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Integrated treatment planning is complex. The first question is, what does integrated mean? Do we mean integrated to whole body health, integrated across the specialties of dentistry or integrated to a patient’s individual needs? The answer is all of the above. In essence, integrated treatment planning means moving away from single tooth dentistry toward a comprehensive care approach.
Communication skills are required to truly listen to patients and to present their options in language that’s easy to understand. When patients become overwhelmed, it’s difficult for them to make decisions. Many times, smile design and restorative treatment planning have layers of complexity. One treatment plan may require discussion about the aetiology of erosion, a periodontal problem, and a tooth with failing endo, while the patient’s main concern is appearance—which may have nothing to do with the health issues that need addressed.
Ultimately, treatment planning is a series of decisions, and therefore a series of choices.
In the book “Choice Theory,” author William Glasser outlines how we make choices to satisfy one or more of our five basic needs:
Points two and three can factor into the choices that patients may make to improve their smile, self-confidence, self-esteem and to feel like they belong socially.
Depending on a patient’s pre-existing condition and the difference between the starting and desired endpoint, those decisions and choices can be simple, like going forward with tooth whitening to improve esthetics, or incredibly complex. The patient’s and the clinician’s own bias and personal experience will have as much of an impact on complex decisions as evidence-based protocols. Even simple cases should be considered in full to prevent missing a condition or risk factor that could be treated early if identified. An example of this is tooth wear. If identified early, it can be treated conservatively, with early intervention preventing more deterioration over the long term.1 How do we know if a patient will be simple or complex? By gathering the information and allowing ourselves time to consider what we find.
If we design our journey correctly, we can use communication skills to identify the big picture vision for our patients. Taking values into account, this will help us determine priorities and ultimately develop a road map that outlines the treatment plan sequence from beginning to end. Pictures and visual aids, such as trial smiles or digital images, can help us work with patients to identify the desired outcome. Deciding on a treatment plan is much easier if we have a shared understanding of the goal and how to set priorities.
There are seven steps to decision-making:
Consider the patient’s journey through a dental practice to happen in stages. Doing so allows us to identify what events need to take place and determine how to tailor the journey to the individual patient and dentist. The goal is to get patients to say yes to the ideal treatment for both health and esthetics, whatever that might be for them.
Dentistry can be a highly stressful profession, but the more time we invest in the early planning stages to get everyone on the same page and to set realistic expectations, the more predictable the outcomes will be. No treatment or procedure is without risk, but if these risks are properly identified and managed, all parties are informed and prepared to meet the patient’s future needs.
To fit with the 7 stages of decision making, the dental treatment planning process can be considered in 5 sections:
It will be interesting to see how the increasing use of artificial intelligence will shape the world of treatment planning. Currently, we still require our eyes and our thinking minds to work to define the big picture, capture the information, identify the priorities, take into account the risks and benefits of alternatives, and present all this to patients as a road map with easy to understand choices.
Investing time in capture, analysis and planning allows the clinician and the patient to communicate and work together toward a shared end-goal. When this happens, the implementation of the clinical dentistry is well planned and considered, which will set expectations, increase patient satisfaction and reduce stress.
Dr. Elaine Halley graduated from the University of Edinburgh in 1992. She is a past president and accredited member of the British Academy of Cosmetic Dentistry and a fellow of the International College of Dentists. She is a board member for the UK Digital Dental Society and has an MSc with distinction in Restorative and Aesthetic Dentistry. She is a Digital Smile Design Master and UK instructor and a clinical Key Opinion Leader for Optident, Ivoclar Vivadent and Align Technology. She teaches the Full Certification Invisalign course for Aligner Consulting. Elaine has an award-winning private practice, Cherrybank Dental Spa, in Perth, and has recently been appointed clinical director for the Pain-Free Dental Group, which has practices across Scotland.
1. Jackson, R. D. (2000). "Loss of cuspid guidance: a functional and aesthetic dilemma." Dent Today 19(7): 56-61.
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Integrated treatment planning is complex. The first question is, what does integrated mean? Do we mean integrated to whole body health, integrated across the specialties of dentistry or integrated to a patient’s individual needs? The answer is all of the above. In essence, integrated treatment planning means moving away from single tooth dentistry toward a comprehensive care approach.
