Keeping it Simple
Most people who contact me regarding dental treatment have suffered a combination of neglect as well as being unsure of how to proceed with the care of their teeth and jaws. A small proportion have had the misfortune of having exotic dental care presented to them: care that is not only way beyond their budget, but also beyond their current ‘dental IQ.’
What do I mean by dental IQ?
Dental IQ is a patient’s own understanding of how to manage their dental health. Many of the patients that have come to me are suffering not only from inadequacies around their dental treatment, but even more importantly they have an inadequacy around their understanding of home care requirements, diet, general health impacts on dental health as well as lifestyle factors such as shiftwork.
Presenting such a patient with an “exotic treatment plan” – often one that carries an overall cost of 20, 30 or sometimes even $40,000 sets these patients up for depression and hopelessness. This is without out even considering the requirements that fall on the patient regarding home care, pluses and minuses of the treatment plan as well as costs, in case something goes wrong. Remember, the more complex a treatment plan, the more places things can go wrong within the plan.
What is the solution around treatment planning?
I’ve always subscribed to a planning methodology that embraces the following:
Keep it as simple as possible – especially when you’re starting out with a new patient;
A keen focus on education – the patient must be clear on shortcomings of the plan (no plan is perfect) and what kind of maintenance program they are signing up for;
A progressive method that underpins the plan (I’ll talk about this below);
Most importantly: Keep the plan as conservative as you possibly can. An alternative way of saying this is: try, at all times, to make the plan as reversible as possible.
Keep it as simple as possible – Identify the key teeth – these are the teeth that provide function, whether it be cosmetic (patient’s ability to smile) or masticatory (ability to chew). Priorities are set, usually starting with teeth most in need or most questionable teeth running down to teeth that warrant attention but are not so urgent. An assessment of gum disease status is also vital at this point.
These are simple assessments to maximize the patient’s own existing functional capacity before even considering any additions to their capacity.
Education – Combine a diagnosis appointment (discussion of planning strategy) with the home care instruction that the patient receives in conjunction with their dental cleaning appointment, information sheets and coaching provided at regular review appointments. Over some years, the patient can develop a good understanding of how to manage their dental health. Education = prevention.
Progressive treatment methodology – Simply put: progressive treatment methodology is about treating problems at the most basic level that we believe will provide a solution for the patient. We can monitor patient response to the implemented treatment and review patient needs as required. Sure, sometimes, we may need to treat a problem using a more sophisticated or involved method – and this is a disadvantage to this system. However, the progressive escalation of the treatment protocols, when required, also reduces or eliminates OVER-TREATMENT of a problem. Combine this with…
A laser focus on saving every speck of viable tooth structure – If I can make plans for my patients that are as close as possible to being reversible – I’ve significantly eliminated patient risks associated with dental care, as well as improved my scope to provide simple and effective lifetime care to my patients. This is my core belief around the delivery of dental care.
Alex has had a career focused on low-biologic cost reconstructive cosmetic dental care – common sense teeth for life.