Diagnosis and Treatment Planning
Diagnosis and Treatment Planning tests whether you can convert scattered findings into a defensible problem list, prognosis, and sequenced plan. The Kuwait Board favors risk-based decisions over tooth-by-tooth repair.
Core rules
- Separate the chief complaint from unmet needs; record medical history, medications, parafunction, caries risk, and periodontal risk.
- Use mounted diagnostic casts, interocclusal records, and a diagnostic wax-up before irreversible preparation.
- Judge strategic value: endodontic status, ferrule, crown-to-root ratio, mobility, root proximity, and occlusal load.
- Sequence disease control, then structural repair, then replacement, then maintenance.
Worked example
A 58-year-old presents with a failing 25-26 fixed dental prosthesis and missing 36. The 26 abutment has a 2 mm ferrule and no periapical pathosis; the 36 space has 7 mm of interocclusal clearance. Reasoning: control periodontal inflammation first; mounted casts show sufficient space for an implant crown at 36; the 26 tooth can be retained as a single crown if preparation preserves the ferrule. The 25 space is better restored with an implant than with a cantilever from 26. Sequence: hygiene phase, 36 implant placement, 26 crown, 25 implant restoration, then review.
Traps that cost marks
- Starting with a crown or denture before defining the problem list.
- Ignoring parafunction, TMD symptoms, or medical risk.
- Not mounting casts or not checking interocclusal space.
- Replacing every missing tooth without assessing strategic value.
- Failing to document prognosis and alternatives.