Once you leave our office, your dentist will take the information
collected, and 'piece' all the items together in order to formulate a
diagnosis as well as a treatment plan. If your case
is very simple, it is likely that you will be consulted during your next hygiene
appointment. In the event that your case requires a bit more information
and input by both you and your dentist, you may be scheduled for a consultation
where you will spend one-to-one time with your treatment plan co-ordinator
and/or dentist.
Your treatment plan as well as
any viable treatment options will be discussed with you to help you make an
informed decision. To
view information concerning today's options for dental materials (fillings,
crown and bridge materials) as well as options to replace missing teeth, please
check out this page regarding restorative
materials.
Treatment
plans, based on today's available options and patient desires, can be very
complex and confusing. We hope that by reading this, you will familiarize
yourself with the process and then be better able to understand and ask questions
about your dental condition. Basically, treatment plans follow what is
referred to as a 'Phase Approach/System" which
is broken down as follows:
Phase I. Treatment of any acute
infections, pain or immediate concerns. Immediate
treatments might include, emergency root canal therapy, extractions, as well
as treatments for gum infections, cold sores and any other treatments required
to reduce immediate pain and discomfort.
Phase II. Basic and Advance
Hygiene services. Our
hygienists will bring your gums (periodontium) up to their optimal health
and will spend significant time informing you of maintenance requirements
and techniques.
Phase III.Work-Up prior to
Restoration of the teeth. This will encompass treatments required in order to prepare you for the final restorative (fixing) phase and may also entail the use of certified specialists. Specialists
are an integral part of dental treatment and will be used where, in our opinion,
their expertise can aid us in treatment planning decisions and/or performing
advanced procedures.
Phase IV.The Restorative Phase. The
teeth/mouth is put back into shape by the fixing of teeth and associated
structures.
Phase V.The Maintenance Phase. As
important as all the others, this is where you are carefully
observed and maintained by the dental team. This is no different than
home or car ownership where neglect can have significant consequences. In
order to maintain your dental health, we will lay out a maintenance schedule
specific to your needs. This schedule will also include radiographic
protocols. In the event that you have any impacted teeth that you do
not intend to remove, a radiographic protocol will be laid out which will
monitor these teeth as well as any other suspicious radiographic
findings. This usually entails specific radiographs (X-ray pictures)
every 2 to 5 years depending on the situation.
An integral part of the treatment plan presentation will
include the prognosis for
your dental condition, with or without treatments. Dentistry is no
different than any other branch of medicine and all treatments carry an inherent
risk of an unexpected outcome, some more than others. There are very few
treatments that are able to withstand a lifetime of use. In addition, there
are situations where compromises may exist and it would be deemed important to
notify you of the possibility of any reduced outcome or expectation due to these
compromises. Some outcomes of treatments and current conditions may include
the following:
Temperature or bite sensitivity after a restorative
procedure (fillings and crowns).
Continued pain or infection after a root canal procedure.
Pulp (nerve) death or inflammation following a restorative procedure.
Tooth fracture and subsequent loss of the tooth (this
is mostly seen in teeth that have had endodontic
therapy).
Failure of long span bridges due to excessive forces on the supporting teeth.
Fracture of teeth due to parafunction (grinding and
clenching habits).
These are but a few of the problems we may see with or
without treatments. Although we cannot accurately predict all possible
events, we can certainly see where you, the patient, may be susceptible. Prognosis
may be affected by treatment plan decisions as well as the existing condition
of your dental structures. For example, a prognosis may be altered
by any of the
following factors:
Presence and size of decay in your teeth. The
bigger the decay, the worse the prognosis.
Materials selected by either you or the dentist.
Treatment
plan options selected by you in the restoration of missing teeth, e.g. bridges, partial dentures, implants or no treatment.
Limitations in treatment presented by you (failure
to follow the maintenance program, failure to treat existing conditions in
a reasonable time frame, failure to complete treatment).
Changes
in health status and the aging process.
Naturally, we will always weigh the risk/benefit of any treatment and
recommend a treatment with the best prognosis (the best chance of
success). In some instances, we may elect to recommend no-treatment as
the best viable option or attempt to dissuade you from treatment we feel has
a poor prognosis.
For more in-depth information on this, please visit the prognosis
page. As
health care providers, our obligation will be to treatment plan your condition
based on current accepted dental therapeutics. In
plain terms, this means all consideration is given to the existing biology
of the patient as well as the physical and biocompatible aspects of the materials
available. The final treatment decisions will of course be yours.
Before
we proceed, we will need you to make the final decisions with regard to treatment
options and materials. As mentioned earlier, that can be a bit confusing
considering the ever increasing array of possibilities and materials. Please
feel free to ask us your questions. Part of the suggested treatment plan
may include a consultation with one or more certified dental specialists. This
will be suggested where we feel you are best served and where specialists
can provide you with advanced treatment procedures. We know that a specialist
referral may be somewhat inconvenient, but it is always made in your best interest. Specialist
referrals may be made to the following categories of specialists:
Orthodontists. For tooth movements (braces) and jaw
orthopaedics
Periodontists. Gum specialists. For gum disease and gum augmentation procedures. May
also be used for implant fixture placement.
Endodontists. For root canal therapies as
well as diagnosis and treatment of failed cases.
Oral and Maxillofacial Surgeons. For tooth
removal as well as other dental surgical treatments, including implant
fixture placements, biopsies and jaw surgeries.
Oral Radiologists. For advanced radiographic
techniques as well as consultation of existing radiographs.
Pedodontists. Children's dentists for advanced
procedures or behavioural problems.
Oral Medicine and Dermatologists. For certain
oral mucosa (lining of the mouth) and gland conditions.
Prosthodontists. For complex restorative rehabilitation,
i.e. major crown and bridge work.
Naturally, if you have any questions, please do not hesitate
to call on us for further explanation and clarification. We wish to make
sure that you have all the information in order to make your decisions. To
contact us, you may either us
or phone us at 604.224.2411.
*Note: What is a reasonable timeframe for
treatment? This a difficult question to answer. In most cases, the
progression of dental disease is quite slow. We will
provide you with a plan for optimal dental health and, in most cases, you
will be in control of the timing of treatment. We will certainly let you
know when treatments are time-dependent.
One of the larger problems we face in managing treatment is when patients
do not complete treatment; completing only enough of the treatment
plan to allow them to comfortably chew on one side of their mouth. The
result is that there is accelerated wear-and-tear on the new prosthesis (bridge,
crown, dental implant crowns) which may cause premature failure. This
is no different than replacing only one faulty hip when two are required. This
will certainly accelerate the degeneration of the new hip.