If you are a dentist or team member in a practice that utilizes physiologic dentistry, you are probably always looking for tools that will aid you in treatment acceptance. Measurable tools enable patients to see the progress they make during the orthotic phase of physiologic bite change. I know that as a dental assistant who was always walking my patients through this journey, I was always looking for a tool by which we could measure success.
One of the greatest tools that I utilized in this process was a subjective summary sheet based on symptoms the patient had when they presented to the practice for treatment. Before patients began the orthotic treatment phase, we reviewed a comprehensive list of signs and symptoms that the patient may have had that was causing them pain or discomfort because of malocclusion. We would go through this comprehensive list, symptom by symptom, and record whether the patient had experienced this symptom. If they had not experienced a particular sign or symptom, we would score that a zero, meaning they had not experienced it at all. The scoring was based on a 0 to 5 scale. If they experienced a particular sign or symptom often or all the time, we would score that a 5. If they experienced the symptom intermittently, it may be a 1 through 4 score. Utilizing the signs and symptoms sheet prior to treatment gave us a baseline of the level of discomfort the patient experienced on a day-to-day basis.
The importance of this metric became vital during the orthotic phase of treatment because it gave us a patient-based measurable as to whether the orthotic was successful. The apparent goal in mind would be to see improvement in any sign or symptom they had presented with initially. At each visit, the team member will update the signs and symptoms sheet with the patient. For a patient who does not have irreversible damage, the goal would be to get them 90 to 100% better in all signs and symptoms categories in which they had pain or discomfort initially. Often, as patients heal, they will forget the pain they once lived with because they become accustomed to the comfort they now experience. The importance of the signs and symptoms sheet is to be able to show the patient in retrospect how much improvement they have had from the orthotic physiologically correcting their bite position. If the patient is the one who gave you the information initially, and they have been the one to also give you the feedback at each proceeding visit, there is no contradicting improvement because all feedback has come from the patient!
Personally, I found this to be one of the most beneficial tools I used in moving my patient into treatment acceptance for the second and final phase of treatment.
