Dental Hygiene Diagnosis Impact on Treatment Options
Diagnosis impact on treatment planning
Disease classification distinguishes the various conditions affecting the periodontium and it facilitates treatment planning. Several classifications are used based on clinical manifestations, including:
* Location
* Degree of tissue change or loss and,
* Rate of destruction

Periodontitis can be classified into three major types based on:
  • Clinical
  • Radiographic
  • Historical and
  • Laboratory characteristics

Classification of periodontal diseases facilitates treatment alternatives and therapeutic outcomes. Chapter 7, pages 101 - 108, has quick references of the classifications of periodontal diseases and conditions. In general these diseases fall into three broad categories:
1. Gingival diseases
2. Various types of periodontitis
3. Periodontal manifestations of systemic diseases

Proper diagnosis of periodontal disease determines:
  • Identify type
  • Extent
  • Distribution
  • Severity and
  • Provides understanding of cause & pathologic process

To obtain the diagnosis, the dental hygienist must analyze and evaluate the patient’s:
  • Case history
  • Clinical signs & symptoms
  • Results of various tests (probing, mobility, radiographs, blood tests, & biopsies.)
  • Findings must correlate and provide meaning for the patient (role of systemic diseases, conditions, behavioral factors. Does the patient require tx modifications and special precautions.)

Tools for Determining Diagnosis:
1. Overall appraisal of patient
2. Medical history & Risk Assessment (patient & family hx)
3. Dental history (patient & family hx)
4. Radiographic interpretation
5. Casts
6. Clinical photographs
7. Extra & Intra Oral examination
8. Periodontal examination & Prognosis
9. Nutritional status
10. Laboratory tests

ALL of these combined are what make an IMPACT on treatment planning; on the ability of the dental hygienist to treatment plan effectively and have it be patient centered.
What happens next after the DIAGNOSIS is made? The dental hygienist has the ability to provide a patient centered treatment plan that is customized to their oral health needs.

The Treatment Plan:
  • Blueprint for case management
  • Procedures required to establish and maintain oral health
  • Treatment encompasses therapeutic objectives according to patient oral health needs; based on diagnosis, disease severity, and other factors.
  • Reasoned decision
  • Techniques to reach objective

The goal of the treatment plan is to eliminate gingival inflammation and correct the conditions that cause and perpetuate it.

Considerations for treatment planning:
  • Extracting or preserving teeth. Removal, retention, of temporary retention of one or more teeth is important for the overall tx plan. Proper function and esthetics are important, may require interdisciplinary consultation with specialists.
  • Occlusal relationship, systemic conditions, and supportive periodontal care

Therapeutic Procedures
Phase I – nonsurgical phase
Phase II – surgical phase
Phase III – restorative phase
Phase IV – maintenance phase

Explaining the treatment plan to the patient:
1. Be specific, explain exactly what conditions are & how they are treated, & prognosis after tx.
2. Begin discussion on a positive note. Long-term service expected and every effort will be made to retain as many teeth as possible.
3. Present the entire tx plan as a unit. Do not let the pt assume that there are procedures that they can pick and choose to do or not do.
4. Explain that not taking action and not proceeding with proposed tx plan is unadvisable. Emphasize the importance of eliminating disease and that maintaining disease may have severe life-threatening risk factors, such as cardiovascular disease, pulmonary disease and stroke.