5.1 Treatment Planning

Recording Treatment Plans

The treatment plan should be written in the patient’s record. The dentist should prioritize preventive, operative, and other care by indicating which procedures should be performed at subsequent appointments. For example, if oral hygiene is to be checked at each appointment, this should be noted, along with other care planned for those appointments, so that all oral health professionals have an understanding of the treatment that the patient needs. Operative treatment should be listed for each tooth; a note of “ops” to indicate restorative needs is insufficient.

Sequence of Treatment

The dentist should determine a treatment sequence that is based on the severity of the patient’s disease as well as on the patient’s ability and willingness to cooperate with treatment. Usually, preventive strategies such as oral hygiene instruction, fluoride, and dental sealant application is completed first; however, in some cases, the sequence of care is different. For example, painful teeth may need immediate treatment, so the dentist may plan to place dental sealants in that quadrant while the rubber dam is in place.

Restorative treatment should be planned by quadrant or half-mouth if possible, with the most severe needs being addressed first. Often, it is convenient to check the integrity of a questionable or incipient interproximal lesion if an interproximal filling is planned for the neighboring tooth.

If this is the case, a note should be in the treatment plan (e.g., MOD #30, ck M #31, MO #31 prn). If dental caries control is necessary, this should be noted in the treatment plan, and the dentist should schedule an appointment to assess the prevention strategies.

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