Dentaltown July 2020 - 53

Chart 1

The standard of care is more like a bell curve
Standard normal distribution

19.1% 19.1%

Definitely below the standard of care
(This is the line no dentist should cross)
9.2%
0.5%

0.1%

Z-Score
Standard
Deviation

1.7%

Cumulative
Percentage

-3

-2

0.1%

4.4%

-1.5 -1 -0.5 0
-1
15.9%

1%

limited to the scope of the specific procedure.
What constitutes "regular" health
history updates? Every time a patient comes
in, you should update his or her health
history. Yes, even if you're an orthodontist!
Updating a health history once every five
years is below the standard of care.
What is a "comprehensive" health
history? For guidance, look at what the
ADA lists for a health history. If your health
history has what the ADA recommends,
you have a comprehensive health history.
If your health history is from 1982, you
probably don't.
What are "regular periodontal updates"?
If you have periodontal charting every year,
you're covered. If your periodontal charting
is once every five years, you're in trouble.
Consider what a reasonable and prudent
dentist would do in a like or similar situation,
in a like or similar locale.
What does "Is the diagnosis consistent
with the treatment plan?" really mean?
If you have a periapical lesion on Tooth

9.2%

4.4%

-4 -3.5 -3 -2.5 -2
-4

Definitely above the standard of care
(Unachievable by most dentists)

15.0%

15.0%

0
50%

.5

11

.5

1.7%

22

0.5%

.5

33

+1

+2

+3

84.1%

97.7%

99.9%

5% 10% 20 30 40 50 60 70 80 90% 95%

0.1%

.5 4
+4

99%

#8 and you're diagnosing acute periapical
periodontitis with a treatment plan of
root canal therapy or extraction, this is a
reasonable diagnosis and treatment plan.
If you're recommending a crown with no
root canal therapy, this would not be a
reasonable diagnosis or treatment plan. The
X-rays should support your diagnosis and
treatment plan.
However, specific procedures require
much more specific detail.
Example 1: When doing root canal
therapy, the radiographic apex can be up
to 3mm different from the actual apex.
Example 2: When doing parenteral or
enteral sedation, blood pressure needs to
be taken a minimum of every 15 minutes.
Best practice is every 5 minutes and the
procedure should be stopped if the systolic
and diastolic blood pressure add up to 300.
Remember, these are only guidelines, and
factors such as "aggravating," "mitigating"
and "compelling reasons" are up to the
practitioner's professional judgment. n
dentaltown.com \\ JULY 2020