Communication skills are required to truly listen to patients and to present their options in language that’s easy to understand. When patients become overwhelmed, it’s difficult for them to make decisions. Many times, smile design and restorative treatment planning have layers of complexity. One treatment plan may require discussion about the aetiology of erosion, a periodontal problem, and a tooth with failing endo, while the patient’s main concern is appearance—which may have nothing to do with the health issues that need addressed.
Ultimately, treatment planning is a series of decisions, and therefore a series of choices.
In the book “Choice Theory,” author William Glasser outlines how we make choices to satisfy one or more of our five basic needs:
Points two and three can factor into the choices that patients may make to improve their smile, self-confidence, self-esteem and to feel like they belong socially.
Depending on a patient’s pre-existing condition and the difference between the starting and desired endpoint, those decisions and choices can be simple, like going forward with tooth whitening to improve esthetics, or incredibly complex. The patient’s and the clinician’s own bias and personal experience will have as much of an impact on complex decisions as evidence-based protocols. Even simple cases should be considered in full to prevent missing a condition or risk factor that could be treated early if identified. An example of this is tooth wear. If identified early, it can be treated conservatively, with early intervention preventing more deterioration over the long term.1 How do we know if a patient will be simple or complex? By gathering the information and allowing ourselves time to consider what we find.
If we design our journey correctly, we can use communication skills to identify the big picture vision for our patients. Taking values into account, this will help us determine priorities and ultimately develop a road map that outlines the treatment plan sequence from beginning to end. Pictures and visual aids, such as trial smiles or digital images, can help us work with patients to identify the desired outcome. Deciding on a treatment plan is much easier if we have a shared understanding of the goal and how to set priorities.
There are seven steps to decision-making:
Consider the patient’s journey through a dental practice to happen in stages. Doing so allows us to identify what events need to take place and determine how to tailor the journey to the individual patient and dentist. The goal is to get patients to say yes to the ideal treatment for both health and esthetics, whatever that might be for them.
Dentistry can be a highly stressful profession, but the more time we invest in the early planning stages to get everyone on the same page and to set realistic expectations, the more predictable the outcomes will be. No treatment or procedure is without risk, but if these risks are properly identified and managed, all parties are informed and prepared to meet the patient’s future needs.
To fit with the 7 stages of decision making, the dental treatment planning process can be considered in 5 sections:
It will be interesting to see how the increasing use of artificial intelligence will shape the world of treatment planning. Currently, we still require our eyes and our thinking minds to work to define the big picture, capture the information, identify the priorities, take into account the risks and benefits of alternatives, and present all this to patients as a road map with easy to understand choices.
Investing time in capture, analysis and planning allows the clinician and the patient to communicate and work together toward a shared end-goal. When this happens, the implementation of the clinical dentistry is well planned and considered, which will set expectations, increase patient satisfaction and reduce stress.
Dr. Elaine Halley graduated from the University of Edinburgh in 1992. She is a past president and accredited member of the British Academy of Cosmetic Dentistry and a fellow of the International College of Dentists. She is a board member for the UK Digital Dental Society and has an MSc with distinction in Restorative and Aesthetic Dentistry. She is a Digital Smile Design Master and UK instructor and a clinical Key Opinion Leader for Optident, Ivoclar Vivadent and Align Technology. She teaches the Full Certification Invisalign course for Aligner Consulting. Elaine has an award-winning private practice, Cherrybank Dental Spa, in Perth, and has recently been appointed clinical director for the Pain-Free Dental Group, which has practices across Scotland.
1. Jackson, R. D. (2000). "Loss of cuspid guidance: a functional and aesthetic dilemma." Dent Today 19(7): 56-61.
Work-life balance. A great income. The ability to own a business. The desire to work with your hands. The opportunity to change lives. Whatever your inspiration for pursuing dentistry as your career, you find yourself here, in the midst of the...
DENTSPLY Sirona (XRAY) announced it has acquired Byte, a leading direct-to-consumer clear aligner company, for $1.04B (all-cash deal). With this deal, management expects its clear aligner business...
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