In the Chart module, click Perio Chart.
Click the Graphical button from within the main perio chart window.
First, Add an exam at the upper left. Once the exam is created, double click in the list to change the date or the provider:
All data that is entered will be automatically saved and the only way to not save it would be to delete the exam. You can see the 6 most recent exams in the grid for easy comparison. Whichever exam you select in the list will be the exam that shows in the grid along with data from all previous exams. For probing depths, each exam gets its own line in each of the four sections, but for the other measurements, only the most recent measurement is shown. All measurements from previous exams will be shown is a slightly greyer color than the current exam so that you can easily see which numbers are for the current exam.
When you add the first exam, any teeth that you have charted as missing in the Chart module will be automatically marked skipped in the perio chart. Subsequent exams will copy the skipped teeth from the most recent exam. So if you later extract a tooth, you would manually mark it skipped the next time you add a perio exam. To mark a tooth skipped, click on the tooth numbers in the grid while holding down the Ctrl key, then click the Skip Teeth button. Skipped teeth are stored with individual perio exams, so each exam can have different teeth skipped. Once a tooth is marked skipped, the background will show gray. You can still record measurements on skipped teeth if you wish, but the autoadvance will normally jump over them.
There can be some complex situations with extra teeth. This can happen with supernumerary teeth and retained deciduous teeth. If there is no way to enter this information into the existing boxes, then notes can be made about specific sites in the Progress Notes.
The auto advance is built-in to take the following path: 1-16 buccal, 16-1 lingual, 32-17 buccal, 17-32 lingual. You will need to start taking measurements in this order if you do not already, since there is no way to change it. The Auto Advance box at the top is handled automatically based on the above path, but you can change the direction temporarily as well.
For all measurements other than gingival margins there are two ways to enter numbers, either by using the numbers on your keyboard, or by using the number buttons on the screen. To enter a number greater than nine, you can either click the 10 button followed by the second digit, or you can hold down the Ctrl key while you press the second number on your keyboard. For instance to input 13 you would press Ctrl+3. The backspace and delete buttons work just like you would expect them to.
Gingival margins - Gingival margins are implied negative values (recession). Hyperplasia is represented with the "+" symbol. To input numbers from 0-9 either press the corresponding number key on the keyboard or use the onscreen keypad. The only way to enter values greater than 10 is to use the onscreen keypad. To enter positive values representing hyperplasia, press Ctrl+nubmber. For example, to enter +3, hold down the Ctrl key while you press 3. To enter a positive value by using only the mouse, check the box for "Ging Marg +", enter the positive value(s), then uncheck the box.
Plaque, Calculus, Bleeding, and Suppuration
These items are entered on the same rows as the probing depths and show as colored dots above each probing number. There is room for all four dots to show above each number. The color for each item can be customized by clicking on the corresponding colored box on the right side of the window. There are two ways to enter these items, either by using the buttons, or by using keyboard keys: plaque (p), calculus (c), bleeding (space or b), or suppuration (s). You can do these as you chart the probing depths, or you can do them separately. If you are entering them at the same time as the probing depths, then it is assumed that the order of entry would be, for instance, 5-bleeding. Since the probing depth comes first, you will already have advanced to the next cell. But that's OK, because if the cell you are in is still empty, then it knows to enter the item on the previous probing entry.
Three at a time
At the upper right, the three at a time option comes in handy for entering lots of plaque, calculus, gingival margins, or any other measurements that tend to be the same for the entire tooth. In the three at a time mode, the backspace key deletes three at a time and editing an existing entry will overwrite three at a time, so be careful to turn it off when done.
Types of rows
Probing- Each date gets it's own row with the date in the left column.
Mobility- Only shows on the buccal. Only allowed one number for each tooth in the middle cell. There is no mechanism yet to show +.
Furcation- Enter a 0-3. A later version will show a V or a triangle instead of the numbers.
auto CAL- Clinical Attachment Level is auto calculated as Probing + Gingival Margin. User not allowed to edit.
Gingival Margin- Gingival margins are implied negative values (recession). Hyperplasia is represented with the "+" symbol.
Muco Gingival Junction- Not present on the palatal.
On the right hand side is a button to recalculate the four index percentages. There are typically 6 sites per tooth and 32 teeth, for a total of 192 possible sites. But if any teeth are marked skipped, then those sites are not considered to be available and are excluded from the calculation. So if you have 19 of the 192 sites marked as bleeding, then the bleeding index is 10%.
Numbers in Red
Below the indices is the 'Numbers in red' section. For each different kind of row, you can set the values which will show in red. Notice that for the MGJ, it shows in red if it is smaller than the number showing instead of greater. The main concern here is that it show sites with little or no attached gingiva. For each kind of row, you can also show the number of teeth that have red numbers on them. On the printout, it will actually list out all the tooth numbers.
Using the print button will give you a printout that matches what you have on the screen.
Voice recognition software can be used with Open Dental, however we do not provide any support. Below are some suggestions if you choose to use it.
Windows 7 comes with voice recognition software. You can turn it on at Control Panel, Ease of Access, Speech Recognition. Other software, like Dragon Naturally Speaking or ViaVoice will also work.
In Dragon, it's probably better to switch to numbers mode ("Numbers mode on") to increase recognition of numbers. You can either do bleeding as a separate pass, or you can switch to spell mode ("Spell mode on") so that it will recognize "b" as a bleeding point.
Numbers greater than 9 will not work until we add support for asterisk (*).
For instance, if you say "twelve", you would want that to go in as "asterisk 2", because that's what Open Dental will recognize as 12 rather than 1,2. Once we add support for asterisk, you may be able to create a macro.
Florida Probe sells a hardware and software system that automatically records the probing depths using a special probe. We provide a bridge to their software. Dental R.A.T. sells a foot pedal that lets the user enter numbers hands-free. It does not require any bridge. It can handle numbers higher than 9 by using the mouse part of the pedal.