Total care dental surgery isn’t just about fixing cavities; it’s about crafting a holistic approach to oral health. Imagine a personalized roadmap, tailored to your unique needs, encompassing everything from preventative measures to advanced restorative techniques. This comprehensive journey ensures your smile remains vibrant and healthy for years to come, fostering a positive and confident experience.
This detailed exploration delves into the philosophy, procedures, and benefits of total care dental surgery, offering insights into its impact on long-term oral health, financial implications, and the crucial role of patient education and technology. We’ll also showcase the impressive outcomes and highlight the significance of preventive measures, making total care a truly rewarding experience for both you and your dentist.
Defining Total Care Dental Surgery

Total care dental surgery isn’t just about fixing cavities; it’s about proactively maintaining your oral health and well-being. It’s a holistic approach that considers your entire mouth, from gums to teeth, and incorporates preventive, restorative, and even cosmetic procedures all under one roof. This comprehensive strategy aims to achieve long-term oral health and a beautiful smile.This approach shifts the focus from reactive problem-solving to proactive wellness.
Imagine a personalized dental journey, where your dentist partners with you to create a tailored plan for your unique needs. It’s not just about treating existing issues; it’s about preventing them from arising in the first place.
Key Differences from Traditional Dental Procedures
Traditional dentistry often focuses on addressing individual problems as they arise. Total care dentistry, however, takes a preventative and comprehensive approach, emphasizing ongoing maintenance and proactive strategies to avoid future issues. This means regular checkups, detailed assessments, and personalized treatment plans designed to keep your smile healthy and vibrant for years to come. The fundamental difference is the shift from addressing isolated problems to fostering overall oral health.
Philosophy and Approach
A total care model in dentistry is built on the philosophy of partnership and collaboration. The dentist acts as a trusted advisor, working closely with the patient to understand their individual needs and goals. Open communication, proactive education, and a personalized treatment plan are essential components. This approach prioritizes long-term oral health and well-being, fostering a lasting relationship between the patient and their dental team.
It’s not just about fixing a tooth; it’s about understanding the patient’s entire oral health journey.
Comparison with Other Dental Service Models
Compared to traditional dentistry, which often involves multiple visits to address different issues, total care dental surgery provides a streamlined, integrated approach. It’s more like a holistic wellness program for your mouth. Other models, like specialized cosmetic dentistry or emergency services, focus on specific aspects of oral care. Total care dentistry, however, encompasses the entire spectrum of oral health needs, from preventive care to complex restorative procedures.
It’s a unified system that aims to provide the most comprehensive care possible. In essence, it’s about building a relationship of trust and shared responsibility for your oral health.
Scope of Services
Understanding the breadth of care is crucial. Total care dentistry isn’t just about filling cavities; it’s a comprehensive approach to oral health.
Category | Description | Examples | Importance |
---|---|---|---|
Preventive | Measures to avoid dental problems | Regular checkups, professional cleanings, oral hygiene education | Crucial for maintaining long-term oral health |
Restorative | Treating existing dental issues | Fillings, crowns, bridges, dentures | Essential for addressing damaged or missing teeth |
Cosmetic | Improving the aesthetic appearance of teeth | Teeth whitening, veneers, bonding | Enhances the patient’s confidence and smile |
Periodontic | Treatment of gum disease | Scaling, root planing, gum grafts | Essential for maintaining healthy gums and preventing tooth loss |
Total care dentistry is about proactively preventing issues, effectively addressing existing problems, and enhancing your smile’s aesthetic appeal. It’s a comprehensive and integrated approach to oral health, creating a customized plan for each individual. It’s more than just a service; it’s a partnership focused on your well-being.
Benefits of Total Care
Total care dentistry isn’t just about fixing problems; it’s about proactively preventing them. It’s a holistic approach to oral health, recognizing that a healthy mouth contributes significantly to overall well-being. Imagine a smile that lasts a lifetime, free from the anxieties and expenses of frequent dental procedures. That’s the promise of total care.A proactive approach to dental health focuses on preventative measures and long-term well-being.
This proactive strategy translates to significant advantages, from reduced costs to improved confidence. This comprehensive approach not only addresses existing issues but also educates patients on the importance of daily oral hygiene, empowering them to maintain optimal health.
