I believe that comprehensive treatment planning is essential for every patient. And, when it comes to extensive dentistry, comprehensive treatment planning becomes even more important. What is extensive dentistry? In general, it’s a series of procedures to eliminate active disease in the mouth, such as caries and periodontal inflammation; restore or replace teeth that are diseased, damaged or missing; therapies for temporomandibular joint pain that include occlusal splints for muscle relaxation, realignment of teeth, and modification of occlusal surfaces to create a harmonious bite; and also, procedures to make cosmetic corrections, oftentimes in concert with above mentioned procedures.
Imagine you need multiple dental crowns, but in order to properly space them and give you a comfortable bite and maintain these restorations for the longest time possible, your teeth need to be realigned into the best position. You would want a comprehensive plan of treatment that will allow for a course of orthodontics plus the crowns. Imagine you have a missing tooth and look forward to replacing that tooth with a dental implant and crown, but you also are unhappy with your smile for other reasons and long for a total smile makeover. Invisalign treatment might be the most appropriate first step before your implant treatment is done. Whatever you invest in today, you want to last and make the next dental work you need or desire, not only feasible but uncomplicated.
I believe that comprehensive treatment planning involves one or more specialists when a patient’s dental procedures would be most appropriately performed by a specialist in those procedures. This includes advanced orthodontics, periodontal soft and hard tissue surgery, third molar extraction, most root canal procedures, implant placement and all implant related surgeries such as sinus lifts and bone grafts.
My patients are special to me, and I believe they are deserving of the best minds and most experienced clinicians coming together to make sure their treatment will successfully achieve the best, most desired outcomes. And, this is why I am in multiple study clubs with specialists in our Boynton Beach area.
As a general dentist, it is my role to understand all the circumstances relating to my patient’s oral health, understand what the patient wants to achieve, and the patient’s priorities and preferences. It’s my responsibility to put my full attention on their unique set of circumstances and understand all the underlying causes of why their mouth is the way it is. This requires meaningful conversations with patients, careful examination, and thorough diagnosis. Many times, it means I will spend significant time analyzing the dental records, including radiographic images, photographic images, and models of the patient’s mouth. Many times, I sculpt wax-up models of changes that will be made and make sure the bite will be harmonious and the aesthetics optimal. Then and only then, am I aware of all the issues that will need to be addressed in order to have the desired best outcome.
When I review a patient’s records with an interdisciplinary specialist, we ask ourselves numerous questions. Will extraction and implant replacement of a tooth be more conservative and long-lasting than a crown on a tooth that is failing? Will Invisalign treatment adequately realign teeth into proper alignment and spacing or will other orthodontic technology be better for the specific situation? Will there be room to place an implant without moving teeth orthodontically? Is there adequate bone tissue in that site for an implant or will a bone graft be needed? Is gum inflammation so great that restorative treatment should be delayed, or can the gum tissue and teeth be treated simultaneously?
Review of a case with a specialist is one aspect of some treatment plans. Review with the patient and patient involvement is always an aspect of a treatment plan.
When it comes to replacement of missing or failing teeth, the patient and I need to spend time talking about what will be most appropriate for the patient. Implant treatment has many major advantages over a removable denture or traditional crown and bridge treatment. Therefore, the standard of care is to always consider implant treatment as an option. Doing so, however, requires determining exactly what would be involved and the cost. Three-dimensional cone beam images will be needed to assess best implant treatment and whether the patient will need a bone graft. I encourage my patients to understand all their options before making the decision that is right for them.
When I think of the comprehensive approach to dentistry, I think of how the entire masticatory system functions, the health of everything associated with the mouth… the aesthetics of the smile… the comfort of my patient. I think about careful, thorough diagnosis and conversations with the patient and the specialists in my study clubs to plan the best course of treatment to address present issues as effectively and efficiently as possible. The goal is quality, long-lasting treatment. I think about what is best for my patient.
Comprehensive treatment planning–no matter how simple or complex your needs might be, always involves:
• evaluation of your medical and dental history
• proper diagnosis
• appropriate dental treatment planning
Sometimes this involves one or more specialists. Sometimes this takes a little time. A proper diagnosis comes from knowledge and experience. After fifteen years in practice and hundreds of hours of advanced post-doctoral education, I confidently go about this. But, patient involvement is critical to appropriate treatment planning. I have found the best pathway to success is to visualize the optimal end result, share it with the patient, and then involve the patient in deciding the best way to get there. Commonly, comprehensive treatment is done in affordable stages. There is a plan of sequential procedures, much like building a house from architectural plans.
Thorough diagnosis and comprehensive treatment planning might take extra time, but I have learned it is worth it. Patients move forward with confidence, and the results are predictable. Life-transforming health, comfort, beauty, and optimal function are achieved.