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 email 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.

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