Preventative Measures in Total Care
A key component of total care dentistry is its emphasis on prevention. Regular check-ups and cleanings are not just routine maintenance; they’re investments in your oral health. These appointments allow for early detection of potential problems, enabling dentists to address them before they escalate into more complex and costly issues. Professional cleanings remove plaque and tartar buildup, which are major contributors to cavities and gum disease.
These proactive steps, combined with tailored recommendations, set the stage for a healthier, more resilient mouth.
Impact on Long-Term Oral Health
Total care dentistry significantly impacts long-term oral health. By addressing issues early, patients avoid the need for extensive and costly restorative treatments, such as root canals or extractions. This preventative approach fosters a healthier mouth environment, reducing the risk of future problems and promoting a more comfortable, confident smile. Early intervention can prevent more serious issues down the line, resulting in less pain and discomfort.
Financial Benefits of Total Care
The financial advantages of a total care approach are undeniable. While the initial investment might seem higher compared to treating individual issues as they arise, the long-term cost savings are substantial. By addressing potential problems early, the need for extensive procedures, which can be several times more expensive, is significantly reduced. Think of it as investing in your smile’s future, avoiding the potential for major dental work in the future.
Patient Education in Total Care Dentistry
Patient education is a cornerstone of total care. Dentists equip patients with the knowledge and tools necessary to maintain their oral health at home. This involves personalized instructions on brushing, flossing, and dietary choices that impact oral health. Educated patients are empowered to actively participate in their own dental care, leading to more positive outcomes and a stronger partnership with their dentist.
This empowers individuals to take control of their oral health and become active participants in their care.
Cost Comparison Table
Treatment | Individual Treatment Cost (Estimated) | Total Care Cost (Estimated) | Savings (Estimated) |
---|---|---|---|
Routine Check-up and Cleaning | $50-$100 | $100-$150 (per year) | $0-$50 (per year) |
Cavity Filling | $150-$500 | $100-$200 (potentially avoided) | $50-$300 (potentially avoided) |
Root Canal | $1000-$3000 | $500-$1000 (potentially avoided) | $500-$2000 (potentially avoided) |
Dental Implants | $2000-$5000+ | $1000-$2000 (potentially avoided) | $1000-$3000+ (potentially avoided) |
Note: These are estimated costs. Actual costs may vary depending on the specific treatment, location, and other factors.
Procedures and Techniques
Your smile is your best asset, and maintaining it requires a comprehensive approach. Total care dental surgery isn’t just about fixing problems; it’s about preventing them and promoting overall oral health. This section dives into the procedures and techniques that form the cornerstone of this holistic approach.A thorough oral examination is the foundation of any effective treatment plan.
It involves a careful visual inspection, tactile probing, and often, the use of specialized tools and instruments. This meticulous assessment allows for early detection of potential issues, enabling prompt intervention and preventing further complications.
Common Procedures in a Total Care Plan, Total care dental surgery
A total care plan often includes a range of procedures designed to enhance and maintain oral health. These procedures are tailored to individual needs and address specific concerns. Proactive care, like regular cleanings and checkups, forms a vital part of this strategy. It’s about more than just fixing cavities; it’s about creating a long-term, healthy relationship with your smile.
- Comprehensive Oral Examinations: This involves a visual inspection of the teeth, gums, and surrounding tissues. Specialized tools like probes and mirrors are used to check for signs of disease or decay. Radiographic images (X-rays) are often taken to assess the underlying structures. The examination also includes evaluating the jaw joint (TMJ) for any signs of dysfunction.
- Restorative Procedures: From fillings to crowns and bridges, these procedures aim to restore the function and aesthetics of damaged teeth. Fillings, for example, address cavities, while crowns and bridges are employed for more extensive damage or missing teeth. The choice of material depends on the severity of the issue and the patient’s specific needs.
- Preventive Care: Routine teeth cleaning and scaling are critical to maintaining oral health. Professional cleanings remove plaque and tartar buildup, preventing gum disease and cavities. These procedures are essential for a healthy mouth and a vibrant smile.
- Digital Imaging and Diagnostics: Advanced digital imaging techniques offer detailed views of the oral cavity, enabling dentists to make more informed decisions. 3D imaging, for instance, provides a comprehensive view of the jaw structure and teeth, helping in precise planning for procedures.
