Comprehensive Treatment Planning  – A paradigm shift for the 21 st century dentist & patient!
Dr Sundar Jagadeesan

Dr Sundar Jagadeesan (Napier, New Zealand) graduated from India & the Kois Centre, USA. He holds a PG certification in Advanced Oral Implantology from Manipal University and was a former faculty for Clinical Dentistry at the same. Currently, he maintains a private practice in New Zealand. He is one of the coveted speakers at the DRDCA 202o International.


The tooth is not in isolation, it is a part of the whole. When a patient walks in the clinic with complaints in his tooth, we must not forget that the treatment should be done keeping not only that tooth in our mind, but also the entire patient. We should avoid ‘only tooth dentistry’ and instead do ‘comprehensive tooth dentistry’!

Disadvantages of Only Tooth Dentistry.

  • By default, you become “process – centered” and not “patient – centered.”
  • Poor occlusal management – Keep the filling short and things will settle down.
  • Poor perio – restorative interface management.
  • Frequent failures of restorations.
  • Frequent repeat work and poor profit margin in private practice.

Advantages of Comprehensive Treatment Planning.

  • Patient – centered outcomes.
  • Long term thinking required by the dentist.
  • Patients gets better results, longevity of restorations.
  • Be ready to accept “rejection” of option from patient.
  • Be assured in yourself and your treatment planning process.
  • You move from “survival” mode to “success” mode (again not meaning process –centered approach)
  • Good occlusion management.
  • Efficient chewing.
  • Better aesthetic outcomes.
  • Move towards an ORAL PHYSICIAN model.
  • “HITMAN” v “HEALER” – Dr John C Kois, you become a HEALER rather than mechanically fix teeth!
Also read:  Crown Restorations for Esthetic Correction of a Single Anterior Tooth

How do you achieve this thought process ?

– By putting in “good clinical governance protocol.”

Good Clinical Governance Protocol

Starts from the reception area, make it look professional and quality looking. Front office staff should exude quality and professionalism in their dealings with any patient.

The Law of Transference will kick in the moment the patient walks in, even the rest rooms should be taken care off. Everything should be clean, tidy, and professionally maintained. Reception should be fitted with well appointed seating material and up to date magazines. Enhance the area with pot-plants (or) aquarium (again well maintained). Take pride in your reception area.

Front office staff should personally greet patients and make them feel comfortable and seat them. Then when the operator is ready, handover the patient to either the clinician (or) to the dental assistant who with then continue the human contact and help calm the nerves the patient might have. Or else they can go through/answer any questions the patient might have regarding anything like the procedure, anesthetic, how much painkillers the dentist will give me, the duration of the appointment and if they have to go somewhere else after the appointment etc.

Then the clinician is here!

Role of Clinician in Comprehensive Treatment Planning

  • Speak well – more importantly “LISTEN WELL”.
  • Make the patient feel they have control and lead the treatment planning.
  • Keep an open mind about treatment options.
  • Treatment plan “as if” dentistry is free.
  • Be ready to honestly discuss options by genuinely addressing the patients concerns, especially about cost.
  • Do not compromise in the quality of the work. -For example, I will not do a “GIC filling” where a ceramic is the only long-term solution – unless the patient understands clearly what he/she is paying for is a provisional restoration.
  • Poor periodontal health – will cause all restorative work to fail. Place more emphasis on periodontal health.
  • Educate patients – it is like an evangelistic responsibility unless we “dentists” say it as it is no one else is going to! You might be the last person to guide that person towards “dental redemption.”
  • Take this responsibility seriously, and as a community we will grow if we work towards it.
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