Caries og de nye nationale indkaldeintervaller
Baggrund
Sundhedsstyrelsen indfører nye nationale retningslinjer for indkaldeintervaller, herunder nye ydelser, fx: Diagnostisk grundundersøgelse (DG/DGBU), Fokusundersøgelse (FU) og Statusundersøgelse (SU), som tandlægeteamet jf. godkendelsen af den nye overenskomst skal bruge i sin daglige omgang med patienter.
Patienttilfældet
Patienteksemplet illustrerer, hvilke anamnestiske og kliniske informationer der er nødvendige at indsamle for at kunne stille relevante cariesdiagnoser og for at kunne klassificere patienten som ”grøn”, ”gul” eller ”rød” risikopatient, som det er blevet obligatorisk at gøre under de nye retningslinjer. Det gennemgås, hvilke behandlinger der er relevante for patienten i forhold til de tre cariesdiagnoser: Caries dentalis progressiva superficialis (CS), Caries dentalis progressiva media (CM) og Caries dentalis progressiva profunda (CP). Diagnoserne angiver aktiviteten og dybden af de klinisk/røntgenologisk observerede læsioner. Det gennemgås endvidere, hvilke risikorelaterede behandlinger der bør iværksættes på patienten (gul), og hvordan de nye ydelser DG (DGBU for unge), FU og SU samt den velkendte IFB (Individuel Forebyggende Behandling) bør bruges i dette patienttilfælde.
Konklusion
Fagligt set er det muligt at håndtere cariespatienter under de nye retningslinjer, men der kan opstå tvivl om, hvornår det er mest hensigtsmæssigt at anvende ydelsen FU frem for IFB.
Caries and the new national examination intervals
Background – The Danish National Board of Health is introducing new national guidelines for dental examination intervals, including new services, such as: Diagnostic basis examination (DG/DGBU), Focus examination (FU) and Status examination (SU), which the dental team, since the passing of the new agreement, must use in the daily handling of their patients.
Case study – The case illustrates, which anamnestic and clinical information should be recorded to enable the dentist to make relevant caries diagnoses, and to classify the patient as ”green”, ”yellow” or ”red” risk, as required by the new guidelines. The case describes which treatments are relevant to the patient, referring to the three caries diagnoses: Caries Dentalis progressive superficialis (CS), Caries dentalis progressive media (CM) and Caries dentalis progressive profunda (CP). The diagnoses indicate the activity and the depth/severity of the clinically/radiologically observed lesions. The case shows, which risk related treatment should be carried out on the patient (yellow), and how the new services DG (DGBU for young adults), FU and SU and the well known IFB (individually preventive treatment) should be used in this case.
Conclusion – From a professional point of view, it is possible to handle caries patients under the new guidelines, but doubts may arise about when it is appropriate to use the FU rather than the IFB service.
