Diagnosis and
Treatment Planning
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HISTORY:
Download (Adobe .pdf form) our medical, dental and personal history form to
fill out and bring with you to your appointment. Please answer every question
completely. Just click on the link provided to download forms.
We take a complete medical and dental
history for each patient, and update it continually. This is necessary in order
to give us all of the background information we need to do a proper diagnosis,
to treat you appropriately and safely, and to do no harm. No matter how unimportant
the questions on our form may seem to you, each and every one is potentially
very important to how we treat you, or to making a proper diagnosis. Please
answer each one completely, and if in doubt, give us more information rather
than less. Feel free to add additional information anywhere.
Your medical history will include:
- medications you are taking or have recently taken. Please include over the counter (OTC) medications, vitamins, and any "natural" products that you take.
- serious illnesses you have had in the past
- your current physician and any specialists (include phone numbers)
- any illnesses you have had recently or have currently
- any ongoing or current treatments you are undergoing or are receiving
- medical investigations that are being contemplated
- past surgeries
- surgeries planned
- implants, transplants, prostheses
- allergies to anything at all, but especially drugs or latex products
- high blood pressure, heart problems, circulation problems
- cancer
- diabetes
- stroke, heart disease of any degree, heart surgery, pacemakers
- sexually transmitted diseases
- kidney or liver disease
- substance abuse problems
- psychiatric treatment
- past problems with medical treatments of any kind
- are you pregnant?
- anything else that you are not certain about, or think might be important
Your dental history will include:
- your past dentist and dental specialists
- a brief outline of "normal" dental treatment you have received
- a history of major dental work you have received
- any ongoing dental work you are receiving
- any specific dental concerns that you have
- any discomfort you are having
- any cosmetic concerns that you might have
- any bad dental experiences you have had
- any side effects from "freezing" or other dental treatment
- anything else that you think might be important or are not certain about
- anything you want to know
Your personal history is to help us to get to know you and your family better, and to enable us to serve you in the most efficient manner possible. We don't just treat teeth. We interact with people. It is fair to say that most of our practice is made up of individuals and families who have been with us for a number of years, some for over 26 years. We consider most to be friends.
Your address and all of your contact information (phone numbers, faxes, cell phones, and e-mail addresses) are obviously important if we are to communicate effectively. It also helps if we know the best time to call, and the best place to reach you. It has been our experience that answering machines or voice mail are not effective, and we really prefer not to rely on them at all if possible. We would rather talk with you directly.
It is helpful to know where you work, your profession, trade, or job, (or if you don't have one). If you are a student, we like to know your school and your grade, as well as your fields of study if in college or university. We also really like to know your personal interests, as it makes our visits much more stimulating. We often share many of these interests ourselves.
Finally, we need to know all of your dental insurance information so that we can help you with any benefits to which you may be entitled. We use Electronic Data Interchange (EDI) to deal with those dental benefits companies who are online, and connected by computer. For all others, we will fill out a standard Ontario Dental Association (ODA) approved claims form on your behalf. We need certain information from you if we are to help you with your claim.
YOUR DENTAL EXAMINATION:
Your dental examination is a necessary part of your first visit to our office as well as a wise follow-up prior to any subsequent treatment. Apart from forming the "blueprint" of any treatment, or the basis of a reasonable diagnosis, it is now a legal requirement in almost any jurisdiction in North America and most other places in the world.
Explorers do not travel to strange places without a map, and master carpenters do not cut the wood until they have carefully measured it twice. Without solid information and a plan, we don't know where we are going. Your dental examination gives us that information.
The examination is a documentation of all of the conditions as they exist at that moment. It will include the teeth, the gums, the supporting bone and muscles, the surrounding oral tissues and extra-oral tissues such as the facial muscles, skin, and neck. It will include position, health, presence or absence of disease, normal or abnormal, appearance, and any relationship to your general health.
Similar examinations occur periodically to update our documentation, and by comparing conditions as documented from time to time, we can see any changes that are occurring, both bad and good.
Following the documentation, a discussion of these conditions will occur, followed by a treatment plan (hot link down) to be followed if any treatment is required or recommended or desired.
