Initial oral surgeon consultation
Most often, the patient, upon registering for an initial consultation, wants to know it all – what and how it will be done. Unfortunately, it is possible to do in simplest cases only when the patient’s occlusion is correct, and only one or a few teeth are missing. In such cases, the patient is immediately introduced to the treatment planned, and the anticipatory time of surgical or therapeutic procedure is provided. However, mostly there are more problems, and they are more severe, demanding a more in-depth analysis. In such cases, the patient’s mouth and teeth are photographed, radiography images are kept, and the patients are asked to sign up for the next appointment -presentation of a treatment plan.
It is mandatory to bring along a panoramic radiograph image. If a patient doesn’t have it, panoramic radiograph or computed tomography can be performed at the clinic. How do they differ from each other? The panoramic radiography image is a two-dimensional shadow image of jaws and teeth. Computed tomography is a three-dimensional image while analyzing it, a jaw and teeth look like real; they can be rotated to the desired side to see a preferred cross-section, to segment out tissues of preferred density. In diagnostics, a panoramic image and computed tomogram can be compared like a car and an airplane.
Clinical examination: during the initial consultation, the oral cavity and teeth are examined, and occlusion is assessed. If need be, the situation is photographed, the images come in handy when compiling a treatment plan. Condition of gums is also identified, a check is performed whether there is a periodontal disease; oral hygiene is assessed.
Radiological examination: for patients who turn to the clinic for implantation or complicated tooth extraction, they must have a radiological examination performed on them.
Presentation of the treatment plan
What is it needed for? If there is a “chaos” in the mouth: malocclusion, crooked teeth, numerous missing teeth, the teeth are prolonged and leaning toward the areas of missing teeth, the doctor needs some time to think, so he could propose an optimal solution, perhaps even several solutions that differ from each other by complexity and price. Treatment solutions are precisely discussed during the presentation of a treatment plan compiled by the doctor. The patient, together with the doctor, sits in front of a computer display and not in the dentist’s chair, so he/she can be more focused on the information provided. In good half an hour, all possibilities of implantation, prosthodontics, and dental treatment are laid out, and the patient can choose the most preferred option, or think it over calmly at home, and decide later.
It is desirable that all related persons who will take part in the making of a decision would come to the presentation of a treatment plan. Mostly these persons are husbands or views, sometimes parents. It matters for several reasons: 1) a few people hear and memorize more information than one person; 2) when coming alone, the patient will not always be able to retell the problem and its solution methods at home without invoking visual material; 3) financial issue is no less important, mostly it’s cost is covered from family budget.
The treatment plan is printed out and handed over to the patient. In extremely complicated cases, the treatment plan can be preliminary, and it is supplemented after the patient visits other specialists, such as endodontists (root canal specialists) or orthodontist, who supplement the treatment plan on their behalf by noticing one or another practicable stage of treatment. It is also important to realize that the treatment plan can change in the course. For instance, after the teeth with bad prognosis were removed, and teeth with better prognosis were left, temporary dentures were applied, and while waiting for implants to naturalize, one tooth suddenly breaks off – it was not possible to foresee it, it was only possible to guess that it could happen. In such a case, the treatment plan is amended and supplemented in the course of treatment. Luckily, a meticulously compiled treatment plan in practice seldom changes by more than 10% in its scope. Today we can foresee all nuances of treatment to the smallest details.