Treatment Planning Model

A “Spectrum of Care” treatment-planning model is one that can be employed for BMS.21 The highlights of the model are as follows:

• client concerns/needs
• dentist/dental hygienist assessment
• dentist/dental hygienist identification of optimal levels of care
• presentation of options and prognoses to client
• plan of care determined by client and dentist/dental hygienist
• plan implementation.

Client concerns and needs:
Good communication skills are needed to discern perceived needs and client concerns. The domains of need that should be explored are:

• Function—ask about the ability to masticate and speak.
• Symptoms and Pathology—ask open ended questions to elicit the most accurate information about pain, quality of life, etc.
• Esthetics—ask clients to elaborate on their concerns about their appearance.

Assessment:

• Discern the type and severity of the clients’ needs and ability to tolerate potential treatment.
• Evaluate the client’s capacity to function in a way that can maintain oral health. Take into account the client’s resources and any physical or psychological limitations.
• Develop a treatment plan based on objective clinical data, focusing on the domains of need already identified.
• Assess the client’s ability to chew and speak. Reviewing the client’s eating habits or asking the client to maintain a food diary are examples of methods to identify problems relating to this need.
• Perform clinical and diagnostic tests as indicated.
• Perform a complete head and neck examination, including an intraoral examination.
• Assess general health status and possible oral relationships.
• Evaluate the client’s ability to tolerate the stress of potential treatment by taking into account age and health status.

Identification of optimal levels of care and treatment options:

• An interdisciplinary approach including the dental hygienist, dentist, physician, and any other health care provider pertinent to the condition identified.
• Present options to client.
• Implement plan.21