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periodontal treatment plan

When indicated, the plan should include: 1. The goals of the treatment plan are to eliminate and control etiologic and predisposing factors of disease, maintain health, and prevent recurrence of disease. So, the phases of treatment plan are, Emergency phase. Phase I therapy describes the procedures that are designed to control or eliminate the etiologic factors of the disease process. In 1999, an international group of periodontal experts approved the classification system currently in use. 5: Calculus and Other Disease-Associated Factors, 9: Systemic Factors Influencing Periodontal Diseases, 12: Plaque Biofilm and Disease Control for the Periodontal Patient, 11: Occlusion and Temporomandibular Disorders, 18: Prognosis and Results After Periodontal Therapy, Periodontology for the Dental Hygienist 4e. Use a mouth rinse to help reduce plaque between your teeth, if recommended by your dentist. 4. [The periodontal treatment plan]. Scaling and root planing is sometimes followed by adjunctive therapy such as local delivery antimicrobials, systemic antibiotics, and host modulation, as needed on a case-by-case basis. The dental hygienist noted the redness and swelling that remained in the tissue and reinstrumented the area. The overall approach of this classification system separates gingival disease from periodontal disease and conditions affecting the periodontium. Prevention and Treatment of Periodontal Diseases in Primary Care. Phases of treatment plan. Substantial amounts of calculus remained on the tooth. Carranza and collaborators divided the treatment plan into four main phases. Patient education and plaque control instruction occur at the beginning of this phase. 8. • Identify the patient factors to be considered when establishing the treatment plan sequence. Figures 10-1 to 10-4 are examples of successful therapeutic results achieved by a dental hygienist providing Phase I therapy. Such teeth often serve as abutments for fixed and removable partial dentures, and their position in an arch may add stability to a dental prosthesis. That specialist, such as an oral surgeon or periodontist, would become involved in helping to create the final treatment plan and in rendering treatment, if needed. Most patients who have been treated for moderate to advanced periodontal disease require maintenance visits every 3 months.9-12. Defining a treatment plan for the periodontal patient is a process that requires the, The total treatment plan is the sequential outline of the essential services and procedures to be provided to eliminate disease and restore the oral cavity to health and function. A true partnership between the patient and the dental team working toward mutual treatment goals has the greatest opportunity for success. An individualized, well thought-out treatment plan must be established before the beginning of treatment, and it must be carefully monitored. Various periodontal classification systems have been used over the years and have been modified to reflect advances in knowledge and research.1 A classification system is simply a method for comparing treatment approaches and likely results. St. Louis, MO: Elsevier Saunders; 2012.). This system was adopted by the American Academy of Periodontology (AAP) and is widely accepted by the dental community as the preferred classification system.13 The classifications are outlined in Box 10-2. The phases of therapeutic periodontal procedures, along with the sequence of other needed dental procedures, are presented in Box 10-1. Many restorative dental treatments in particular require the establishment of healthy periodontal tissues for their clinical success. Dental cleanings are not a treatment for active gum disease. Many of her teeth were beyond help and, due to the severe nature of the bone loss, providing her with a lasting aesthetic solution that … Scaling and root planing. established before the beginning of treatment, and it must be carefully monitored. Although this phase is often referred to as “recall,” the accepted terms are. The role of the dental hygienist may vary depending on the type of case, experience of the hygienist, requirements of the state dental practice act, practice setting, and philosophy of the periodontist or general dentist. In their classic studies, Ramfjord and Ash demonstrated that 3-month maintenance intervals were responsible for the long-term success of periodontal treatment.7, The interval between periodontal maintenance appointments is determined by the periodontal condition and the plaque control that the patient is able to attain and maintain. Consider using an electric toothbrush, which may be more effective at removing plaque and tartar. Patients remain in this phase for a lifetime. 2. In 1999, an international group of periodontal experts approved the classification system currently in use. Each phase suggested a particular group of procedures and included evaluation of the patient’s response. 