Quartz 4

T1 Treatment Planning

7 min read

Introduction To Treatment Planning

DENT4219: Lecture 1

Defining Treatment Planning12

This session serves as an introduction to the fundamental question: What is treatment planning?

Definition

Treatment planning involves determining the sequence of restorations or actions required. It is necessary to consider everything presented and coordinate the information.

Contact Information: poh.hun.loh@uwa.edu.au

Course Overview and Assessment

Learning Activities3

  • Lectures and small group activities
  • Formative group activities
    • Case planning simulation

Assessment Components

  • Module assessment (Semester 2 exam period):
    • Multiple Choice Questions (MCQs)
    • Short Answer Questions (SAQs)
  • Ongoing clinical assessment
  • Professionalism and attendance

Defining Treatment Planning4

What is treatment planning?

Terminology and Definitions5

Core Concepts6

  • Management
  • Treatment
  • Sequence
  • Procedure
  • Step

Rationale for Treatment Planning

Objectives of a Treatment Plan7

  • Address patient’s problem(s)
  • Sequence and prioritise
    • Step
  • ==Sequence of Action: Planning what is being done and when it is being done.==
  • ==Preventive Measures: Decisions made during the planning process often involve undertaking preventive measures.==-wise model vs. Reactive
  • Estimates costs ($)
  • Patient Communication leading to Consent
  • Medico-Legal requirement
  • Communication with other clinicians
    • ==Coordinated Sequence: A primary objective is to provide a coordinated sequence; even a very simple treatment plan can solve a significant number of issues.==

Professional Standards for Fees and Planning9

According to Simon Gomersall, solicitor:

“Time and time again, dentists face criticism because they had not given the patient a clear treatment plan and details of proposed fees.”

Documentation and Timing10

Ensure that you provide written treatment plans setting out the cost of each part of the proposed treatment as well as other treatment options and provide your treatment plans in advance of the treatment itself.

Patient Deliberation11

Allow your patients time to consider these and come back with any questions.

Assumptions Regarding Consent12

If you are seeing a patient on behalf of a colleague or are taking them over from a previous practitioner, never assume their consent to treatment on the basis of previous notes; always ask.

Professional Communication1314

Stakeholders in Communication15

  • Internal (within the practice):
    • Institutions
    • OHCWA – critical, especially with multiple clinicians of varying skill levels.
  • External:
    • Specialists and other dentists interstate or overseas.
  • Health funds
  • Medico-legal:
    • Regulatory authorities (AHPRA), lawyers, etc.

Timeline: 9:30 AM - Pizza time! Pizza party

OHCWA → PMP (now digital)

Clinical Application

Complexity and Limitations16

Simple vs. Complex Examples17

  1. Perio IPT
  2. OHI
  3. G6 DO
  4. Maintenance 6/12 review

Simple vs complex

Human Behavior in Clinical Settings

Human behavior in schools can sometimes be restricted by programmed sequences, creating a contrast between a simple treatment plan and a "perfect station."

Misconceptions of Treatment Planning18

A treatment plan is not:

  • Reactive: It should be proactive, though modified in response to new information.
  • Fixed: It must be adaptable.
  • Item numbers on a page: Patient management software like TOHM fosters this narrow view.
  • All about money: While patients worry about the treatment estimate, do not let finances dictate the clinical treatment.

Factors Influencing the Plan

Clinical Foundations19

A treatment plan depends on:

  • Planning requires examining questions appropriately and utilizing details and information from recent revitalized dentists.

  • History

  • Thorough assessment, evaluation, and clinical findings

  • Diagnosis

  • Problem list

  • Treatment options

  • Indications and contraindications

  • Prognosis (Short, medium, and long term)

  • Competence
  • Education and Skills
  • Experience
  • Geography
  • Facilities and equipment
  • Access to technical support
  • Specialist services

  • Relationship with clinician
  • Expectation
  • Attitudes and motivation
  • Age
  • Gender
  • Cost and finances
  • Attendance
  • Maintenance

Patient Education and Psychology

Patient Understanding and Risk Management22

  • The key goal is to make the patient understand they have a problem.
    • Educate them about the condition.
    • Explain the consequences if left untreated.
    • Position yourself as helping them.
    • Establish the treatment plan as the first step.
  • Complications and Prognosis:
    • Risk management through advanced warning.
    • Full disclosure.

The Health Belief Model

Core Concepts of Treatment Acceptance23

Patients must accept, believe, or understand four concepts before accepting treatment:

  1. They are susceptible to disease.
  2. Having or contracting the disease has serious consequences.
  3. Disease can be prevented or limited if the patient receives treatment or alters behavior/activities.
  4. Preventive activities are better than the disease.

Model Components24

  • Modifying Variables influence:
    • Perceived Benefits vs. Perceived Barriers
    • Perceived Threat (derived from Perceived Seriousness and Perceived Susceptibility)
    • Self-Efficacy
  • Likelihood of Engaging in Health-Promoting Behavior is determined by:
    • Perceived Benefits vs. Barriers
    • Perceived Threat
    • Self-Efficacy
    • Cues to Action

Effective Communication Strategies

Bridging the Knowledge Gap25

  • The majority of patients do not understand dentistry.
  • Patients understand tangible issues:
    • Holes/decay
    • Disease
    • Redness/bleeding
    • Pain
    • Black/discoloured teeth
    • Gaps
    • Ugly/Crooked teeth
  • Most patients provide informed consent if you address these specific concerns.

Professional Conduct26

  • Most patients are reasonable and seek value and high-quality treatment for their money.
  • Avoid the “sales pitch”:
    • Act as a health professional.
    • Ignore the competition.
    • Always present the ideal treatment option.

Clinical Reasoning and Documentation27

Compliance and Records28

  • Patient consent
  • Documentation
  • Record keeping
  • Financial Costs (short, medium, and long term)

Teaching Clinical Reasoning29

Instructor Resources from the Faculty of Nursing & Midwifery, University of Newcastle.

The Clinical Reasoning Process30

Figure 2: The clinical reasoning process with descriptors (The University of Western Australia).

Clinical Reasoning Focus

The process involves giving "oxygen" or careful consideration to all factors in front of the clinician to ensure they are responsible for the decisions made.

Summary and Conclusion

Key Takeaways31

  • Work towards helping and solving the patient’s problem.
  • Control disease.
  • Prioritise care.
  • Focus on maintenance.
  • Establish prognosis across short, medium, and long-term horizons.

References and Suggested Reading

Audio Appendix

Additional Audio Content

The following sections from the lecture audio did not correspond to any heading in the main document.

Case Study: Decision Making in Dentistry

In specific cases, decisions are made based on the information gathered to determine the necessary preventive measures and the sequence of restorations.

Footnotes

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