Pocket Input

Nov. 14, 2014
Technology has simplified the process of periodontal charting

Technology has simplified the process of periodontal charting

BY Jamie Collins, RDH, CDA

As the world becomes more conscious about the transfer of disease, so do the dental and medical communities. How often do you think back to your microbiology courses, which taught us how easily bacteria and viruses are transferred? In our daily lives as clinicians, we're faced with a list of tasks we must complete within a one-hour span, and periodontal charting is one of them. Not only do we need something to help us be time efficient, we also need to be safe and provide a certain standard of care.

To prevent cross contamination of the keyboard while entering the periodontal charting, do you have an assistant to help? I know I don't! Do you cover the keyboard with a barrier film? Or maybe you just enter the numbers without changing gloves and wipe it all down at the end. Patients are increasingly more aware of their surroundings and what happens in the operatory. How do you want to be portrayed in your patients' eyes?

When it comes to data input in the periodontal chart, there are options for hands-free devices that appeal to a variety of tastes. The Florida Probe, Dental R.A.T., and voice-recognition technology are all good choices to perform input without an assistant and without the risk of cross contamination. All provide a slightly different method to input data while eliminating the use of a keyboard.

The Florida Probe Systems utilizes computer technology to read and record data into a chart that can be customized to include all the needed recordings such as suppuration, recession, furcation, and bleeding - to name a few. It requires the use of a computerized probe handpiece, and the hybrid system can use either a foot pedal or voice recognition device for data input. By inserting the computerized probe into the pocket and tapping the foot pedal the provided reading should be consistent between clinicians. The probe provides 15 gm of constant force pressure while the probe tip and sleeve are inserted into the sulcus. Once the foot pedal is tapped, the data is recorded into the chart with an accuracy of up to 2/10 millimeter.

Florida Probe has the steam autoclavable handpiece or the lightweight disposable Dolphin probe handpieces available. The company has developed a disposable probe tip and sleeve to help eliminate the risk of contamination between patients, and the patient is able to watch as the clinician opens a new package prior to use. The disposable tips are discarded after each use, and the handpiece can be steam sterilized in the autoclave.

The Florida Probe System does require special software that is able to bridge with most dental software systems. Like any new product, there is a learning curve associated with the use, and the company provides the initial training to each office. In addition there are minimum computer compatibility requirements to operate the system.

Florida Probe has also developed the GoProbe System, which allows for the use of any periodontal probe the clinician prefers, not only the specific Florida Probe handpieces. The GoProbe System also utilizes required software that can bridge with most dental software systems to operate, but is compatible only with Windows XP. Using the small GoProbe keyboard, the clinician has the option to input data his or herself, or to involve the patient in their own care by inputting the data into the keypad while the clinician calls out the pocket depths. Inputting the data onto a small keypad still requires touching a device while gloved and the potential for cross contamination exists; extra precautions must be taken.

The Florida Probe software system provides a color-coded chart with easy-to-read visual charts and graphs, even allowing for patient education printouts. The patient is able to hear the numbers while correlating the pockets depths to the area of the mouth. The audio option may be turned off or on depending on clinician preference; alarms can be customized to alert attention to pocket readings past a certain depth. The software program has the ability to be set and easily changed between any of 15 different languages.

I believe one of the key features is the option to evaluate risk of periodontal disease based on lifestyle, plaque index, systemic disease, and age. It presents a fantastic, visual aide for the patient to take home and refer to. When diagnosing disease and treatment recommendations are made, the patient often has to take time to process and often discuss it with a significant other at home. Giving that patient the periodontal chart and patient risk information to take home often will help refresh and possible increase the acceptance of treatment.

Another great option for hands-free charting is one of the many voice recognition software programs. Some of the major programs have their own headpiece microphone voice recognition system for input of the periodontal charting. Most of these products are easy to learn and use, provided the clinician can keep the patient from talking while charting. The microphones are sensitive and easily pick up other noises, causing charting to become a little more challenging. If the patient talks or the clinician does not speak clearly, the data may not be recognized by the system and may be entered into the chart incorrectly. Most systems have an audio option where the program will repeat the pocket depths as charted. The voice recognition systems are easy to use and allow the patient to hear the data while it's charted.

The Dental R.A.T. is the only hands-free charting system that can run the whole computer from a foot-operated mouse. It is compatible with almost all dental software systems and does not require a monthly subscription. Once you purchase the R.A.T. there are no other costs incurred for basic use. Inventor Becky Logue is a hygienist who was looking for a product that would be easy to use and allow hands-free periodontal charting. With a tap of the foot-operated mouse, the numbers can be input into the chart, and it's compatible with other dental software programs. It has variable speeds and audible readings while entering data.

Dental R.A.T. provides not only periodontal charting, but allows the clinician to go between screens by moving the cursor and clicking on any file or icon. The R.A.T. does require a learning curve and will initially slow down input until the clinician finds a rhythm. The ability to operate the entire computer with a foot pedal provides great benefits with the elimination of cross contamination of the computer. The company has also developed Boomer, a foot-operated mouse complete with left and right click buttons for dental operatories where periodontal charting is rarely needed. Outside of the dental operatory, Boomer is especially beneficial for those with limited use of their arms and hands.

The use of any hands-free charting technology should help increase production. Many people like to know their numbers to compare to previous exams. Now they can hear the numbers spoken back to them by the computer. As patients lie there hearing or inputting the series of numbers, many are wondering what those numbers mean, and this leads to conversations about the periodontal disease process and treatment recommendations.

We've all learned about infection control and the spread of pathogens, but what are we doing to decrease the risk of cross contamination? If you decide to go with a hands-free periodontal charting system, look for the features that you find appealing and applicable in your practice. Some companies require purchasing the product and specific software to run the program, as well as a monthly subscription fee for use. Don't hesitate to ask your dental peers what they like or dislike about the products they use, and remember that manufacturers will also provide a wealth of information about their products. The benefits of increased production, patient confidence, and infection control are well worth the investment of a hands-free periodontal charting system. RDH

Jamie Collins, RDH, CDA, resides in Idaho with her husband, Cory, and their four children. She currently works as a full-time hygienist as well as an educator at the College of Western Idaho. In addition, she acts as a content expert and contributor in multiple upcoming textbooks. She can be contacted at [email protected].