanced diet with exclusion of cariogenic and retentive food. Use of topical fluorides. Use of anti plaque agent (chlorhexidine, delmopinol etc ). Pit and fissure sealants.

14. Evaluation to Non-Surgical phase Rechecking Pocket depth and Gingival inflammation. Plaque , Calculus , Caries.

15. The most popular traditional indication is the presence of pockets of ≥ 5mm . Irregular bony contours Degree II and III furcation involvements. Distal areas of last molars with expected mucogingival problems. Persistent inflammation. Root coverage. Removal of gingival enlargements.

16. Includes extraction of teeth which cannot be restored / which do not have adequate bone support. It includes periodontal surgeries , including placements of implants. Endodontic procedures. Surgical Phase

17. Final restoration Periodontal examination Space maintainers for children Fixed and removable prosthodontic appliances Single crowns, inlays or onlays Restorative Phase

18. Maintenance P hase Recall Periodic rechecking Evaluation of procedure after treatment is done Usually after 6 month of interval

19. EMERGENCY PHASE NONSURGICAL PHASE MAINTENANCE PHASE SURGICAL PHASE RESTORATIVE PHASE

20. Comprehensive treatment plan (based on levels of prevention) Emergency phase Promotive phase : Based on health promotion. Eg: oral hygiene instructions, diet counseling, habit counseling. Preventive phase: Sealants, fluoride application, oral prophylaxis if preventive.

21. 4. Curative phase : based on early diagnosis and prompt treatment and disability limitation. Eg: Oral prophylaxis if curative, restorations, extractions, periodontal treatment. 5. Rehabilitative phase : dentures- CD, RPD , FPD 6. Maintenance phase : periodic recall

22. Modified Treatment P lan for Medically C ompromised P atient Based on medical complexity status classification and protocol ,patients are categorized and treatment planning is done accordingly.

23. It is helpful to focus on the following three questions. What is the likelihood that the patient will experience an adverse event due to dental treatment ? What is the nature and severity of the potential adverse event ? What is the most appropriate setting in which a patient can be treated ?

24. T he four major concerns that must be addressed when assessing the likelihood of the patient experiencing an adverse event are : Possible impaired hemostasis Possible susceptibility to infections Drug action and drug interaction The patient’s ability to withstand the stress and trauma of dental procedure

25. Finally based on the type and severity of the medical condition the patient can be treated as one of the following: Outpatient in general dental office Outpatient in dental office with more extended resources for resuscitation Patient in a short procedure unit in a hospital Inpatient in a operating room

26. Treatment Planning in our context Based on the patient’s economic condition, treatment plan can be either ideal or economical. Ideal for patient with high economic status , I n addition to reconstructive works, cosmetic and implant procedure (veneers, laminates, braces) are the expected outcomes.

27. Economical Patient with low economy and require basic dental work in order to have functional mouth. E.g. Replacement of fixed partial denture with removable partial denture and Fixed appliance with removable appliances

28. Merits of Treatment P lanning Chair time can be saved and begin immediately. Diagnostic decisions are made at once avoiding rediagnosing at each time. Permits the dental assistants to prepare the required instrument.

29. Hence, treatment plan is a blue print for a case management that includes all procedures required for the establishment and maintenance of oral health .

30. References Burkett's Oral Medicine Carranza’s clinical Periodontology Public Health Dentistry 5 th edition Soben Peter Wikipedia

31. Soft-tissue injuries. Injuries to the soft tissues, which include the tongue, cheeks, gums, and lips, result in bleeding. To control the bleeding , Rinse your mouth with a mild salt-water solution . Use a moistened piece of gauze or tea bag to apply pressure to the bleeding site. Hold in place for 15 to 20 minutes . To both control bleeding and relieve pain, hold a cold compress to the outside of the mouth or cheek in the affected area for 5 to 10 minutes . If the bleeding doesn't stop, see your dentist right away or go to a hospital emergency room. Continue to apply pressure on the bleeding site with the gauze until you can be seen and treated.

32. MCQ

33. 1. Occlusal therapy and minor orthodontic movement comes under which phase of treatment plan? Surgical Phase Non Surgical phase Restorative phase Emergency phase

34. 2. An ideal treatment plan should be? Rational Scientific Definitive All of the above

35. 3. Based on history, clinical and radiographical examination ,clinical diagnosis of ameloblastoma was made. Treatment plan was formulated to manage the case. what is the phase of treatment. Preliminary phase Surgical phase Phase 1 Phase 2 Both b & d

36. 4. Which of the following is correctly matched for treatment planning? Phase 1--- emergency phase Phase 4--- surgical phase Phase 3--- restorative Phase 4--- oral prophylaxis