oh goodness - so much to remember
Treatment planning
1. Assess client’s present level of knowledge about mouth protectors
2. Teach client about the value of wearing a mouth protector during contact sports
3. Teach parent and client emergency care for avulsed tooth
4. Construct a mouth protector and discuss use and care with client
5. Evaluate and fit client with mouth protector
6. Teach both parent and child about perio disease process – use S/S in client’s mouth to help
7. Root planning and anti-microbial therapy
8. Teach parent and child self-care stuff
9. Evaluate knowledge after 1 month
Treatment sequencing
1. Chief compliant – no1, even if just discussion
2. Medical/systemic care – e.g. medically related diagnostic tests and consultations (pt status and control of diabetes
3. Emergency care – Head/neck pain/infection
4. Treatment plan presentation (and consent) – discussion - + alternatives
5. Disease control – To control active disease: endo, perio, restorative, behaviour mod
6. Re-evaluation – reassessment – to continue, alter or discontinue tx
7. Definitive care – procedures to enhance fn and esthetics: ortho, prostho, cosmetic
8. Maintenance care – maintenance of perio health, prevention/detection/tx of caries, prevention of dental attrition/erosion/abrasion
Things to note:
- Functional needs: functional and parafunctional needs/assessment (material selection)
- Esthetics: tooth coloured vs. non-tooth coloured – ANT=composite (43.5mths -72mths), POST=stressbearing amal
o Full/partial cusp coverage: amalgam or cast-metal restorations (good for parafn habits)
§ All-ceramic vs. metal-ceramic: porcelain = esthetics, tho zirconia ceramix core is 7x stronger
Treatment phases
Systemic Phase
Protection of pt health
Conditions that contribute to perio conditions
Conditions req mods of tx plan
Need for medical consultation
Protection of operator/auxillary
Infectious control methods
Hygienic/Initial/Aetiological Phase
Eliminate/reduce plaque
Addresses plaque retentive factors
Tx modalities
Supra-gingival plaque control regime - OH
Root debridement – Subgingival instrumentation
Correction of restorative defects
Antimicrobial agents as adjunct
Extraction of hopeless teeth
Reevaluation
Assessment of clinical response to tx
Indication of tissue response & maturation
Tissue char; colour, contour & texture
Bleeding +/- exudate
Subgingival plaque +/or calculus
Clinical probing depths & AL
Elimination of inflamm à maintenance
Selective instrumentation à reevaluation
Surgical tx req
Corrective Phase
Tx of sequelae of disease
May involve: Occlusal
Sx
Restorative
Aims to satisfy needs for aesthetic & function under condition of health
Maintenance Phase/Supportive Perio Therapy
Principle of Chronic Disease mgmt
Reevaluation
Early interception – selective instrumentation
Prevention – OH review; plaque/calculus removal; evaluation of risk factors
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