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
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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
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Dentaltown July 2020 - 30
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Dentaltown July 2020 - 59
Dentaltown July 2020 - 60
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Dentaltown July 2020 - 63
Dentaltown July 2020 - 64
Dentaltown July 2020 - Cover3
Dentaltown July 2020 - Cover4
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