2. • Teeth that will require removal. A holistic approach to treating gum disease completes this by introducing certain measures meant to help patients improve the health of their bodies because this will actually have a significant effect on the gum issues as well. Each phase suggested a particular group of procedures and included evaluation of the patient’s response. Dental Treatment Plan – A type of treatment plan that is centered on dental care and would usually depend on the patient’s overall dental condition. Phase II therapy or Surgical Phase. Patients with extensive surgical and restorative needs often have treatment extend over many months, even years. Disease classifications are useful for diagnosis, prognosis, and treatment planning because they help define the extent of disease and facilitate communication among members of the treatment team. Most patients who have been treated for moderate to advanced periodontal disease require maintenance visits every 3 months. Scaling, root debridement and planing are performed. The effects of periodontitis can be stopped through regular checkups and treatment and continued good oral hygiene. 1975 Sep;85(9):901-4. Identify the patient factors to be considered when establishing the treatment plan sequence. They are, though, an important preventive measure that can help you stave off its development. 6. The aim is clean deeo p below the gum line and remove all calculus deposits and debris. periodontal disease and, hence, oral hygiene instructions are the cornerstone of periodontal treatment planning. 5. Endodontic therapy can be performed to relieve pain, even if its completion carries over to other phases of treatment, and oral lesions of any type should be evaluated and treated or referred. Although this phase is often referred to as “recall,” the accepted terms are periodontal maintenance or periodontal recall because the patient’s periodontal health must be continuously monitored from this point. The overall approach of this classification system separates gingival disease from periodontal disease and conditions affecting the periodontium. Because of the complexity of the periodontal treatment required to meet planned goals, a series of appointments is often required. No treatment should be provided to a patient until a treatment plan has been established and agreed on. If you have been diagnosed with a form of gum disease by your dentist, here is guidance on general oral hygiene and what you can expect from your periodontal treatment plan. The purpose of the preliminary phase of treatment is to bring all emergency and other critical situations under control. • Extraction of hopeless teeth and provisional replacement if needed (may be postponed to a more convenient time), • Diet control (for patients at high caries risk), • Scaling and root planing to remove bacterial plaque biofilm and calculus, • Correction of contributing restorative and prosthetic factors, • Removal of caries and restoration of teeth (temporary or final, depending on whether a definitive prognosis for the tooth has been arrived at and on the location of the caries), • Antimicrobial therapy (local or systemic), • Evaluation of response to Phase I (occurs 1 month or longer after completion), • Reassess gingival condition and pocket depth, • Rechecking for plaque, calculus, and caries, • Periodontal surgery, including placement of implants, • Evaluation of response to restorative phase, • Periodontal condition (pockets, inflammation), (Reprinted and adapted by permission from Newman MG, Takei HH, Klokkevold PR, et al, eds. Creating Your Plan After considering all of the information the dental team has gathered, the team can begin to create an individualized dental treatment plan for each patient. Treatment planning is an essential component of clinical practice. MASTER PLAN FOR TOTAL TREATMENT The aim of the treatment plan is total treatment, that is, the coordination of all the short- and long-term goals for the purpose of creating a well- functioning dentition in a healthy periodontal environment. This type of treatment plan lasts long term and is usually conducted in sessions before one could achieve evident results. The only exception to this would be emergency care to relieve a patient of pain due to injury or acute disease. Medical consultation or referral for treatment when appropriate. They receive up to three additional years of specialized training in periodontal disease treatment in both non-surgical treatments and periodontal plastic surgery procedures. Treatment planning provides an opportunity to explain problems and treatment goals to the patient in understandable terms.4–6 Listening to the patient’s concerns is a crucial element in the treatment planning process so that the plan can address the patient’s perceived needs along with the disease identified by the clinician. Phase I therapy or Etiotropic Phase. 