Our examination will include:
- marking a chart of your teeth to record missing or displaced teeth
- to record positions of teeth
- to record the health of gums and bone
- to record levels of bone and record bone loss
- to record tooth decay and restorations (fillings) and the condition of those restorations
- to identify any tissues that do not appear normal and attempt to discover why
- to look for any signs of oral cancer
- to look for signs of systemic disease or other medical conditions
- to record conditions, which if left untreated could result in problems later on
- to record signs of oral habits which may affect oral health
- to record the effects of smoking, night grinding, fingernail biting, thumb sucking, etc.
- to identify developing orthodontic problems in children and adolescents
- to record anything that does not appear "normal"
- to record all of that which does appear normal (important for future change)
- to record signs of habits or conditions, such as sore neck muscles, which may not be immediately evident to casual observation
Our examination may also include:
- "X-rays" (radiographs) to show us hidden structures in or below the bone, inside of teeth or under fillings, decay which is not yet visible to direct observation, and evidence of disease not visible externally. X-rays are taken based on individual need, and not on any fixed schedule as was common and formally recommended some years ago. However X-rays do have to be taken from time to time. They will be kept to the minimum prudently or legally required to adequately give the us the information needed to diagnose or treat any given situation.
- Impressions or molds for models of your teeth. These may be required for further evaluation or diagnostic modeling. They may also be required in certain circumstances as a permanent 3-D record of your teeth, particularly for orthodontic diagnosis, or where it is anticipated that teeth will be moved, removed, or otherwise substantially altered.
- Records of how your teeth fit together, or how your jaws move and function.
- Records of temporo-mandibular joint (TMJ) function and movements.
- Photographs of your teeth from different views and angles.
- Computer imaging of your teeth for digital manipulation.
- Other diagnostic tests or records as conditions or specific situations dictate.
TREATMENT PLAN
Following the collection of data and the documentation of oral conditions, we will discuss your wants and needs, and then formulate a plan to be followed. In the case of simple or routine dental examinations where little or nothing is "wrong", this will likely be a relatively short, to-the-point discussion, notes will be made, estimates may be sent to your dental benefits company, and any necessary follow-up appointments will be booked.
For more extensive, lengthy, or complicated cases, it may be necessary for us to digest the information after you have left, and draw up several possible courses of action with pluses and minuses, advantages and disadvantages, and possible costs for each alternative. There would then be a follow-up appointment to discuss all of the findings and present all of the alternatives. In such cases, you will be given a written copy of all of this along with a summary of choices to take home and consider. In such a case, the decision on how to proceed will be yours, and no appointments will be made until you feel comfortable with your choice.
In every case for more extensive or involved cases, we will not make any appointments until estimates have been sent to your insurance company, and a reply has been received. We will then send you a letter outlining the exact costs of the service, both in total as well as any portion for which you will be responsible. Payment options will be offered, and arrangements will be made that are satisfactory to you before we proceed. We do not wish any surprises, and we want you to be comfortable with your financial arrangements before we begin.
Appointments for this kind of work will be made once all of these steps have been taken and you are comfortable with the arrangements. If you have any questions about this, please call at any time.
REFERRALS:
In some instances, we may feel it is prudent or necessary for you to consult with a dental or medical specialist. This will occur when medical conditions dictate, or when the level of difficulty or "comfort" with the proposed or necessary treatment is beyond our ability to provide in a safe, efficient, pleasant, or reliable manner.
In these instances we will recommend one or several specialists whom we know will be able to meet your needs. Wherever possible, we will happily pass along duplicates of any records we have taken (such as x-rays) that the specialist may be able to use, in order to avoid unnecessary duplication.
We want you to be comfortable with any treatment or services that we provide. It is our experience that the best results occur when informed decisions have been made, when procedures have been fully-explained, and when reasonable expectations are fully understood in advance. Our best patients are well-informed and knowledgeable about what they want done before we start.
If at any point you wish to seek a second opinion, we are very comfortable with that option. It should be emphasized that it would be rare for any two dentists to agree 100% of the time on everything. In almost every instance there is more than one option, and most dentists will favour different options for many different reasons.
Even within our own practice, the three dentists of LaSalle Dental often have differing approaches to different situations based on familiarity, training, education, expertise, personal comfort, philosophy, and past experience. For a dentist, much of the attraction of practising in a group setting is bouncing ideas, cases, and courses taken off of one another.
Therefore it is not unreasonable for you to want to get another opinion if you are uncertain about how you wish to proceed, or if a diagnosis is a concern. You will not hurt our feelings by requesting a second opinion at any time.