Perio Chart

Perio Chart



From the Chart Module , click on the “Perio Chart” button.


The Perio Chart window will open.



Create a New Perio Exam/ Charting

Before data can be entered, an exam must be created. There are three ways to do this:
  1. Add: Creates a blank perio exam, which you will then populate with probe depths from scratch.
  2. Copy: Copies the patient's most recent perio exam into a new exam. You can then edit any probe depths that have changed.
  3. Default: Creates a new perio exam and populates it with your practice's default probe depths. You can then edit any measurements that don't reflect the patient's condition. View the "Setting Up or Editing a Default Perio Chart" section on this page for additional details.
To select a method of exam creation, click the corresponding "+" button below the Exams grid in the patient's Perio Chart.



Exams

The six most recent exams can be seen in the grid for easy comparison. The selected  exam 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.

On the first exam, any teeth that have been 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. If a tooth is extracted later, you will  manually mark it skipped the next time you add a Perio exam.

Skip Teeth

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.

Auto Advance

The auto-advance is set to take the following path: 1-16 buccal, 16-1 lingual, 32-  17 buccal, 17-32 lingual. The measurements must be taken in this order. The top Auto Advance box is handled automatically based on the above path.

Entering Probe Depths

There are two ways to enter numbers, either by using the numbers on the keyboard, or by using the number buttons on the screen. To enter a number greater than nine, either click the ‘10’ button followed by the second digit or hold down the shift key while pressing the second number on the keyboard.

Plaque, Calculus, Bleeding, and Suppuration

Plaque, Calculus, Bleeding, and Suppuration are entered on the same rows as the probing depths and show as colored dots above each probing 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). These can be done as the probing depths are charted, or they can be done separately. If they are entered 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, it will already have advanced to the next cell. If the cell you are in is still empty, then it knows to enter the item on the previous probing entry.

Triplets

In the upper right, the three at a time option ("Triplets")  is good 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 sure to turn it off when done.

Types of Rows

  1. Probing- Each date gets its own row with the date in the left column.
  2. Mobility- only shows on the buccal. Only allowed one number for each tooth in the middle cell. There is no mechanism yet to show +.
  3. Furcation - Enter a 0-3.
  4. Auto CAL- Clinical Attachment Level is auto-calculated as probing + Gingival Margin. User is not allowed to edit.
  5. Gingival Margin- All displayed gingival margins are implied negative values (recession). There is no mechanism yet to enter a positive gingival margin (hyperplasia).
  6. Mucogingival Junction- Not present on the palatal.

Index Percentages

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.

Numbers in Red

In the lower right is the 'Numbers in red' section. For each different kind of row, values can be set which will show in red.

Print

Using the print button will produce a printout that matches what is on the screen.

Setting Up or Editing a Default Perio Chart

Before you can use a the Default Perio Chart, you will need to set the default probe depths. The Perio Setup window will open by default the first time you click the "+ Default" button below the Exams grid, and can then be accessed for editing later by clicking "Setup" above the Exams grid.



For faster setup, click the "Set All 323" button, which automatically populates the facial and lingual sides of each tooth with the 3-2-3 pattern, represented as "323." These can be edited to suit the preferences of your practice. For example, you might prefer to set  just the third molars to a 5-4-5 pattern, represented as "545, 323, 323..."  A periodontal office might fill every tooth and surface with a 5-4-5 pattern, represented as "545, 545, 545..."

Set the probe depths to your preferences, then click "Ok" to save.

Graphical Perio chart 

The Graphical Perio Chart displays a 3D view of the data entered and can be especially helpful for patient education.

Before the Graphical view of the Perio Chart can be viewed the computer must have the newest direct X drivers from Microsoft installed and the computer's graphic card must be able to handle the graphics. For information about Direct X please see System Settings/Select Tooth Chart Type. 


To view the Graphical Perio Chart, click on the Graphical button (lower right) on the Perio Chart window. 


Setup Colors

Clicking the Setup Colors button opens the Graphical Perio Setup as shown below.


Double-click on a color square to select a new color for the corresponding chart notation. 

Save to Images

To save a copy of the chart to the Tooth Charts folder in the Images Module, click the Save to Images button.
The Print button sends the graphical tooth chart to your office printer.

Voice Perio



Practice-Web allows you to document a periodontal exam hands-free using only your voice. No special equipment is needed, but your computer must have a microphone or headset with a microphone that Windows recognizes. The Voice Perio feature uses the Universal Tooth Numbering system and responds to specific commands as outlined below.

To start and stop Voice Perio, click the microphone button.

