Treatment planning – assessment,planning and treatment

Treatment  planning  involves  applying  learned
didactic scientific knowledge to clinical realities.
To  achieve  this  goal,  a  systematic  approach  is
necessary,  using  the  acronym APT  (assessment,
planning  and  treatment)  (Fig.  1.1).  Aesthetic
treatment,  unlike  other  forms  of  dental  care,
requires  a  radically  different  approach.  For
example,  the protocol  for endodontic  treatment
is  infection  removal  and  subsequent  sealing  of
the canal(s), requiring little or no input from the
patient. In fact, the patient is usually oblivious to
the treatment modality, and is only aware of res-
olution of symptoms. Aesthetic treatment on the
other  hand,  is  highly  subjective,  with  active
patient  participation.  The  colour,  form  and
characterisation of anterior aesthetic restorations
are open  to  scrutiny by  the patient,  family and
friends.  The  clinician  therefore  has  to  adopt
a  different  protocol  to  meet  these  challenges
for  avoiding  disagreements  and  unsatisfactory
outcomes.
In  order  to  execute  aesthetic  treatment  suc-
cessfully, the following items are prerequisite:
! Time
! Aptitude
! Knowledge
! Skills
! Experience
! Patience
Without  these  qualities,  aesthetic  treatment
is  neither  possible  nor  successful.  To  achieve
these  objectives,  use  of  a  systematic  approach,
such  as APT, maximises  success  and minimises
failures.
Assessment
Assessment  begins with  an  initial  consultation,
which is a mutual evaluation between the patient
and  clinician.  This  appointment  generates  rev-
enues  below  the  clinician’s  usual  hourly  rate,
but  is  worthwhile  in  the  long  run.  The  initial
encounter  is  predominantly  psychological,  the
clinician determining the patient’s persona, emo-
tional make-up and needs, and the patient assess-
ing his/her confidence of the dental team, as well
as the ambience of the dental practice. The clin-
ician’s  approach  should  be  empathetic  and
sincere, rather than dismissive and authoritarian,
since this meeting will determine whether a sat-
isfying  dentist–patient  relationship  is  possible.