Why stage dental treatments?

I have written on this topic before multiple times, but not recently. It is an important topic and a way that I address the problems of many of my new patients who walk into my office for the first time. Many are immigrants from far away places and grew up being treated by dentists who employed a different standard of care. Patients can present with a fairly significant number of dental problems and all deserve being presented an ideal treatment plan. These plans often can not all be addressed completely and thoroughly in a six month period of time. it can be impossible that finances may dictate the need for spreading out their treatments over a longer time.  Also, it is not unusual for the treatment recommended to be "multidisciplinary and can include Oral surgery, implant surgery, periodontal treatment.,orthodontics, endodontics and cosmetic dentistry. Even for patients with no financial limitations complicated treatment plans can take a year or more ( sometimes several years).

So what should a patient with financial limitations or complicated treatment plans do? Stage their treatment. Stage 1 involves removing hopeless teeth, cleaning out all decay, endodontic treatmetn  and fabricating inexpensive transitional tooth replacements. Stage 2 may involve other needed treatments ( orthodontics, bone grafting, periodontal surgery). hopefully by the end of Stage 2 the foundation has been set and the final leg of the dental journey may take place which usually involves making multiple lab generated "permanent restorations" in order to fabricate long lasting and beautiful restored mouths.

This staging of treatment should be planned and explained in a manner that is understandable to the patient and started with their full approval. I often employ various types of glass inonomer fillings in order to allow interim restorations of extensively decayed teeth. Although these are carefully executed, they are meant to last for 6 months to two years depending on a patients needs and are needed to help insure that their mouth and teeth are less likely to deteriorate while waiting for them to complete their propose treatment.

Some dentists employ composite restorations as interim restorations to help implement proposed changes including opening a bite or altering the lengths of anterior teeth. These can be highly esthetic and often last for years. Still, they should be viewed as interim measures employed to correct patients problems so they don't get worse and help the dentist try out future proposed changes. Free hand bonding using applied with putty matrixes or clear omivac molds can be employed to help complete these restorations more rapidly and affordably.

Once these have been employed a patient can save the money needed for the next stage that can involve multiple lab generated restorations made of ceramic or metal materials or both. For some patients the cost of the final phase of treatment can be as much as a pricey luxury automobile and can require some patients considerable time to line up credit or save the necessary funds.

For some patients with simpler plans finding the funds to pay for dentistry can also  be a real challenge. Staging of their treatment and using longterm interim restorations can be their best bet to start out since it allows them to "kick the can" down the road and keep the condition of their teeth from worsening until they are able to afford some of their more expensive but desired treatments. For all of these reasons, staging treatment can be a necessary step that if used properly can make salvaging peoples teeth more attainable and more predictable as well.

When dentistry is not staged yto fit a patients time table and monthly budget it can lead to patient only getting one or two teeth properly treated with definitive dentistry before they exhaust their available funds. When this happens the condition of teeth that still require treatment  can worsen and even lead their loss.For this reason, financial considerations must be explored and a comprehensive staged treatment plan is the solution for many patients with significant dental disease.

from Ask Dr. Spindel - http://lspindelnycdds.blogspot.com/2018/09/why-stage-dental-treatments.html - http://lspindelnycdds.blogspot.com/

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