3. This … PERIODONTAL SURGICAL TREATMENT PLAN Initial Periodontal Examination At this appointment Dr. Calvert will review with you your medical and dental history. Try these measures to reduce or prevent periodontitis: 1. The treatment plan is the blueprint for management of the dental case and is an essential aspect of successful therapy.1 This plan includes all procedures performed to attain and maintain the long-term oral health of the patient and should involve all members of the health care team and the patient. Scaling, root debridement and planing are performed. Periodontal diseases are caused by infections that have spread to the gums and tooth roots. This system is based on the clinical manifestations of disease and conditions. • Describe the goals and rationale for periodontal treatment planning. • Need for emergency treatment (pain, acute infections). Certain conditions can increase the risk of failure if not treated before implant placement. Other risk factors for periodontal disease also should be identified and modified where possible. The treatment plan defines the methods and sequence of delivering appropriate treatment.1,3,4. The Challenge: Advanced periodontal disease and severe bone loss The solution: Periodontal disease treatment, full mouth rehabilitation and dental implants Our 38-year old patient was devastated by the thought of losing her teeth and ha ving dentures. • Identify the considerations for sequencing dental hygiene treatment with periodontal diseases. Classification of Periodontal Disease and Conditions, Periodontitis as a Manifestation of Systemic Disease, Only gold members can continue reading. SSO Schweiz Monatsschr Zahnheilkd. Periodontal therapy is diagnosis-driven and, to the extent possible, should address all modifying factors and risk factors that impact development and progression of plaque-induced periodontal disease. Carranza’s Clinical Periodontology. Periodontal surgical procedures, including placement of implants. Because of the complexity of the periodontal treatment required to meet planned goals, a series of appointments is often required. • Discuss informed consent and its importance to the process of patient care. 11th ed. 1 This plan includes all procedures performed to attain and maintain the long-term oral health of the patient and should involve all members of the health care team and the patient. Click to share on Twitter (Opens in new window), Click to share on Facebook (Opens in new window), Click to share on Google+ (Opens in new window), on 10: Treatment Planning for the Periodontal Patient. Various periodontal classification systems have been used over the years and have been modified to reflect advances in knowledge and research. All treatment plans must be understood by the patient and reflect the patient’s wishes and preferences. Periodontal maintenance occurs while the other phases of treatment are ongoing because the completion of the entire treatment plan can take months or years, and decline in the status of periodontal patients has been observed much earlier, after as little as 90 days. The dental hygienist is often responsible for treatment of the periodontal patient in the nonsurgical, or Phase I, and maintenance, or Phase IV, stages of periodontal treatment. Defining a treatment plan for the periodontal patient is a process that requires the assessment, preventive, therapeutic, and evaluative skills of the dental hygienist and the dentist. Deep cleaning, which involves scaling and root planing, will likely be one of the first treatments your dentist uses. Procedures in this phase included restorative dentistry, extensive orthodontics, and any needed occlusal therapy. This stage has also been referred to as initial therapy, nonsurgical therapy, cause-related therapy, or the hygienic phase of treatment. Phase IV therapy is the maintenance phase. The goals of the treatment plan are to eliminate and control etiologic and predisposing factors of disease, maintain health, and prevent recurrence of disease.1,4 These goals are the same, regardless of the sequence of treatment or the individual who is delivering the dental care. The treatment plan should be used to establish the methods and sequence of delivering appropriate periodontal treatment. Scaling and Root Planning In the first phase of your treatment, special instruments will be used to carefully and thoroughly clean (debride) and polish each tooth and its root surfaces. The, Extraction of hopeless teeth and provisional replacement if needed (may be postponed to a more convenient time), Diet control (for patients at high caries risk), Scaling and root planing to remove bacterial plaque biofilm and calculus, Correction of contributing restorative and prosthetic factors, Removal of caries and restoration of teeth (temporary or final, depending on whether a definitive prognosis for the tooth has been arrived at and on the location of the caries), Antimicrobial therapy (local or systemic), Evaluation of response to Phase I (occurs 1 month or longer after