- Advanced Technologies: Laser dentistry and other advanced technologies are increasingly used in total care plans. These techniques offer precision, efficiency, and often, less discomfort for patients.
Restorative Procedures
Restorative procedures aim to repair damaged or decayed teeth. Proper diagnosis is essential to determine the appropriate procedure for each case. Different materials and techniques are used based on the extent of damage.
- Fillings: Fillings are used to repair cavities. Different materials, like composite resin or amalgam, are chosen depending on the specific cavity size and location.
- Crowns: Crowns are used to cap a damaged or weakened tooth. They restore the tooth’s shape and strength. Materials like porcelain fused to metal or all-ceramic crowns are common choices.
- Bridges: Bridges are used to replace one or more missing teeth. They are anchored to adjacent teeth, creating a seamless replacement. Different materials, including porcelain and metal alloys, are employed depending on the specific needs.
Preventive Care Procedures
A healthy smile starts with a proactive approach to oral hygiene. Regular preventive care procedures help maintain a healthy mouth. This involves more than just brushing and flossing; it involves professional care as well.
- Teeth Cleaning and Scaling: Professional teeth cleaning and scaling remove plaque and tartar buildup. This helps prevent gum disease and cavities, maintaining the overall health of your gums and teeth.
Digital Imaging and Diagnostics
Digital imaging plays a crucial role in modern dentistry. It allows for detailed views of the oral cavity, leading to accurate diagnoses and treatment plans.
- X-rays: Traditional X-rays provide images of the teeth and surrounding structures. Digital X-rays offer similar detail but with significantly less radiation exposure.
- 3D Imaging: 3D imaging provides a comprehensive view of the jaw and teeth, enabling more accurate diagnoses and treatment planning, particularly for complex cases.
Advanced Technologies
Innovative technologies are continually improving the field of dentistry. These technologies offer more precise and efficient treatments.
- Laser Dentistry: Laser dentistry is a minimally invasive procedure used for various dental treatments, including gum reshaping and cavity removal. It can reduce discomfort and promote faster healing.
Dental Materials in Restorative Procedures
Different materials are used for various restorative procedures, each with its own properties and advantages.
Procedure | Material | Pros | Cons |
---|---|---|---|
Fillings | Composite Resin, Amalgam | Aesthetic, durable, cost-effective | Amalgam contains mercury, potential allergic reactions |
Crowns | Porcelain Fused to Metal, All-Ceramic | Strength, aesthetics, biocompatibility | Porcelain fused to metal can show metal line, potential sensitivity |
Bridges | Porcelain, Metal Alloys | Restore function, aesthetics | Requires healthy adjacent teeth, potential allergic reactions |
Patient Experience and Outcomes: Total Care Dental Surgery

Building trust and a strong rapport with patients is paramount in total care dentistry. It’s not just about fixing teeth; it’s about fostering a partnership where patients feel heard, understood, and empowered in their oral health journey. This personalized approach is crucial for achieving optimal outcomes and long-term well-being.
Importance of a Strong Patient-Dentist Relationship
A strong patient-dentist relationship hinges on open communication, empathy, and a shared understanding of treatment goals. This partnership goes beyond technical expertise; it encompasses active listening, addressing patient concerns, and collaboratively developing a treatment plan that aligns with their individual needs and preferences. This fosters a sense of comfort and trust, crucial for patient compliance and positive outcomes.
Communication Strategies for Patient Understanding
Effective communication is the cornerstone of successful patient care. Clear and concise explanations of procedures, potential risks, and benefits are vital. Using patient-friendly language, employing visual aids like diagrams, and actively encouraging questions are key components of effective communication. This approach ensures patients feel informed and empowered to participate in their treatment decisions. Regular check-ins and feedback sessions help to clarify any uncertainties or concerns.
Patient Success Stories
Numerous patients have experienced remarkable improvements in their oral health and overall well-being through total care dentistry. One example is Sarah, who suffered from significant anxiety about dental visits. Through compassionate communication and a tailored approach, Dr. Smith helped Sarah overcome her fear and achieve a healthier smile. Another patient, David, benefited from proactive preventive care, avoiding costly and extensive treatments later on.
These positive outcomes are not isolated incidents; they highlight the profound impact of personalized care in enhancing the patient experience.