Voice Perio Commands

Adding Exams

  1. Add Perio Exam  or  New Perio Exam : Adds a new perio exam.
  2. Copy Previous Exam : Copies the previous exam.
  1. Stop Listening : Tells the system that you're pausing your charting. No commands will be recognized until you say "start listening." (This is not the same as turning the microphone off, as done by clicking the microphone button.)
  2. Start Listening : Tells the system to listen for commands again.
  3. Stop Giving Feedback : Tells the system to stop repeating measurements.
  4. Start Giving Feedback : Tells the system to resume repeating measurements.
  5. Left : Moves the cursor left.
  6. Right : Moves the cursor right.
  7. Delete : Deletes the selected item.
  8. Backspace : Works like a computer backspace by moving the cursor back one cell and deleting any information already in the cell.
  9. Resume Path :  Moves the cursor to the first empty probing position.
  10. Check Triplets: Checks the Triplets box/ turns Triplets feature on- begins marking your recordings (gingival margins, plaque, etc.) in sets of three and backspacing in sets of three.
  11. Uncheck Triplets : Uncheck the Triplets box/ turns Triplets feature off.
  12. Triplets : Checks or unchecks the Triplets box.
  13. Skip Tooth [Number] :  Tells the system to skip the tooth.
  14. Skip Current Tooth :  Skips the tooth that's currently selected.

Selecting Teeth

Note: When calling out a tooth to select, the system will place the cursor in the probing section. If you're charting other things (bleeding, calculus, etc), you will need to follow your selection command with a command to chart your other diagnosis as covered in additional sections below.
  1. Go to [Number] Facial or  Select [Number] Facial : Moves the cursor to the facial side of the tooth number you provide.
  2. Go to [Number] Lingual or  Select [Number] Lingual :  Moves the cursor to the lingual side of the tooth number you provide.
  3. Go to [Number] Mesial Facial   or Select [Number] Mesial Facial :  Moves the cursor to the mesial facial side of the tooth number you provide. 
  4. Go to [Number] Mesial Lingual or Select  [Number] Mesial Lingual : Moves the cursor to the mesial lingual side of the tooth number you provide.
  5. Go to [Number] Distal Facial  or  Select [Number] Distal Facial:  Moves the cursor to the distal facial side of the tooth number you provide.
  6. Go to [Number] Distal Lingual or  Select [Number] Distal Lingual : Moves the cursor to the distal lingual side of the tooth number you provide.
  7. Go to [Number] or Select [Number] : Moves the cursor to the the tooth number you provide. The cursor will land on whichever surface was selected previously. 

Charting Probe Depths

  1. Probing :  Moves the cursor to the probing section for the selected tooth.
  1. Practice-Web recognizes the numbers 0-19 and will mark them as probing depths when spoken. To add depths greater than nine, you can also say "Plus" and then the number.

Charting Bleeding

  1. Mark Bleeding : Marks bleeding at the selected probing site.
  2. Bleeding Facial or Bleeding Lingual or  Bleeding Mesial or Bleeding Distal : Marks bleeding on the selected tooth on the side you say.

Charting Calculus

  1. Mark Calculus : Marks calculus at the selected probing site.
  2. Calculus  Facial  or  Calculus  Lingual  or  Calculus  Mesial  or  Calculus  Distal : Marks calculus on the selected tooth on the side you say.

Charting Suppuration

  1. Suppuration : Marks suppuration at the selected probing site.
  2. Suppuration  Facial  or  Suppuration  Lingual  or  Suppuration  Mesial  or  Suppuration  Distal : Marks suppuration on the selected tooth on the side you say.

Charting Plaque

  1. Plaque : Marks plaque at the selected probing site.
  2. Plaque  Facial  or  Plaque  Lingual  or  Plaque  Mesial  or  Plaque  Distal : Marks plaque on the selected tooth on the side you say.

Charting Furcation

  1. Furcation : Moves the cursor to the furcation section for the selected tooth. From there, you can call out numbers just as you would with probing and the cursor will automatically advance.
  2. Furcation  Facial  or  Furcation  Lingual  or  Furcation  Mesial  or  Furcation  Distal : System will repeat the command back and then wait for you to provide the number.

Charting Gingival Margin

  1. Gingival Margin : Moves the cursor to the gingival margin section for the selected tooth. From there, you can call out numbers just as you would with probing and the cursor will automatically advance.
  2. Gingival Margin   Facial  or  Gingival Margin   Lingual  or  Gingival Margin   Mesial  or  Gingival Margin  Distal : System will repeat the command back and then wait for you to provide the number.

Charting Mobility

  1. Mobility : Moves the cursor to the mobility section for the selected tooth. From there, you can call out numbers just as you would with probing and the cursor will automatically advance. Mobility scores are recorded per tooth and marked in the mesial facial position.

Charting Mucogingival Junction

  1. Mucogingival Junction or MGJ : Moves the cursor to the mucogingival junction section for the selected tooth. For best results, provide a tooth selection command that includes lingual or facial positioning (ex. "Select 23 lingual"), then say "MGJ," and either provide your measurement or tell the system "left" or "right" to move to your desired positioning before saying the measurement. 





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