Planning is KEY to Dental Stability
“Not having a plan is a plan to fail.” We’ve all heard this before – it’s about strategy. Sure, planning doesn’t guarantee success, but at least, a plan identifies the starting point, it identifies possible hurdles, it sets a goal and can help with the order of activity. This is an activity that we engage in with every patient. It can range from being very simple, right up to multiple phased plans. In every instance, the plan embodies the goal.
So, what is the goal? Simple – it is largely set by the expectations of the patient. What’s the most common expectation of patients that I see: “I would like to keep my teeth for life.”
Before we can write a plan, the most important activities we can engage in is a ‘stocktake’ of dental health and a conversation with the patient around their expectations of dental treatment. In my practice, this is the new patient examination. A careful assessment can be made around which teeth are present, inadequate restorations, gum disease, home care and diet. Probably even more important are the questions that we ask the patient to understand their expectations: Is the patient able to chew their food (functional capacity), are they satisfied with the cosmetics of their smile and the most obvious question, are they dentally comfortable?
A relatively common scenario is that the patient has desires around their dental treatment, and they can’t afford all of it at once. This is where strategic planning comes into play. In combination with the flexibility allowed by the use of composite resin as a restorative material, it’s possible to develop sound restorations that be remodelled or resurfaced at a later date without compromising the more urgent, current demand for an improvement in dental health.
Sometimes the patient has both urgent treatment needs (pain and infectious disease) as well as important treatment needs (deteriorating fillings that will become urgent if not addressed).
Often the urgent treatment needs have a degree of inevitability about it – for example, teeth that require root canal therapy to be saved. Instead of completing the root canal therapy now – stabilise the tooth with sound restoration and dressing and come back to it next year. In the meanwhile, identify the teeth that are drifting towards root canal therapy …and work on restoring these teeth durably to prevent future root canal therapies.
This strategy has the effect of both spreading costs as well as reducing costs in the long term – simply by virtue of the identification of important problems that can be more immediately and durably addressed (instead of getting bogged down in dental treatments that have reached a stage of inevitability).
Many patients now understand how this kind of goal setting, planning and phasing dental treatment can deliver progressive, durable, flexible and beautiful dental health outcomes. In fact, if your dental problems have arisen over 10 or 15 years, I can assure you that your development of understanding around diet, home care and working through the inevitable hiccups of a dental plan will take around two years. And this is good because progressive change, especially when coupled with education and understanding will be a permanent change.
I’m not talking about two years of appointments every fortnight. What I’m suggesting is an average of three or four longer treatment appointments, two professional cleans and one examination in each of those two years – focused on education, coaching and treatment that will deliver durable change. And durable change can mean teeth for life.