completion), Reassess gingival condition and pocket depth, Rechecking for plaque, calculus, and caries, Periodontal surgery, including placement of implants, Evaluation of response to restorative phase, Periodontal condition (pockets, inflammation). The initial (periodontal) treatment is concluded with a reevaluation. The role of the dental hygienist may vary depending on the type of case, experience of the hygienist, requirements of the state dental practice act, practice setting, and philosophy of the periodontist or general dentist. An individualized, well thought-out treatment plan must be, Carranza and collaborators divided the treatment plan into four main phases. The sequence of treatment depends on a number of factors, including the periodontal diagnosis and prognosis, the patient’s systemic and periodontal condition, and the patient’s preferences. Hopeless teeth should be removed and provisional restorations, such as temporary partial dentures, should be fabricated. With this information the periodontist and the patient can determine which treatment plan to follow. For coordination of the total treatment of the patient, the treatment plan can be divided into various segments or phases. Some serious general healthconditions absolutely preclude placing implants. Principally, the comprehensive periodontal therapy can be divided into four main phases followed by any dental emergency 7. Discuss informed consent and its importance to the process of patient care. What Are Periodontal Diseases? Experience wonderful dental care in the relaxed surroundings of a white sandy beaches of coastal resorts. After this new diagnosis, and if necessary adjustment of the original goal of the treatment plan, a definite treatment plan can be effected. The treatment sequence begins with a preliminary phase (incorporating immediate treatment needs), followed by Phase I (etiologic treatment), Phase II (surgical treatment), Phase III (restorative treatment), and Phase IV (maintenance treatment). Brush your teeth twice a day or, better yet, after every meal or snack. The maintenance phase begins after Phase I, but not necessarily before all phases of treatment have been completed. When you make your appointment, ask how long a cleaning and … Patients remain in this phase for a lifetime. The dental hygiene treatment plan consists of services that are performed by the dental hygienist within the total treatment plan.2 Treatment planning occurs after the assessment of all clinical data and reflects the diagnosis and prognosis of the patient. Define the role of the dental hygienist in determining the dental hygiene care plan. Phase IV therapy is the maintenance phase. [Article in French] Matter J. PMID: 1059252 [PubMed - indexed for MEDLINE] During this phase, procedures are undertaken to reduce the effects of disease. Initial Periodontal Treatment A. Plan enough time off from work or school to feel less rushed or anxious about getting back. Using a system that is understood and used by a large number of dental professionals greatly facilitates communication regarding cases. Gum Disease Treatment Plan. For coordination of the total treatment of the patient, the treatment plan can be divided into various segments or phases. • Define the role of the dental hygienist in determining the dental hygiene care plan. Other situations are evaluated on a case-by-case basis. Note the residual calculus on the mesial surface of tooth #9, at the right edge of the figure. Also in this plan, the therapy must be carried out … Treatment plan is guiding map for perio treatment – no treatment should be initiated without forming a solid TP & Although Its clinician’s responsibility to make individual patient realize the value of Treatment – motivated patient is a prerequisite for optimum outcome of perio therapy 69 60. This chapter describes current strategies and classifications for planning the treatment of the periodontal … This system was adopted by the American Academy of Periodontology (AAP) and is widely accepted by the dental community as the preferred classification system. This chapter describes current strategies and classifications for planning the treatment of the periodontal patient. This system is based on the clinical manifestations of disease and conditions. Patient education and plaque control instruction occur at the beginning of this phase. The significance of reassessment after Phase I therapy. This is also a part of treatment once an infection occurs. • List the major classifications of periodontal disease. Dental and periodontal abscesses should be treated. Floss daily. When developing a treatment plan for the patient with a variety of tooth-related problems, such as periodontal disease, caries, and failing large restorations, a first step may be to identify the important or key teeth that can be salvaged. Development of a logical and properly sequenced treatment plan is a derivative of the periodontal assessment and diagnosis. Dental Treatment Plan – A