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Clinical Treatment Planning
Treating Clinician:
Patient Name:Gender:Date of Birth:Age:Marital Status:Race:Date of Initial Examination:Occupation: Personality Type:
Treatment Planning Case Presentation.
Introduction and Background.
Introduction-Background
Chief Dental Complaint:
Reason for Initial Visit:
Oral Image and Expectation:
Medical History
ASA:Medications: Allergies:Smoker:Systemic Diseases:
Dental History
Previous Dental Treatment History: What does the patient desire?
Diagnostic Findings Head and Neck Nodes: TMJ/Mandibular: Range of Motion: Functional: Joint sounds: Tenderness to musculature palpation:
Myofacial pain: Headaches:
Extra-Oral - Face/Profile/Symmetry
Extra-Oral : Lips/Smiles
Extra-Oral - Buccal Corridors
Combination Dental-Perio. Chart
Periodontal ChartGI – PI –
Intra-oral Images: (Soft tissue)
LR
Intra-oral, Anterior – (Soft Tissue)
LR
Intra-oral - Occlusal Views LR
Radiographs LR
Radiographs LR
Radiographs LR
Radiographs LR
Images - Intra oral, Including casts LR
Images - Intra oral, Including casts LR
Images - Intra oral, Including casts LR
Occlusal Notes
Class occlusion:Class:Incisal guidance and Canine GuidanceNo non-working interferences.CO/CR/MIP - relationship:
Slide
Occlusal Images LR
Occlusal Images LR
Problem list
Diagnosis and Prognosis
AAP Type: AAP Hopeless: #’sGuarded: #’s See risk factors.Good: The rest, assuming homecare improvement, and patient pursues prescribed treatment.
Comprehensive CareComprehensive Care
CariesEndodonticsPeriodonticsPeriodontics
Restorative Dentistry
PredictabilityFunction and
Esthetics.
Treatment Planning Work Sheet.Additional consultations requested:Disease control, aka. Initial Therapy, Phase 1 Therapy,
Restorative: Periodontal: Endodontic: Oral Surgical: Other:
Reconstructive DentistryPeriodontal:Orthodontic:Oral Surgical:Restorative:Prosthodontic:Esthetic enhancement:Functional:Other:
MaintenanceProfessional:Patient:
•Treatment Plan•Break out time - 30 min
•Group A Ideal, costs are not a factor•Group B Ideal, costs are a factor•Group C The best you can do,
costs and time are major factors.
•Outline Goals/Objectives of Treatment
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