Discover how easy it is to manage treatment options with Dentrix.
Dental consultants stress the importance of offering patients treatment alternatives as an integral part of the dental office’s responsibility to gain informed consent. Plus, you may find it helpful to give patients options when their preferences don’t align with your preferred or recommended treatment. Dentrix makes it easy for you to create and manage treatment alternatives in the Treatment Planner by linking alternate treatment recommendations together or creating alternate cases.
In order to create alternative treatment cases, you must first add both sets of procedures to the patient’s treatment plan. For example, if you are going to recommend an implant to a patient but also offer the option of a bridge, you need to treatment plan all of the procedures for the implant and all the procedures for the bridge. It may seem like you have a lot of things treatment planned for the patient, but once you organize the treatment into cases in the Treatment Planner you will be able to make sense of the options.
Linked Cases vs. Alternate Cases
Once you have added all alternatives to the treatment plan you can create treatment alternatives in one of two ways: by linking cases or by creating an alternate cases. By linking cases, you connect two treatment cases together in the Treatment Planner so that they function as alternatives to each other. When one linked case is accepted, the other is rejected.
Alternate cases are also connected together in the same way as linked cases, but there is one distinct difference between the two. When you create an alternate case, in addition to the two treatment options you can also include the treatment that will be required in either case. For example, if you are offering a patient the option of a bridge or an implant, but the patient needs to have several fillings completed regardless of which treatment option they choose, you would create alternate cases and copy the fillings into both cases. That way each treatment alternative would include the restoration option plus the fillings.
Creating Linked Cases
When you have two different cases created in Dentrix that contain different procedures to address the same problem, you can link those cases together and create treatment options. When the patient accepts one of the treatment options the other will be automatically rejected because they are linked together.
Dr. Smith would like to present treatment alternatives to Hannah Cahill for a cracked molar. He wants to give her the option of either an MB porcelain onlay on #30 or a crown on #30.
To link cases:
- From the Chart, treatment plan all of the procedures for the onlay and the crown.
- In the Treatment Planner, create a case called Onlay and a separate case called Crown.
- Add the onlay procedure to the Onlay case and the crown procedures to the Crown case.
- Click the Link Cases button and select Link Alternate Cases. The Linked Cases dialog box appears.
- Check the Onlay case and the Crown case. In the Recommended Case drop-down, select the case you want to recommend to the patient.
- Click OK. The cases will be linked together as alternate cases.
A linked symbol appears next to each case, indicating the connection. A star on the link symbol indicates the recommended case.
Keep in mind:
- Dentrix automatically assigns a recommended case, but you can change that as needed. The case you set as the recommended case should be the treatment alternative that you believe provides the best care for the patient’s dental condition. To change the recommended case, right-click the desired case and click Set as Recommended Case.
- Only the treatment-planned procedures within the recommended case show in the Patient Chart, which means that when you are viewing a patient’s treatment procedures visually you will only see the options for the recommended case. Changing which case is set as the Recommended Case will change which procedures paint on the Chart.
- A linked case cannot be the patient’s default case. If you link a new case to the default case, Dentrix automatically creates another treatment case and designates that case as the default case.
- You can unlink cases as necessary if you make a mistake or need to change your settings. To unlink cases, in the Treatment Plan Case Setup section of the Navigation panel, select one of the cases you want to unlink and click the Link Cases button, and select Unlink Selected Case from the menu.
Creating Alternate Cases
When patients have two or more different treatment options and they also have treatment that must be completed regardless of which treatment option they choose, you should create alternate cases for the treatment. The Create Alternate Case tool lets you copy treatment planned procedures to multiple cases, allowing you to create alternatives that each include non-optional procedures.
Jesse Doyle has several procedures in his treatment plan including some composite restorations and treatment alternatives for a missing tooth. Dr. Smith wants to present Jesse with two treatment alternatives for the missing tooth: an implant and a bridge. The implant case should include an implant and an abutment on #29, and the bridge case should include retainer crowns on #28 and #30 and a pontic on #29. Jesse also needs two fillings, so both cases should include a DO composite on #3 and an ML composite on #5.
To create alternate cases:
- In the Patient Chart, treatment plan the composites, all of the procedures for the implant, and all of the procedures for the bridge. The procedures will be added to the patient’s default case in the Treatment Planner.
- Right-click the default case and select Create Alternate Case. The Create Alternate Case dialog box appears.
- Name the new case “Bridge.:
- Uncheck everything except the composite procedures since those are the only procedures that will be in both cases.
- Click OK. A new case called Bridge will be created and will contain the composite procedures. As with linked cases, a linked symbol appears next to each case, indicating the connection.
- In the default case, select all of the bridge procedures and drag them into the Bridge case. You will now have one case containing the implant procedures and one case containing the bridge procedures, but both cases will include the composites.
- Right-click the default case and select Rename Case. Rename the default case to Implant.
- Create a new case called Default Case. Right-click the new case and select Set Case as Patient’s Default Treatment Plan.
Keep in mind:
- Any time you treatment plan procedures, they are added to the default case in the Treatment Planner. Because you do not want any new procedures added to the cases you just defined, it’s important that you make a new default case once you have set up your alternate cases.
- You can tell which case is the default case because the case name appears in bold.
- When you select the procedures in the Create Alternate Case dialog box, you are telling Dentrix to add a duplicate copy of the procedures to the new alternate case. You should only check the procedures that both cases will have in common.
- When you complete an alternate case, the procedures that were duplicated in the other case will also be marked as completed. They will not be duplicated in the Chart.
Check Your Understanding
Use the following case studies to check your understanding of working with alternate treatment cases in Dentrix. Discuss the following scenarios with your team and decide whether you should create multiple unrelated cases, create an alternate case, or link alternate cases:
- Q: Keri Brown has a missing tooth. Dr. Jones recommends that she have an implant to replace the tooth, but she could have a bridge to replace the tooth.
- A: Keri will be choosing between two options for treatment, and there is no other treatment that needs to be completed. You should link the alternative cases.
- Q: Jane Sterling needs to have a root canal. Dr. Jones wants to present some cosmetic bleaching to her as well. The root canal and the bleaching do not need to be completed at the same time.
- A: Since the procedures are not alternatives to each other and are just separate treatments, you should create two unrelated treatment plans for Jane: one for the root canal and one for the optional cosmetic procedures.
- Q: Raul Hernandez needs to have fillings on #18 and #19. Dr. Jones is giving him the option of either amalgam or composite fillings.
- A: Raul will be choosing between two options for treatment, and there is no other treatment that needs to be completed. You should link the alternative cases.
- Q: Tina Leung needs to have fillings on #6-7 and #15. Dr. Jones wants her to have composites on #6-7, but Tina can choose either an amalgam or a composite on #15.
- A: Tina needs to have the fillings on #6 and #7 completed regardless of which option she chooses for #15, so you should create alternate cases for the amalgam and composite on #15 that both include the composites on #6-7.
For advice and ideas about increasing case acceptance, read Increasing Treatment Acceptance and Getting Paid.
By Erin Brisk, Senior Editor
Originally published Dentrix Magazine, Summer 2016