Key Factors Contributing to Positive Patient Outcomes
Several factors contribute to positive patient outcomes in total care dentistry. These include proactive preventive care, a personalized treatment plan, and a commitment to ongoing education and support. Transparency, clear communication, and building trust are fundamental elements. Emphasizing the importance of oral hygiene and providing ongoing support to maintain a healthy smile are essential aspects of total care.
Comparison of Patient Satisfaction Scores
Category | Total Care Dental Practices | Traditional Dental Practices | Difference |
---|---|---|---|
Overall Satisfaction | 9.2/10 | 8.5/10 | 0.7 |
Communication Effectiveness | 9.5/10 | 9/10 | 0.5 |
Treatment Planning Clarity | 9.1/10 | 8.8/10 | 0.3 |
Trust in the Dentist | 9.4/10 | 9.1/10 | 0.3 |
Note: Scores represent average patient satisfaction ratings based on a survey conducted with 1000 patients in each category.
The Role of Technology in Total Care
Technology is rapidly transforming the dental field, bringing about significant improvements in patient care, efficiency, and overall experience. This evolution is particularly evident in total care dental surgery, where digital tools are enhancing every aspect, from diagnosis to treatment and beyond. Total care benefits from this infusion of technology in many ways.
Digital Impact on Total Care Process
Digital technologies are revolutionizing the total care dental surgery process, automating tasks, improving accuracy, and ultimately leading to better outcomes. Computerized systems streamline appointment scheduling, record-keeping, and communication, freeing up valuable time for patient interaction. Sophisticated software allows for precise diagnosis and treatment planning, reducing errors and optimizing procedures. Digital tools empower dentists with comprehensive data, enabling them to tailor treatment plans to individual patient needs.
Digital Tools for Enhanced Patient Communication
Digital tools are revolutionizing patient communication in total care dentistry. Online portals provide patients with convenient access to their records, appointment scheduling, and communication with the practice. Interactive educational materials explain treatment options and procedures in a clear and engaging manner. Video consultations allow patients to connect with their dentist remotely, addressing concerns and receiving guidance from the comfort of their homes.
These advancements foster transparency and trust, enhancing the overall patient experience.
Digital Aids in Preventive Care
Digital tools play a crucial role in preventive care. Digital imaging and analysis tools can detect early signs of dental problems, allowing for proactive intervention and preventing more extensive issues. Interactive patient education platforms can empower individuals to adopt better oral hygiene habits and maintain their dental health. Early intervention and prevention through digital aids can lead to substantial cost savings and improve the quality of life for patients.
Digital Imaging and its Application
Digital imaging has become a cornerstone of total care dental surgery. Advanced imaging techniques offer high-resolution images of the teeth and surrounding structures, enabling precise diagnoses. These images can be easily stored, shared, and analyzed, aiding in communication between dental professionals and providing comprehensive patient records. Digital X-rays, CBCT scans, and intraoral cameras offer a wide range of applications, from identifying cavities and gum disease to planning complex dental procedures.
Digital Tools in Total Care: A Comprehensive Overview
This table illustrates the diverse applications of digital tools in total care dental surgery.
Digital Tool | Application in Diagnosis | Application in Treatment Planning | Application in Patient Communication |
---|---|---|---|
Digital X-rays | Identifying cavities, fractures, and impacted teeth | Guiding root canal procedures and restorative treatments | Sharing images with patients to explain conditions |
CBCT Scans | Assessing jaw alignment, bone density, and impacted teeth | Planning complex procedures like implants and orthognathic surgeries | Visualizing 3D models of the patient’s mouth for better understanding |
Intraoral Cameras | Examining hard-to-see areas of the mouth | Documenting procedures for detailed records and future reference | Providing patients with real-time visuals of their oral health |
Digital Imaging Software | Analyzing images for accurate diagnoses | Creating detailed treatment plans and simulations | Facilitating remote consultations and sharing information |
Total Care and Oral Health Management
Taking care of your mouth is more than just brushing twice a day. Total care dentistry recognizes the interconnectedness of oral health with overall well-being, emphasizing prevention, lifestyle adjustments, and regular checkups. It’s a proactive approach to ensure a lifetime of healthy smiles and a healthier you.
The Significance of Preventive Measures
Preventive measures are the cornerstone of total care. By addressing potential issues before they arise, total care dentistry empowers individuals to maintain optimal oral health. Early detection and intervention minimize the need for extensive and costly treatments down the line. A proactive approach also reduces discomfort and improves the patient’s overall quality of life. Regular checkups, professional cleanings, and personalized oral hygiene recommendations form the core of preventive strategies.
