With your consult it is important to be methodical and use simple terminology so that the patient can follow along with what you are saying. Go through each of these points out loud so that your nurse can write notes for you and so the patient can get an idea of what you are thinking.
Cosmetic / Invisalign Consult
- size and shape of teeth – are they worn away? difference in width between centrals and other teeth
- width of smile
- amount of gums showing
- amount of crowding
- shade of teeth – from a scale of 1-10, 1 being white and 10 being yellow, its xxx
- during resting lip position and smile, mention position of incisal edges in relation to wet and dry border of lower lip in mm
- amount of plaque/ gum disease. mention any large extensive decay
- TMJ: press masseters/ and temporalis. check for symptoms
General Work Consult
If pt. is mainly here for general work or is here for both cosmetic and general work then go through these parts. Sometimes you will encounter patients that are adamant that they only want to have their main concerns addressed. If that is the case let the patient know that there are things to address down the track.
- check the size of decay in percentage – e.g. original teeth only left 10%. tooth very heavily filled by 80%m how far from the nerve in the x ray.
- gums: % of bone and gum loss. amount of gum recession in mm
- slight mention on colour and size and shape
- TMJ: press masseters/ and temporalis. check for symptoms
What happens if there is general work necessary but it’s a cosmetic consult:
I’ve noticed that some of your other teeth have started to break down. We don’t have to address all of it today but I have to let you know that there are some holes that we need to fix sometime down the track. Would you like me to focus on (MAIN CONCERN) today or go through everything?
All on Implants
When Treatment planning for All ON x the main consideration is gum disease and cost of repair for the patient. For example if patient is going to needs 4+ implants in several different spots on one arch it may be worthwhile considering All on 4.
Always do option 1/option 2
- save teeth band aid solution
- Restore with options of which jaw is better upper or lower first
Focus on :
- Extent of gum disease: eg severe gum disease with grade 2 mobility
- mention approximately how many teeth can be saved and if there’s a better jaw (to guide the patient to only doing 1 jaw if you sense that affordability may be an issue).
- extent of bone loss and possibility of not being able to do all on 4
- Give some good news!
