Treatment planning help for dentists

August 7, 2013

I know many dentists read my blog, and I’m honoured with the number of emails I get asking for help

I’m going to write a series of blogs aimed at helping you improve patient care.  This isn’t an in depth explanation, rather a brief overview to help you improve understanding

In this first one, we’re going to start talking about facially generated treatment planning.  This is the core of attaining outstanding results

In order to assess how easy or difficult the case is going to be, you need to assess where the incisors currently sit and where you would like them to end up.  Visualise in your mind where the ideal position would be, at the stage do NOT think about what is there.

It’s wise to make a note in your records, I personally use a custom screen on my software.  Something along the lines of:

Final incisor position: Use current position of UR1 but lengthen by 2mm

You need to then measure the current length of the incisor and relate it to gingival display, lip travel and skeletal relationship.  The average upper lip length for a male is 19-21mm and for females 20-22mm.  Average lip travel is in the region of 5-8mm.  Gummy smiles can ONLY be corrected with Botox if hypermobility is an issue.  If the problem is a short upper lip or VME then you will end up with a very odd looking result

Start assessing facial structures, and start visualising final positions before anything else enters your mind.  The final desired result dictates what treatment is required, what is currently present is a modifier to that end and nothing more.  I know this is a difficult concept for many to get their head around but when you do it’ll improve your aesthetic evaluation hugely


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