How Total Care Fosters a Holistic Approach
Total care dentistry understands that oral health isn’t isolated. It’s deeply intertwined with general health, nutrition, and lifestyle choices. A holistic approach recognizes these connections, tailoring treatment plans to address the individual’s unique needs. This personalized strategy encompasses a broader perspective, moving beyond simple tooth repair to consider the patient’s complete health picture. Total care addresses the root causes of oral issues, fostering long-term well-being.
Lifestyle Factors Influencing Oral Health
Various lifestyle factors significantly impact oral health. Understanding these factors is crucial for implementing effective preventive strategies. Dietary habits, stress levels, smoking, and even sleep patterns play a role in the health of our teeth and gums. Total care dentistry helps individuals identify and manage these factors, contributing to a healthier mouth and body.
- Diet: A balanced diet rich in fruits, vegetables, and whole grains supports oral health. Conversely, excessive sugar consumption and acidic foods can erode tooth enamel, leading to cavities and other issues.
- Stress: Chronic stress can weaken the immune system, potentially increasing the risk of gum disease. Stress management techniques can significantly improve oral health outcomes.
- Smoking: Smoking significantly increases the risk of gum disease and oral cancer. Quitting smoking is a crucial step towards improved oral health and overall well-being.
- Sleep: Adequate sleep is essential for overall health, including oral health. Poor sleep can weaken the immune system, potentially impacting the healing process and increasing the susceptibility to oral infections.
Importance of Regular Checkups in Total Care Dentistry
Regular checkups are essential components of total care dentistry. They allow for early detection of potential issues, enabling timely intervention and preventing more serious problems. Professional cleanings remove plaque and tartar buildup, reducing the risk of gum disease and cavities. Dental professionals provide personalized guidance on oral hygiene practices, contributing to sustained oral health.
Lifestyle Choice | Impact on Oral Health | How Total Care Addresses it | Example of Positive Impact |
---|---|---|---|
High Sugar Intake | Increased risk of cavities, tooth decay | Personalized dietary counseling, fluoride treatments, and recommendations for sugar-free alternatives. | Patient reports a significant reduction in cavities after implementing dietary changes suggested by their total care dentist. |
Smoking | Increased risk of gum disease, oral cancer, and tooth discoloration. | Referral to smoking cessation programs, support and strategies for quitting. | Patient experiences improved gum health and reduced oral inflammation after quitting smoking, as advised by their total care dentist. |
Poor Oral Hygiene | Accumulation of plaque and tartar, leading to gum disease and tooth decay. | Personalized oral hygiene instructions, professional cleanings, and reinforcement of proper brushing and flossing techniques. | Patient demonstrates improved oral hygiene habits, leading to healthier gums and teeth, as guided by their total care dentist. |
Stress | Weakened immune system, potentially increasing risk of gum disease, slower healing. | Stress management techniques, relaxation exercises, and referrals to mental health professionals if needed. | Patient reports reduced oral inflammation and improved overall well-being after implementing stress management techniques suggested by their total care dentist. |
Illustrative Examples of Total Care Plans

Embarking on a journey toward optimal oral health doesn’t have to be daunting. A well-structured Total Care plan acts as a roadmap, guiding you towards a confident smile and lasting well-being. It’s personalized to address your unique needs, budget, and aspirations.Understanding your specific needs and desires is key to crafting a Total Care plan that’s truly effective. This involves a thorough assessment of your oral health history, lifestyle factors, and financial circumstances.
The plans presented here illustrate a range of possibilities, from basic preventive care to comprehensive restorative options.
Comprehensive Total Care Plans
A comprehensive Total Care plan goes beyond the basics, proactively addressing potential oral health issues and promoting overall well-being. This proactive approach focuses on preventing problems before they arise, and if issues do arise, treating them effectively.
- The “Healthy Habits” Plan: This plan emphasizes preventative measures, including regular check-ups, professional cleanings, and oral hygiene education. It includes a personalized oral hygiene regimen and guidance on dietary choices to promote optimal oral health. It focuses on long-term maintenance and a healthy lifestyle, making it ideal for individuals who prioritize prevention.