DT0520_Dovgan_Standards_AG.indd 53

53

6/22/20 12:20 PM


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Dentaltown July 2020

Table of Contents for the Digital Edition of Dentaltown July 2020

Dentaltown July 2020 - Intro
Dentaltown July 2020 - Cover1
Dentaltown July 2020 - Cover2
Dentaltown July 2020 - 1
Dentaltown July 2020 - 2
Dentaltown July 2020 - 3
Dentaltown July 2020 - 4
Dentaltown July 2020 - 5
Dentaltown July 2020 - 6
Dentaltown July 2020 - 7
Dentaltown July 2020 - 8
Dentaltown July 2020 - 9
Dentaltown July 2020 - 10
Dentaltown July 2020 - 11
Dentaltown July 2020 - 12
Dentaltown July 2020 - 13
Dentaltown July 2020 - 14
Dentaltown July 2020 - 15
Dentaltown July 2020 - 16
Dentaltown July 2020 - 17
Dentaltown July 2020 - 18
Dentaltown July 2020 - 19
Dentaltown July 2020 - 20
Dentaltown July 2020 - 21
Dentaltown July 2020 - 22
Dentaltown July 2020 - 23
Dentaltown July 2020 - 24
Dentaltown July 2020 - 25
Dentaltown July 2020 - 26
Dentaltown July 2020 - 27
Dentaltown July 2020 - 28
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Dentaltown July 2020 - 30
Dentaltown July 2020 - 31
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Dentaltown July 2020 - 35
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Dentaltown July 2020 - 37
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Dentaltown July 2020 - 40
Dentaltown July 2020 - 41
Dentaltown July 2020 - 42
Dentaltown July 2020 - 43
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Dentaltown July 2020 - 45
Dentaltown July 2020 - 46
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Dentaltown July 2020 - 48
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Dentaltown July 2020 - 50
Dentaltown July 2020 - 51
Dentaltown July 2020 - 52
Dentaltown July 2020 - 53
Dentaltown July 2020 - 54
Dentaltown July 2020 - 55
Dentaltown July 2020 - 56
Dentaltown July 2020 - 57
Dentaltown July 2020 - 58
Dentaltown July 2020 - 59
Dentaltown July 2020 - 60
Dentaltown July 2020 - 61
Dentaltown July 2020 - 62
Dentaltown July 2020 - 63
Dentaltown July 2020 - 64
Dentaltown July 2020 - Cover3
Dentaltown July 2020 - Cover4
https://www.nxtbook.com/farran/dentaltown/2020NewGrad
https://www.nxtbook.com/farran/dentaltown/2020October
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https://www.nxtbook.com/farran/dentaltown/2020July
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https://www.nxtbook.com/farran/dentaltown/2020February
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https://www.nxtbook.com/farran/dentaltown/2019December
https://www.nxtbook.com/farran/dentaltown/2019November
https://www.nxtbook.com/farran/dentaltownuk/2019OctoberNovember
https://www.nxtbook.com/farran/dentaltown/2019October
https://www.nxtbook.com/farran/dentaltown/2019NewGrad
https://www.nxtbook.com/farran/dentaltown/2019September
https://www.nxtbook.com/farran/dentaltown/2019August
https://www.nxtbook.com/farran/dentaltown/2019July
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https://www.nxtbook.com/farran/dentaltownuk/2019FebruaryMarch
https://www.nxtbook.com/farran/dentaltown/2019January
https://www.nxtbook.com/farran/dentaltownuk/2018Winter
https://www.nxtbook.com/farran/dentaltown/2018December
https://www.nxtbook.com/farran/dentaltown/2018November
https://www.nxtbook.com/farran/dentaltownuk/2018November
https://www.nxtbook.com/farran/dentaltown/2018October
https://www.nxtbook.com/farran/dentaltownuk/2018October
https://www.nxtbook.com/farran/dentaltown/2018NewGrad
https://www.nxtbook.com/farran/dentaltown/2018September
https://www.nxtbook.com/farran/dentaltownuk/2018September
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https://www.nxtbook.com/farran/dentaltown/2018March
https://www.nxtbook.com/farran/dentaltownuk/2018March
https://www.nxtbook.com/farran/dentaltown/2018February
https://www.nxtbook.com/farran/dentaltownuk/2018February
https://www.nxtbook.com/farran/dentaltown/2018January
https://www.nxtbook.com/farran/dentaltown/2017December
https://www.nxtbook.com/farran/dentaltownuk/2017Winter
https://www.nxtbook.com/farran/dentaltown/2017November
https://www.nxtbook.com/farran/dentaltown/2017October
https://www.nxtbook.com/farran/dentaltownuk/2017october
https://www.nxtbook.com/farran/dentaltown/NewGrad2017
https://www.nxtbook.com/farran/dentaltown/2017September
https://www.nxtbook.com/farran/dentaltownuk/2017September
https://www.nxtbook.com/farran/dentaltownuk/2017August
https://www.nxtbook.com/farran/dentaltown/2017August
https://www.nxtbook.com/farran/dentaltown/2017July
https://www.nxtbook.com/farran/dentaltownuk/2017July
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https://www.nxtbook.com/farran/dentaltownuk/dentaltownuk/2017march
https://www.nxtbook.com/farran/dentaltown/February2017
https://www.nxtbook.com/farran/dentaltown/2017January
https://www.nxtbook.com/farran/dentaltown/2016December
https://www.nxtbook.com/farran/dentaltown/2016November
https://www.nxtbook.com/farran/dentaltown/2016October
https://www.nxtbook.com/farran/dentaltown/2016nge
https://www.nxtbook.com/farran/dentaltown/2016september
https://www.nxtbook.com/farran/dentaltown/2016august
https://www.nxtbook.com/farran/dentaltown/2016july
https://www.nxtbook.com/farran/dentaltown/2016june
https://www.nxtbook.com/farran/dentaltown/2016may
https://www.nxtbook.com/farran/dentaltown/2016april
https://www.nxtbook.com/farran/dentaltown/2016march
https://www.nxtbook.com/farran/dentaltown/2016february
https://www.nxtbook.com/farran/dentaltown/2016january
https://www.nxtbook.com/farran/dentaltown/2015december
https://www.nxtbook.com/farran/dentaltown/2015november
https://www.nxtbook.com/farran/dentaltown/2015october
https://www.nxtbook.com/farran/dentaltown/2015nge
https://www.nxtbook.com/farran/dentaltown/2015september
https://www.nxtbook.com/farran/dentaltown/2015august
https://www.nxtbook.com/farran/dentaltown/2015july
https://www.nxtbook.com/farran/dentaltown/2015june
https://www.nxtbook.com/farran/dentaltown/2015may
https://www.nxtbook.com/farran/dentaltown/2015april
https://www.nxtbook.com/farran/dentaltown/2015march
https://www.nxtbook.com/farran/dentaltown/2015february
https://www.nxtbook.com/farran/dentaltown/2015january
https://www.nxtbook.com/farran/dentaltown/2014december
https://www.nxtbook.com/farran/dentaltown/2014decemberb
https://www.nxtbook.com/farran/dentaltown/2014november
https://www.nxtbook.com/farran/dentaltown/2014october
https://www.nxtbook.com/farran/dentaltown/2014newgrad
https://www.nxtbook.com/farran/dentaltown/2014september
https://www.nxtbook.com/farran/dentaltown/2014august
https://www.nxtbook.com/farran/dentaltown/2014july
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https://www.nxtbook.com/farran/dentaltown/2014february
https://www.nxtbook.com/farran/dentaltown/2014january
https://www.nxtbook.com/farran/dentaltown/2013december
https://www.nxtbook.com/farran/dentaltown/2013november
https://www.nxtbook.com/farran/dentaltown/2013october
https://www.nxtbook.com/farran/dentaltown/2013newgrad
https://www.nxtbook.com/farran/dentaltown/2013september
https://www.nxtbook.com/farran/dentaltown/2013august
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https://www.nxtbook.com/farran/dentaltown/2013june
https://www.nxtbook.com/farran/dentaltown/2013may
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https://www.nxtbook.com/farran/dentaltown/2013march
https://www.nxtbook.com/farran/dentaltown/2013february
https://www.nxtbook.com/farran/dentaltown/2013january
https://www.nxtbook.com/farran/dentaltown/2012december
https://www.nxtbook.com/farran/dentaltown/2012November
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