IMPLEMENTATION GUIDE Module 5 Treatment Planning

Transcription

1 IMPLEMENTATION GUIDE Module 5 Treatment Planning Dental Hygiene Solutions Module 5 Dentalhygiene.solutions 1

2 Please take time to view the Documentation Bonus Video Module 5 Point Clinical Philosophy 1. Individualized Restorative/Aesthetic Periodontal Treatment Planning 2. Open-ended Restorative/Aesthetic/Periodontal Treatment Planning 3. Repetitive Therapy 4. All Encompassing Therapy 5. Closely Monitored System 6 Categories of Gingival Diseases 7 Categories of Periodontitis Numerous sub-categories Balance Point / Biofilm Threshold is defined as: The length of time a patient can go between professional sub-gingival biofilm disruption and remain in disease remission. Periodontal Maintenance Periodontal Therapy designed to help keep the patient in disease remission after establishing the patients balance point. Dental Hygiene Solutions Module 5 Dentalhygiene.solutions 2

3 Treatment Flow Chart Gingivitis Patient Dental Hygiene Solutions Module 5 Dentalhygiene.solutions 3

4 Chronic Periodontitis Chronic periodontitis is defined as inflammation of the gingiva extending into the adjacent attachment apparatus. The disease is characterized by loss of clinical attachment due to destruction of the periodontal ligament and loss of the adjacent supporting bone. Therapeutic Goals The goals of periodontal therapy are to alter or eliminate the microbial etiology and contributing risk factors for periodontitis, thereby arresting the progression of the disease and preserving the dentition in a state of health, comfort, and function with appropriate esthetics; and to prevent the recurrence of periodontitis. In addition, regeneration of the periodontal attachment apparatus, where indicated, may be attempted. Goals During Treatment Eliminate the microbial etiology Eliminate contributing risk factors for periodontitis, preserve the dentition in a state of health, comfort, and function with appropriate esthetics Prevent the recurrence of periodontitis. regeneration of the periodontal attachment apparatus, where indicated, may be attempted. More Information Access Here: Dental Hygiene Solutions Module 5 Dentalhygiene.solutions 4

5 Treatment Flow Chart Chronic Periodontitis Patient Dental Hygiene Solutions Module 5 Dentalhygiene.solutions 5

6 Patient: 69 Yr. Old African-American Female Retired Medical History Arthritis Osteoporosis High Blood Pressure Medications Corig 5 yrs 1 X/day Diovan 5 + yrs 1X/day Fosamax 3 yrs 1X/wk Case Study 1. How would you describe the above (in the red circle) 2 X 3 mm lesion? What is this lesion and what would you recommend to the patient regarding this (if anything)? Dental Hygiene Solutions Module 5 Dentalhygiene.solutions 6

7 RADIOGRAPHS Dental Hygiene Solutions Module 5 Dentalhygiene.solutions 7

8 Perio Chart Now Write Your Treatment Plan According To This Information What is the AAP Classification? What is the Prognosis? What are your Treatment Goals? Write your Treatment Plan Include all your chart notes: What was completed today for treatment What anesthetic will you use? Write your post-op instructions Write homecare instructions How do clinicians sign the patient record? Are clinician initials acceptable? Do you include clinician license#? What other information do you want to record in the patient record? Dental Hygiene Solutions Module 5 Dentalhygiene.solutions 8

9 If you use abbreviations always have documentation about what those abbreviations mean in case this record becomes a court of law and you are asked what these abbreviations mean. Your Treatment Plan Notes After viewing the Bonus Video for this module, write your documentation notes and share with your team. Does everyone provide documentation notes that includes the same information as mentioned in the video? If you use electronic records, can you create a simple (fill-in the blank) template so all clinicians will provide the same chart notes for each patient? Dental Hygiene Solutions Module 5 Dentalhygiene.solutions 9

10 Here is what the original clinicians notes for Phase I Therapy: Lesion Documentation Notes: 2 X 3 mm Papilloma on facial between #21-22 (lower left canine and 1 st bicuspid) Observe this lesion as it is benign today. ORALID assessment is negative. 1 st Hygiene Appointment: SRP UR/LR Quads o Cavitron with thin inserts o Graceys and Universals o Localized delivery of Arestin (Upper right second Molar #2D & Lower right second molar #31B) 2 nd Hygiene Appointment: SRP UL/LL Quads o Cavitron with thin inserts o Graceys and Universals o Localized delivery of Arestin (Lower left second molar #18M) Treatment Goals Alter or eliminate microbial etiology FM Subgingival irrigation w/ CHX o SRP o Localized delivery of Arestin Arrest disease Preserve periodontium in a state of health, comfort and function Patient instruction and reinforcement and evaluation of home-care Patient Education Provided: MI Paste (prevention of dentin hypersensitivity) Power Toothbrush Floss (demonstrate correct use) End-tuft brush (use dry to control supra in lower lingual areas) Dental Hygiene Solutions Module 5 Dentalhygiene.solutions 10

11 Post Therapy Images Gingival Description Post Treatment Gingiva Pale Pink, firm consistency and slight generalized inflammation on the lingual and facial aspect. Prognosis Fair Dental Hygiene Solutions Module 5 Dentalhygiene.solutions 11

12 Post Treatment Perio Chart Dental Hygiene Solutions Module 5 Dentalhygiene.solutions 12

13 Comparison Perio Chart Therapeutic Results Alter or Eliminated microbiological etiology Perio disease progression arrested Dentin preserved to a state of health Restored function and patient comfort 3 Month Periodontal Maintenance Patient has high risk for: BOP In-efficient home-care Advanced CAL Medications: adverse reactions Consider systemic risks Dental Hygiene Solutions Module 5 Dentalhygiene.solutions 13

14 Do you agree with this clinician s findings and notes? What would you do differently? If you would change anything about what this clinician completed or recommended, why would you change this? What evidence-based science will support your changes or recommendations? Dental Hygiene Solutions Module 5 Dentalhygiene.solutions 14