- always look at the ‘bigger picture’ of dental problem
- always consider a long term prognosis in order to secure patient’s oral health
- take into consideration patient wishes and requests
- communicate clearly in terms of options, risks and benefits
- keep treatment plan as simple as possible
- while treatment planning liasie on local specialists, experts and consultants
- maintain good relationship with senior colleagues and more experienced professionals
- delagate clinical tasks when possible
- keep up-to-date with current dental knowledge
- enhance your practical skills by attending hands-on trainings, eg. minor oral surgery, interceptive orthodontics to minimize referrals numbers
- avoid highly invasive dental procedures if not well clinically justified
- some alteration made on original treatment plan may be necessary
- be clear, consistent and concise
- inform about the cost
- inform about the length of whole treatment
- go ahead with straightforward procedures without any delays
- be realistic re: treatment under LA
- be flexible re: treatment under IH, TM or IV
- be cautious re: treatment under GA
- be careful re: terminally ill patients, recently resuscitated patient, persons with multiple overlapping medical comorbidities
- sometimes there is a need to close COT and open a new one after a few months time, when receiving eg. a letter from orthodontis
- in case of elderly patients with dementia family/relatives must be informed about proposed dental treatment
- clearly put and mark all crucial items included in eg. FP17 NHS form
- add any other clinical observations to tx plan, if necessary
- tx plan must be signed by patient, legal guardian or person with parental responsibility
- Patient needs to understand fully a proposed treatment plan, if any doubts to consider capacity assessment
- patient’ best interest meeting may be necessary to proceed further with proposed dental treatment
- IMCA may be needed to provide additional advice regarding patient capability to dental treatment.
- Important UDA’s target: close COT while awaitinig for eg. second orthodontic opinion.
- Differential diagnosis should be an essential part of treatment planning: dentin hypersensitivity vs reversible pulpitis, sinusitis vs upper posterior teeth pulp pathology, periapically originated vs periodontal origin, symptomatic impacted wisdom tooth vs salivary stones, periapical pathology vs atypical facial pain, odontogenic pain vs neuralgia.
- Patients suffering from dysphagia, dystonia, repetetive spasms, breating difficulties and clenching may benefit from receiving a botox type A injections on regular basis (neck, shoulders, facial muscles) which can be provided by hospital unit.
- asymptomatic dental problems (eg. retained roots) with no signs of local odontogenic inflammaiton potentially can be left and monitored, especially in case of elderly patient with multiple medical problems
- basic vital signs check: RR, BP, 02 saturation, glucose, complete blood count essential for sedation or more complex invasive dental procedures