{"id":441,"date":"2012-03-12T00:51:15","date_gmt":"2012-03-12T05:51:15","guid":{"rendered":"http:\/\/allisonwatts.com\/blog\/?p=441"},"modified":"2020-12-24T15:50:52","modified_gmt":"2020-12-24T21:50:52","slug":"esthetic-diagnosis-treatment-planning","status":"publish","type":"post","link":"https:\/\/allisonwatts.com\/esthetic-diagnosis-treatment-planning\/","title":{"rendered":"Esthetic Diagnosis and Treatment Planning"},"content":{"rendered":"\n\n\n
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Esthetic Diagnosis and Treatment Planning<\/span><\/b><\/span><\/span><\/h1>\n
by Allison Watts, DDS<\/span><\/i><\/span><\/span><\/strong><\/div>\n

We are walking through the steps of a  full – mouth reconstruction.<\/b>  I enjoy learning all the parts of something and putting it all together and presenting it in a meaningful, easy-to-understand way. That is my goal here. The trick is whether it comes across in print…. and whether I’ve included enough detail…<\/span>
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Here’s what we’ve covered so far:<\/span> <\/span>
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  1. Phone call\/First encounter<\/b><\/span><\/span>
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  2. NP experience\/First appointment<\/b><\/span> <\/span>
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  3. Data collection\/Records<\/b><\/span>
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  4. Treatment planning and sequencing<\/b><\/span> <\/span>
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  5. Setting fees <\/a>– <\/b>I just want to add quickly that much of fee-setting is mindset—how comfortable are we with the value of what we do and do we believe that what we do is a commodity or a highly valuable service (the more training and skill we have, the more valuable). <\/span><\/span><\/li>\n<\/ol>\n

    Back to diagnosing and treatment planning Esthetics:<\/span><\/span><\/strong><\/em><\/p>\n

    Remember diagnosis comes from information we get from the examination and records.  We want to gather information first, identify the condition (make a diagnosis), decide on the desired outcomes and then decide how to get to the desired outcome (treatment plan and sequence). You may need to do the following in order to make an excellent diagnosis (and treatment plan):<\/span><\/span><\/div>\n
    Mock-up\/Trial smile<\/strong> – I find it helpful to do this, not only for the patient to see what’s possible, but for me to see what’s possible and help clarify the plan.<\/span><\/span><\/div>\n
    Mounted models<\/strong> – We get so much information from mounted models. From esthetic information to occlusal information, most cases I treat require and benefit greatly from mounted models. Full mouth rehabilitation definitely requires mounted models.<\/span><\/span><\/div>\n
    Waxup <\/strong>– Usually when doing large cases, I will do a mockup in the mouth and take impressions of it. I will sometimes mockup the models and sometimes I will just give the lab the parameters, such as length of upper and lower incisors, overjet, overbite, steep or shallow guidance, broaden the buccal corridors, etc. Any, some or all of the above in any combination are good. Leaving it up to the lab is usually not a good idea.<\/span><\/span><\/div>\n
    Urgent care may need to be done <\/strong>in order to make a correct diagnosis and decide the treatment plan for questionable teeth.<\/span><\/span><\/div>\n
    Specialist consultations may help<\/strong> in the diagnosis and treatment planning phase as we try to decide whether orthodontics, periodontics, endodontics and oral surgery can get us where we want to go.<\/span><\/span><\/div>\n
    Considering all of the above, let’s go through esthetic diagnosis and treatment planning.<\/strong> Remember, EFSB <\/strong>is the facially-generated model taught by Frank Spear.  Esthetics, Function, Structure, Biology is the order used for treatment planning. Many say reverse the order when working through the diagnosis: Biology, Structure, Function, Esthetics. We need to make the diagnosis BEFORE we treatment plan.  This system is based on the idea of treatment planning from the outside in, using the face to determine where the teeth go. If you’d like a copy of my diagnosis and treatment planning form, please contact me at insights@allisonwatts.com<\/u>.<\/a><\/strong><\/em><\/span><\/span><\/div>\n
    Much of esthetic diagnosis and treatment planning is done from the photos. Again, let me say, photography is a must<\/strong> for excellent diagnosis, treatment planning, patient education\/case acceptance, and case documentation… especially the esthetic portion.<\/em>  <\/span><\/span><\/div>\n
    Esthetic diagnosis (most of this is a la Frank Spear)<\/b><\/span><\/span><\/div>\n
    The key photographs are the full face smile, the close up smile, lip at rest and the retracted teeth apart photos.<\/span><\/span><\/div>\n
    Maxillary tooth position<\/b><\/span><\/span><\/div>\n