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Barrie dentist: dental treatment sequencing, or “My mouth is a mess! What do I do first?

The home page of our website says it already: you’re the star and we’re the director.  This means that it is up to our patients only to give us direction on where to head with their treatment, and not to worry about the mechanics.  But, that doesn’t stop them from worrying!  So, in general terms, this blog post describes how dental treatment should progress.  Proper dental treatment sequencing is of utmost importance in complex oral reconstructions, and if done out of the proper order, can lead to costly and undesirable end results.  Done properly, a case that is managed well from the start will give people the best and most satisfying treatment, with the least amount of time.

Step 1: Talk to your dentist, or else your dentist will talk to you.  Give us your vision!

People are keen to “just get on with treatment”, but the most important part of reconstruction is not in the mouth at all – it is to describe what it is you actually want out of your dental treatment!  This can be simply: “I want my teeth to be healthy” or “I want a Hollywood smile”, to very specific requests such as “I feel something in this tooth when I bite some of the time.”  Whatever your desires or concerns, let your dentist know!  The more information we have to work with, the better we can address your wants.  We don’t want to just assume that we know what people want, because we don’t know what bothers them.  For some people, dental aesthetics is not a concern.  For others in the public eye, teeth are all-important.

In our dental office, we have a specific set of questionnaires that we give to people to elicit the information we require.

Proper dental treatment sequencing flows entirely from this set of initial demands.  When you start building a pool, you don’t want to end up with a barn.

The Simpsons are a great source of wisdom:


And so is Alice in Wonderland:

“Would you tell me, please, which way I ought to go from here?”
“That depends a good deal on where you want to get to,” said the Cat.

Step 2: The examination, both outside and inside the mouth

Next up would have to be a detailed examination of your teeth and surrounding structures.  We look at your bite and jaw joints (TMJ’s), teeth, gums, and also the aesthetics of your smile to really understand what is going on.  This also includes appropriate x-rays to inspect bone and tooth issues, and the complication of all this information, in addition to your preferences, will guide us to a treatment plan.

Step 3: The treatment presentation

Prior to beginning any treatment, we have a discussion about your current problems, and how we need to address them in order to satisfy your demands.  This includes options, the pros and cons of them, and their respective costs.  Ultimately, a final treatment plan is accepted.  From a practical point of view, the biggest delay in a dental treatment plan is not the dentistry, it is typically the preparatory paperwork.  Often insurance matters muddle and confuse people enough that we often feel people without insurance end up with better dental treatment.

Step 4: The point of this blog post

Now the nitty-gritty.  You want details, you got ’em.  Here is the order we do things in:

1)  Gums – Your teeth are “cleaned”, or more properly, debrided of plaque and tartar.  The amount of time required is dependent on the buildup and pocketing you have.  This may be as much as four separate appointments of an hour each, with local anesthetic.  Only when gums are stable can we embark on more elective treatment.  Sometimes periodontist referrals are required to deal with more severe problems.

2)  Teeth – Active disease is addressed, such as cavities, faulty fillings or crowns, root canal /pulp problems.  Hopeless teeth or those with poor prognoses may be extracted.

3)  Joints and bite – We stabilize your bite by appropriate means before more detailed reconstruction.  This may mean a deprogrammer with bite adjustment, or perhaps orthodontic treatment to manage the problems.

4)  Aesthetics – This is where we deal with cosmetic issues, such as tooth alignment problems, colour problems, unaesthetic gum levels, etc.  Sometimes this is limited to whitening of teeth, but in more dramatic or involved cases, may include veneers, crowns, orthodontics, and gum and/or bone recontouring.

If missing teeth are needing to be replaced, the steps are modified to seamlessly incorporate the prosthetic phase:  this may be the placement of implants while other work is progressing, or perhaps bridges or dentures at the end.

This only scratches the surface of dental treatment sequencing, and is really not something that people need concern themselves with.  For a more specific and individualized plan, please contact us!  We’d love to be your dentist in Barrie.

Dr. Elston Wong Portrait

About Dr. Elston Wong

Dr. Elston Wong completed his dental degree at The University of Toronto in 1999 before arriving in Barrie in 2002. After graduating, he continued to learn everything he could about dentistry. Now he has taken the time to share important information for anyone to read.

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