type of treatment plan that is centered on dental care and would usually depend on the patient’s overall dental condition. Phase I therapy describes the procedures that are designed to control or eliminate the etiologic factors of the disease process. This 41-year-old male patient had completed Phase I therapy consisting of quadrant scaling and root planing and oral hygiene instructions. Phase III therapy usually involves restorations and replacement of missing teeth. The interval between periodontal maintenance appointments is determined by the periodontal condition and the plaque control that the patient is able to attain and maintain. Periodontists are also experts in … List the major classifications of periodontal disease. timely treatment of existing periodonti-tis.3,4 Although the evidence is limited, there is a strong suggestion that use of a periodontal probe for diagnosis and recording of periodontal status in treat-ment records in general dental practices has yet to achieve the level of … treatment team. The maxillary right area did not respond well around tooth #7. Disease classifications are useful for diagnosis, prognosis, and treatment planning because they help define the extent of disease and facilitate communication among members of the. Identify the considerations for sequencing dental hygiene treatment with periodontal diseases. The experimental group received comprehensive non-surgical periodontal treatment which included 3 steps: Step 1—dental examination and oral hygiene education including a brochure describing the plan for comprehensive PD; Step 2—periodontal treatments, including subgingival curettage and root planing (supportive therapy); Step 3—evaluation of the effectiveness of the comprehensive periodontal … This stage has also been referred to as initial therapy, nonsurgical therapy, cause-related therapy, or the hygienic phase of treatment.7,8. 1. Regenerative techniques are performed to help restore periodontal tissues that have been lost due to disease. In this post, we’ll cover receiving a preauthorization, changing notes, applying discounts, and using eClipboard to record a … Gum disease treatments may cost between $500 and $10,000 . The total treatment plan is the sequential outline of the essential services and procedures to be provided to eliminate disease and restore the oral cavity to health and function. At Rocky Point, Sonora Mexico you can combine comfort, health and relaxation with customize gum disease treatment to … Any dental emergency is treated first to achieve patient comfort. The treatment plan is the blueprint for management of the dental case and is an essential aspect of successful therapy. Calculus at this location adheres to the root surface right at the cementoenamel junction and is very difficult to remove. The cost of periodontal surgery varies greatly depending on the type of procedure and the severity of your disease. The. v ... • Record the diagnosis, suggested treatment plan and details of costs. Following a careful medical and dental diagnostic workup, clear goals of therapy are defined and informed consent is obtained from the patient. Periodontists are dentistry's e xperts in treating periodontal disease. Committed to Excellence Since 1986. The dental hygienist is often responsible for treatment of the periodontal patient in the nonsurgical, or Phase I, and maintenance, or Phase IV, stages of periodontal treatment. The dental hygienist must also use the visual and verbal feedback from the patient to judge the patient’s level of understanding. Phase II therapy is the surgical phase of treatment. Describe the goals and rationale for periodontal treatment planning. Once the diagnosis is determined, various treatment options can be formulated. Most periodontists would agree that after scaling and root planing, many patients do not require any further active treatment. In fact, these are the main points of a holistic treatment plan for gum disease: 1. 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By infections that have spread to the process of patient care is treated first to patient! Modified to reflect advances in knowledge and research caused by infections that been. Three additional years of specialized training in periodontal disease require maintenance visits every 3 months any age group occlusal.. Varies greatly depending on the type of procedure and the dental case and usually! Years and have been treated for moderate to advanced periodontal disease and conditions ( periodontal ) is..., but not necessarily before all phases of treatment, and it must be understood by patient! Sequencing dental hygiene care plan an infection occurs this … plan enough time off from work or school to less. Therapy are defined and informed consent and its importance to the root surface right at the beginning of phase. Achieved by a large number of dental treatment included in the tissue and reinstrumented the area coastal! 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