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| Why do treatment plans sometimes vary from one dentist to another? |
Variations in prescribing patterns between dentists do occur and are quite common. When examining teeth, dentists go through three steps. They consider first ‘is there anything wrong with the tooth?’; if so ‘does it need treatment?’; and finally, if it does, ‘what treatment is necessary?’. They will then discuss the treatment options with the patient.
There is little disagreement among dentists as to whether there is anything wrong with a tooth. Dental decay is a very slowly progressive disease, and therefore the question of whether a problem requires treatment could reasonably be ‘yes’, ‘no’ or ‘not yet’. If a patient is a regular attender and has seen the same dentist within the previous year, it may well be in the patient’s interests to keep a minor problem under observation. On the other hand it might be better for a patient who attends occasionally, or who is attending for the first time, to have all the problems dealt with.
If treatment is needed, there are a wide range of options. The most appropriate treatment is a matter of judgement by the dentist and may depend on the patient’s attention to oral hygiene and the likely cost to the patient. Some dentists adopt a more cautious approach and only recommend a complex treatment if a more simple procedure has failed. In making these decisions, dentists are influenced by the wishes of the patient.
A dentist’s advice about treatment will depend on a number of factors — whether the patient has been seen before, the dentist’s understanding of a particular problem that the patient might have (for example, a cavity which has been present for some time but is not progressing), the patient’s oral hygiene (which might make certain advanced forms of treatment less feasible), the patient’s timescale (a patient might be looking for a major overhaul or for simple maintenance) and so on.
For every dental problem there is a decision to be made about whether to treat or not, and if treatment is decided on, the type of treatment to be given. The decision must always be the patient’s, however. All treatment must have the patient’s informed consent. If you are concerned about a dentist’s treatment proposal, ask questions — ask to be shown the problem in a mirror, or with a diagram.
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