Vocal mouse

Nov. 1, 2003
A talking mouse? Or is it an imitation? I like to think of it as a mini-talking digital dental hygienist tucked inside my computer tower, assisting me in my daily hygiene charting duties.

By Victoria DaCosta

A talking mouse? Or is it an imitation? I like to think of it as a mini-talking digital dental hygienist tucked inside my computer tower, assisting me in my daily hygiene charting duties. How cool is that? I no longer have to be "on the hunt for help." With a sleek microphone headset and computer software voice program, I'm well on my way to digital land. (I wonder if the headsets come in pink?) I like it because it's another technology phenomenon.

I don't really understand how the computer knows to chart what I speak, but I know it's a "must have tool." Did you know that we have 768 notations to document in only eight minutes? This bit of information was brought to my attention by a fellow hygienist, who, incidentally, created a talking digital tool now on the market called Perio Pal.

So what exactly is a digital voice dental hygienist and what does it cost? It is a voice command or voice dictation computerized software program driven by your voice.

Voice triggers actions, dictation triggers words and typing. The software hears your voice through the microphone, repeats your words, and records them on the patient's digital chart. The digital voice program is primarily used for perio charting. The module packages cost from $800 to $1,800. The top three dental management software companies selling digital voice dental hygienists are Dentrix, PracticeWorks and EagleSoft.


Voice command — For many years there has been the "voice" module, which is designed to accommodate voice "commands." The important word here is "command."

Think of it as a "vocal mouse" or input device. This module has had several generations, and the current version is the best yet. This module is primarily designed for perio charting, where it easily responds to things like tooth number, pocket depth, and more.

Voice dictation — The newer module is the "dictation" module. This works more like a typical voice recognition program, such as "Naturally Speaking," and is designed for the practitioner to talk in the clinical notes. It has no "command" capabilities, but purely recognizes words. I speak key phrases into my microphone and the computer leads me quickly to the screen I want. It's very easy once you've done it a few times.

Unique re-check design — Perio Pal turns on a light to remind you to go back and recheck areas. The light is a color. Once you have rechecked the noted areas, the light turns off. This feature seems to be one of the most practical ways to "see it, say it, no need to remember it" method of perio charting.

Perio chart report options — There are many choices for printed perio charts. For example, you can speak "graphics only, combined data chart and graphics, and existing comparison data charts." Colored numbers are displayed in the vertical box with a graphic print out of the teeth's bleeding spots. This is a very nice feature.

Customized settings — Is there more than one dental hygienist in your office? The digital voice software program can be customized for each dental hygienist. You can customize your own recording preferences and voice.

It doesn't matter whether you like to chart right to left, or left to right.

Key digital voice phrases — You have a large selection of key phrases to voice such as "activate listening," "save exam," "select tooth," "summary," "cancel," "stop listening," and "print." All these, and a whole lot more!

(Side note: If your voice software is activated on your desktop, your headset microphone will pick up any sound in your room and document it on your screen. Your patient's gum health will go from having healthy numbers to advanced perio!)


Hands-free — With a digital voice software program, all you need to do is speak into a headset microphone. You simply train your voice by reading a script for 10 minutes and, "Walla!" — the computer will recognize your voice and chart on the computer what you tell it to! It's a bonus to have my hands free to work in the patient's mouth and not have to de-glove after every patient quadrant to manually write down the perio numbers I just probed.

Assistant-free — Your energy is now spent putting on a headset and speaking "select two," vs. hunting down a warm body outside your territory who is willing to help you record.

So much of my time is spent looking for help. Often, I have to interrupt a co-worker from their duties. Being able to grab my headset with the voice activated software program is liberating. I call that freedom.

Time — I can now input more data in a short amount of time. Because there are so many things you see which contribute to perio disease, you're able to verbally record these observations quickly and efficiently. Bleeding points, oral pathology, furcations, and recession all become effortless.

Instant digital calculator — At the end of your perio charting, you tell the computer to "save exam," then "summary." In seconds, your patient's bleeding score is calculated. I love this feature and use it all the time. In the past, the assistant would highlight the bleeding spots with a yellow or pink magic marker. She also had to manually add up all the yellow and pink markings and write the number on the chart. Not any more! With the instant calculations, my patients live for their score each appointment. They like to compare their scores with the last visit, and with family members who have also been scored! It's a lot of fun to get them to finally enjoy flossing!


The reality is that both systems are excellent, but they have some very stringent demands in order to work well. The first issue is that hardware must be chosen carefully, particularly which motherboards to use, and how sound is implemented in a soundcard.

The second issue is the headset. Cheap headsets don't work well. The third issue is the user's voice. Some voices work well, while others don't, especially if someone trains with a sick voice.

The fourth issue is how dedicated the person using it is. The user must speak clearly, consistently (timing, inflections, pitch), and use the right equipment properly. A dental software rep recently told me, "Highly compulsive people have great success with voice, and 'casual' users want their money back."


• Increased perceived patient value of perio charting
• More control with your time when to perio chart
• Instant editing of your patient's perio chart
• Organizes perio chart data with history
• Increased patient understanding of disease and diagnosis
• Assistant availability for charting
• Verbal data collection enhances patient questions

Hy-Tech user tips ... for voice-activated perio charting

• Beware of the long headset cords to the computer tower
• Place the computer tower close to your chair for headset usage
• Voice train both when healthy and sick
• First-time users should practice on co-workers
• Test out different voice program versions at trade shows
• Voice train with your mask on
• Don't forget to speak, "Save exam"
• Practice using every day to increase your confidence
• Place the headset microphone close to your mouth
• Lower office music in your operatory when recording
• Make sure that when the voice software is not in use it is in "stop listening" mode on your desktop

Victoria DaCosta, RDH, BS, is founder and president of Hy-Tech Solutions. A practicing dental hygienist for 17 years, DaCosta is a speaker, author, consultant, and an expert in the design of medical/dental software. She is also on the new technologies committee for the California Dental Hygienists' Association. DaCosta can be contacted at www.hy-techsolutions.com.