When consulting with a patient, the modern dental practitioner must inform patients of all the treatment options and arrive at a satisfactory treatment plan. This requires the practitioner to look at the patient in a comprehensive manner so that optimal treatment can be provided.
The successful consultation consists of diagnosing the conditions, educating the patient and understanding the patient’s expectations.
However, before addressing the patient’s complaints and concerns, the dentist must evaluate the patient.
Evaluating the Patient
There are several important components in the initial patient evaluation. The first is the patient’s medical and oral health, as reviewed and discussed in Chapter 4. Provided the patient meets these health criteria, the dentist can initiate a discussion of what treatment the patient wants to have and, in turn, what can be provided. The first thing that the dentist must do in this regard is to inform the patient of their options and let them and their desires lead to the best treatment plan.
The best way to approach this for, say, a complete denture patient, is to outline what those options are along with reasonable expectations of masticatory forces, see Table 5.2.
There are, of course, other factors and these vary with the patient’s treatment needs and desires. For example, in a case where the supporting teeth for a removal partial denture (RPD) are failing or there is a general breakdown of the dentition, replacement with a more stable and satisfactory prosthesis is necessary. However, if the patient has worn RPD’s for years and is happy with them, then an overdenture may be an appropriate treatment option. On the other hand, in the situation where a patient has missing teeth that need replacement but is terrified of, or totally averse to, a removable prosthesis, then a fixed implant supported bridge may be the best option.