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Pedo 3

Pedo 3

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Published by Salam Bataieneh

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Published by: Salam Bataieneh on Jul 13, 2013
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05/03/2014

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This is the last lecture in Midterm Exam .LEC No. 3Dear Colleagues :The Dr. started talking about treatment planning steps and concepts , then shemoved to explain some photos from the slides without any addition, Please return toslides ( from 11 to 55 )
 ---------------------------------------------------------------------------------------------------------
TREATMENT PLANNING
Sequence of treatment planning when a child comes to your clinic starts with the
emergency care
, and then
preventive care
, and then
any surgical treatment andendodontic treatment
 
. After you finish everything there’s a
recall and review system
,Your patient now has a clean mouth , no microorganisms , all restorations are done ,all extractions are finished and the patient has nothing else to be done right now . But ,
this doesn’t m
ean that you leave the patient . You should see the patient and reviewinghim based on a review system every three months , six months .. etc , according to thecase
( Check up )
, to make sure that filling are good ,no overextension , the child isbrushing his teeth .. etc.
So , the steps that you should follow in order to reach a treatment plan .
 
Collect general observations:
 
Child/parent interactions, behavior :
1
st
of all , you have to collect general informationof the patient , actions and behaviors . So this a very important principle
Address reason for presenting FIRST :
when your patient asking what is the reason forhis coming ? what is the problem ? Is he complaining from anything ? esthetic ? likecrowding for example , color of the teeth ,or there is an ulcer or any sort of complaint .Sometimes , when there is no major complaint like
pain
, usually they just come for
check up .
 
 
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|
Page 
 
Start with history:Medical, dental, family, social
 
 
Record past dental care
 
Now we move to STEPS IN DIAGNOSIS & TREATMENT PLANNING
 
You have to Conduct head and neck exam
 
 
Also to Perform a complete oral examination
 
 
Use a thorough and detailed form
 
 
Establish a provisional diagnosis
( preliminary Diagnosis ) , I
f there’s some sort of 
gingivitis or caries or ulcer . But ,sometimes you are not sure what is the cause of ulcer (caused by chemical burn,precancerous , aph
thous ulcer … )
 
Obtain any additional tests:
 
Radiographs, blood tests, study models, medical consults,etc.. to insure your treatment plan .
 
 
Finalize diagnosis and treatment plan
 
Present case to patient/parents :
After I write my treatment plan , I usually talk to
child’s parents and tell them that’s this is the plan , and then I start explaining to them (
procedures , type of the material I will use , cost .. )
 
Then we Outline recommended treatment plan
 
 
Involve parents in planning , WHY ? regards the pulpotomy , the parents has to acceptor refuse it !
Because the insurance about doing any procedure either pulpotomy orSSC is refered to them .
Secure parental consent :
The parents should sign for approval of the treatment
TREATMENT PLAN SHOULD INCLUDE THESE FEATURES
 
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|
Page 
 
Treat existing problemsPrevent progression of existing problems : S
o if the child has dental caries ,you treatthe dental caries and you prevent that any carious lesion occur in the future , byinsuring that your restorations are adequate and good durability.
 
Prevent any anticipated future problems
: by insuring oral hygiene instructions ,andmaking sure that your patient come back to review his treatment .
 
Plan periodic exams, preventive care and treatment :
Sometimes we postpone thetreatment . For example we want to fissure seal the sixes (molars) when there are fullyerupted .According to TREATMENT PLANNING CONCEPTS
 
Consider behavior (eg. Desensitizing app
(by starting with simple procedures)
/procedure, modeling)
it’s consi
der as a principle in treatment planning .
Because if the child has good behavior , he will be better comfort with local anesthesiaand treated in the clinic. But , if he has a very bad behavior, he has to be treated inhospital
.
 
 
Involve parent in treatment choices, but don’t be dictated to!
 
, the parents have noright to change your decision , they have the right to accept or refuse only !
 
Incorporate prevention : prevention is our GOAL !
 
 
Plan efficient use of LA(QUADRANT THERAPY)
I anesthetize the whole quadrant and I do treatment for the whole quadrant. foryou as students we want you to write treatment plan as ideal as possible , but this
doesn’t mean that you have to do this kind of treatment in the clinic because you are
still in the beginning . We just have to write the treatment plan .

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