Efficiency of obtaining dental records
I was thinking about a situation in the car on the way home today. It was one of those: "well if they said that then I would say this, if they did this then I would do that" kind of moments. The scenario was that of an examination appointment where you've figured out the patient's goal is to improve their aesthetics or their function and in the course of your examination you know that it will be a full mouth rehabilitation. In any case this isn't something that you should plan or discuss on the spot. Therefore it is something that you should take records i.e photos, models, bite and facebow to plan the case out.
As to the extent that you inform the patient of the plan I would say something like: "well sir/madam, according to your goals as I understand them, we want to improve your aesthetics/function and to do this is requires quite complex and expensive work. At this moment I am not sure if it is possible to do in a way that will fit your budget and expectations but I would like to take some photos and impressions to try and plan out your case. Are you okay with this?"
I then thought about how I would approach this record gathering task the most efficient way possible. Ideally there is no downtime where either you or your assistant is standing around doing nothing. In my current job, this is how I would approach it:
-Try the trays in for the impression
-I take the patient to stand up against a blank wall while the assistant sprays the trays with adhesive
-I take extraoral and intraoral retracted photos with the patient holding the retractors
-When the trays are sprayed, the assistant begins to warm the mirrors under hot water. This should be completed by the time I am finished with my first set of photos
-I sit the patient on the dental chair and the assistant brings the mirror over allowing us to take a retracted maxillary and mandibular occlusal photo
-The retractors are taken by the assistant and they begin to mix the impression material (alginate).
-After the impressions I take the facebow and bite registration. The assistant disinfects all the records
-The patient is rebooked for a second consult appointment
Some aspects I would do differently in another job would be:
-Ideally the mirror would be on a mirror warmer to avoid the need to run it under hot water
-A second assistant will prepare all the record equipment whilst the exam is still occurring at the start
-An assistant or OHT would take the impressions, facebow and bite. They may even be able to take the photos if I trusted them to.
-While the impressions and records are being taken, a second assistant is uploading all the photos in case I want to discuss any aspects of the patient's condition before the end of the appointment
As to the extent that you inform the patient of the plan I would say something like: "well sir/madam, according to your goals as I understand them, we want to improve your aesthetics/function and to do this is requires quite complex and expensive work. At this moment I am not sure if it is possible to do in a way that will fit your budget and expectations but I would like to take some photos and impressions to try and plan out your case. Are you okay with this?"
I then thought about how I would approach this record gathering task the most efficient way possible. Ideally there is no downtime where either you or your assistant is standing around doing nothing. In my current job, this is how I would approach it:
-Try the trays in for the impression
-I take the patient to stand up against a blank wall while the assistant sprays the trays with adhesive
-I take extraoral and intraoral retracted photos with the patient holding the retractors
-When the trays are sprayed, the assistant begins to warm the mirrors under hot water. This should be completed by the time I am finished with my first set of photos
-I sit the patient on the dental chair and the assistant brings the mirror over allowing us to take a retracted maxillary and mandibular occlusal photo
-The retractors are taken by the assistant and they begin to mix the impression material (alginate).
-After the impressions I take the facebow and bite registration. The assistant disinfects all the records
-The patient is rebooked for a second consult appointment
Some aspects I would do differently in another job would be:
-Ideally the mirror would be on a mirror warmer to avoid the need to run it under hot water
-A second assistant will prepare all the record equipment whilst the exam is still occurring at the start
-An assistant or OHT would take the impressions, facebow and bite. They may even be able to take the photos if I trusted them to.
-While the impressions and records are being taken, a second assistant is uploading all the photos in case I want to discuss any aspects of the patient's condition before the end of the appointment
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