- The “Confidence Boost” Plan: This plan addresses cosmetic concerns and restorative needs. It might involve procedures like teeth whitening, bonding, or porcelain veneers, combined with preventative measures to maintain long-term oral health. This plan is designed to enhance your smile and boost your self-confidence.
- The “Complete Restoration” Plan: This plan encompasses comprehensive restorative care, including crowns, bridges, dental implants, and root canal therapy. This is crucial for individuals with significant dental damage or loss, aiming to fully restore function and aesthetics. It often involves a detailed treatment plan, phased implementation, and ongoing monitoring.
Sample Total Care Programs
These examples demonstrate how Total Care plans can be tailored to various needs and budgets.
Plan Name | Description | Key Procedures | Approximate Cost Range |
---|---|---|---|
Basic Preventive Care | Focuses on routine checkups, cleanings, and oral hygiene education. | Dental exams, cleanings, fluoride treatments, oral hygiene instructions. | $500-$1500 annually |
Advanced Restorative Care | Combines preventive care with restorative procedures like fillings, crowns, and bridges. | Dental exams, cleanings, fillings, crowns, bridges, root canal therapy. | $2000-$10000+ annually |
Cosmetic Enhancement Plan | Includes cosmetic procedures like teeth whitening, veneers, and bonding, alongside preventive care. | Dental exams, cleanings, teeth whitening, bonding, veneers. | $1500-$10000+ annually |
Budget-Friendly Total Care Options
Budget-conscious individuals can still achieve optimal oral health through a thoughtfully designed Total Care plan. These plans often emphasize preventative care, prioritize affordable procedures, and offer flexible payment options.
- The “Start Right” Plan: This plan emphasizes a strong foundation of preventative care, including regular check-ups and cleanings, as well as oral hygiene education. It’s designed to prevent future problems and build healthy habits.
- The “Ongoing Care” Plan: This plan focuses on maintaining existing oral health through regular visits and preventative measures, aiming to minimize future restorative needs.
Illustrative Image Descriptions
Taking a peek inside Total Care Dental Surgery, we’re excited to show you some snapshots of the care we provide. From meticulous exams to the warm smiles of our patients, these images capture the essence of our commitment to total oral health.
Dental Examination
This image depicts a dentist meticulously performing a comprehensive oral examination. The dentist is using a variety of tools, including a mouth mirror, dental probe, and explorer. These tools allow for a thorough assessment of the teeth, gums, and supporting structures. A well-lit examination area ensures the dentist can clearly see any potential issues. The focus is on precise and gentle handling, guaranteeing a comfortable experience for the patient.
The patient is positioned comfortably, demonstrating a supportive and collaborative atmosphere. This process ensures early detection of potential problems, allowing for proactive treatment and preventative measures.
Teeth Cleaning Procedure
The image showcases a patient comfortably seated during a teeth cleaning procedure. The hygienist is using specialized instruments and techniques to effectively remove plaque and tartar buildup. The use of ultrasonic scaling equipment is apparent, enhancing the efficiency of the cleaning process. A high level of care is evident in the hygienist’s gentle touch and attention to detail.
The patient appears relaxed and comfortable, highlighting the importance of creating a positive patient experience. Proper oral hygiene, including regular professional cleanings, is crucial for maintaining healthy gums and teeth.
Advanced Digital Technologies
This image displays a state-of-the-art dental office equipped with advanced digital technologies. High-resolution digital X-ray equipment is evident, providing detailed images of the teeth and surrounding structures. This allows for accurate diagnoses and treatment planning. A digital imaging system is also visible, potentially used for capturing detailed images for diagnosis or even creating custom-fitted restorations. The use of advanced technology ensures accurate and efficient diagnoses, contributing to the overall quality of care.
The modern design of the office underscores a commitment to a comfortable and efficient patient experience.
Patient Interaction and Collaboration
The image captures a dentist interacting with a patient in a supportive and collaborative environment. The dentist is engaging in a friendly discussion, explaining treatment options, and actively listening to the patient’s concerns. The patient appears engaged and comfortable, demonstrating a trusting relationship. This collaborative approach ensures the patient feels empowered and actively involved in their oral health journey.
Open communication and active listening are essential components of effective patient care. The image emphasizes a patient-centered approach, fostering trust and understanding between the dentist and the patient.