As part of treatment planning,
you as the dentist introduce options to your patients. After a relaxed
conversation, a treatment plan is agreed upon between you and your dental patient.
You use the best available research-based literature, clinical experience and
patient opinions to guide your treatment decisions. As a dentist, you exercise
substantial influence on which treatment method is chosen. Patients’ decisions can
lead to less than ideal, though clinically adequate, treatment plans that give
patient satisfaction over the long-term1. Patients’ decisions are most affected by
their relationship with you as their dentist over factors such as time, access, and cost1. Health service providers may affect the
decision-making process between you and your patient if specific treatments are
favored or excluded on financial grounds. Kalsi and Hemmings recommends letters
should be sent to patients explaining the “nature of all proposed options,
including advantages and disadvantages, complications, success rates, biological
and financial costs” and the consequences if no treatment is carried out1.
Many psychological and social
determinants influence patients’ values and decision-making when choosing a
treatment plan in restorative dentistry. Frequently, a component of compromise between
both parties in deemed acceptable even when clinical evidence indicates an
alternative treatment to be more appropriate.
The best possible treatments should
be based on the best available literature; however, the majority of treatment
plans are greatly impacted by patients’
desires and expectations, which may not be based on sound knowledge1. Patients’ wishes should be determined at
the first treatment planning consultation to sort out whether they are
realistic and possible within your own skill set, experience and knowledge1. It is widely known that no dentist should
perform any treatment that could harm a patient.
Time, number of appointments, use
of anesthesia or sedative agents, pain and suffering are significant aspects to
your patients’ decisions when selecting a treatment plan. You need to clarify
biological and financial cost-benefit analyses to the patient1. Also identify clinical factors, such as
age, medical history and economics.
Patients seek dental treatment
for three main reasons: comfort, aesthetics, and function. Patients are the real judge of whether their treatment is
successful or not, so it is vital that they are pleased with their dental
product1. Their
subjective assessments of a proposed treatment do not always correspond with
their acceptance of evidence-based suggestions from clinical research literature.
This assessment is contingent on the value patients accredit to a treatment.
Aesthetic awareness can push patients to ask for destructive, biologically
invasive work in situations where appearances could easily and equally be
improved with lower risks of morbidity. For example, bleaching and bonding with
veneers may “improve aesthetics with the same effect as full coverage crowns,
with less tooth destruction and risk of dental pulp death and pain”1.
Factors that affect patients’ decisions when deliberating
treatment options:
•
Availability
and access to care
•
Real cost
per treatment option
•
Perceived value
for money
•
Past dental
history: positive or negative attitudes
•
Dentist’s
confidence and competence
•
Patient’s
confidence in dentist’s competence
•
Patient’s confidence
in the treatment plan
•
Time and
number of appointments
•
Perceived
impact to quality of life
•
Pain and
inconvenience associated with treatment1
Interestingly, patients place
more emphasis on your recommendations rather than on objective, evidence-based
literature1. If a
dentist advocates a treatment, the patient is 2−21 times more likely to have it
done1.
Comparatively, Kalsi and Hemmings found the endorsements made by evidence-based
literature made no difference to a patient when choosing to proceed with a
treatment. Confidence in your advice establishes the foundation of a
professional relationship with the patient.
The significance of the
dentist-patient relationship cannot be minimized, and a positive relationship is
most likely to prompt a patient consenting for treatment. Patients put a lot of
value on your recommendations. At the same time, patients want to play a collaborative role with you in the
decision-making process. A treatment plan that is not evidence-based or
approved with the patient runs the risk of losing a patient or, at worst,
medico-legal action1. However,
treatment plans with an “element of compromise can be acceptable if, following
full discussion with the patient, and taking into account all relevant factors,
the benefits outweigh the disadvantages. This is the basis of informed consent”1.
About the Company
Since 1991, Iverson Dental
laboratories have provided dentists with high quality dental lab products and excellent
dental lab services to ensure dental patients are completely
satisfied with their restoration outcome. Iverson
dental labs strongly believes in using high quality certified materials and
authentic manufacturing components to fabricate their dental prosthetics given
that material quality influences longevity of the restoration. Iverson values
their skilled team of certified dental technicians because clinical evidence
has shown adequate skills of the technician are important for the long-term
success of a restoration. Iverson labs
strive to be a great dental resource for dental professionals, offering
training on CAD/CAM technologies in digital dentistry and advanced dental implant techniques at their cutting edge on-site
operatory and training facility.
To find more helpful
resources about restorative dentistry or to inquire about our dental lab services, please visit http://www.iversondental-labs.com or call us at (800) 334-2057.
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