How to assess new pt?
- Comprehensive hx: HPC etc
- Clinical exam
- Special investigation
- Diagnosis and prognosis
- Tx strategy
How to take comprehensive hx?
- Reason for attendance: PC, HPC
- Relevant medical hx
- Relevant dental hx
- Relevant social/ family hx
- Expectations
What q’s to ask when doing HPC?
SOCRATES Nature of pain Site Duration Initial onset Exacerbating factors
What q’s ask dental hx?
Previous tx
Dental attendance record
Anxiety
Dietary info
What should be included clinical examination?
- General: EO/IO
- BPE and dental chart
- Focus PC
- Detail: endodontics, prosthodontics, periodontics
What involved diagnosis?
Establish diagnosis for every condition noted in assessment
If can’t find diagnosis - give differential (must be addressed in tx strategy)
What factors are prognosis based of?
Individual and specific risk factors
Ability to institute prevention
Operative considerations
Ability to institute maintenance
What is aim of tx?
Functional, disease free and structurally sound dentition that can be maintained effectively in a durable and predictable manner
6 stages of tx strategy?
- Establish aims of tx
- Concentrate stabilisation of disease
- Undertake pt-centred review of outcome - consider plan for restoration of structure, aesthetic and missing teeth
- Tx plan for advanced restorative care
- Evaluation outcome
- Establish maintenance plan
7 stages of tx planning?
- Initial assessment/ emergency tx
- Control of disease
- Stabilisation of structure
- Assessment of foundation of structures
- Definitive tx plan
- Review outcomes
- Maintenance plan
How to maximise pt factors?
Assess motivation - +Ve feedback Present options - give advice based on best option Agree tx plan Tx phase - explain problems may arise Maintenance - ensure compliance
How to avoid litigation?
Present problems honestly/ clearly
Explain possible complications
Don’t underestimate pt compliance
Clear and comprehensive notes
