Charting conditions

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Pruce Dental
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Charting conditions

Post by Pruce Dental » Sun Jul 11, 2010 2:30 pm

I am only playing with a trial verison (soon to make the leap to a full OD user)....

I want to chart conditions on the graphical chart...Can someone teach me how to with a dummies guide explanation? I saw in the OD manual to set up a dummy procedure code.

1) This is the list where all the American Dental Association Codes are stored right?

2) So then I have to choose a paint type but my choices are the paint types for extractions, filling dark, rct, filling light etc. but there is no different color choice that I can use so conditions stick out right?..Can I define my own paint color type like create a paint type called caries? Can I somehow make a paint color that consists of red slash lines so It stands out on the chart as something being wrong that needs treatment? and even better can I make white slash lines that can be superimposed over say an amalgam restoration to show that it also has caries?

3) So once I have my code set up is there a way I can have some quickbutton on the chart screen to chart caries or do I need to go thru the procedure code list and hunt for my code for every tooth if 10 teeth have caries?

4) So If I chart caries on the graphical chart then post a restoration on the tooth will OD know to overlay the filling over the caries color? (assuming that the caries were charted on an earlier date)

5) similiar to Question #2 can I make a different paint color for open margins?


6) If I want to show a periapical lesion I guess I can use the drawing tool to draw a red circle at the apex of the root. Now in the future after the tooth is treated etc. If I erase the painted periapical lesion will OD remember that the paint was saved there in the past? (thinking ahead to someday when there is a slider bar to run thru past charts on a certain date)..or do I need to save an image of the chart to document what I charted?
Robert L. Pruce, DMD
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Rickliftig
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Re: Charting conditions

Post by Rickliftig » Sun Jul 11, 2010 4:32 pm

Hi Robert -

Welcome to Open Dental. One of the ways I handle this is by using the 'Draw' function. It's on the tabbed list at the top of the treatment plan box. So when a new (or exisiting) patient comes in with an open margin, I will scribble that area in red or magenta(using my wonderful artistic ability). With new patients, after charting, I will save the image of the chart - this is in the pull down menu for tooth chart.

I use the dummy codes for many things, such as "watch this area - which I have programmed to enter in a surface in yellow"; "Tooth note - which applies to a numbered tooth (this is handy when you filter the chart for one tooth); inserts; untreated perio and others.

The colors are set up in the definition setup and somewhere on the board there is a very nice post about this. Play with the definition menu and you will get an idea of what does what. You can customize a lt in OD.

Now let's see if I have answers to your questions:
_____________________________________________________________________________________________________________________
I want to chart conditions on the graphical chart...Can someone teach me how to with a dummies guide explanation? I saw in the OD manual to set up a dummy procedure code.

You can enter in a diagnosis (the box next to "enter treatment" with various conditions, but I don't particularly like to do that because it's a lot of work; But if you want to, this is set up in the definitions setup and on mine I have listed: New caries,incipient caries,recurrent caries, deep caries, abfraction,defective restoration, broken tooth, cracked tooth,periapical pathology"

1) This is the list where all the American Dental Association Codes are stored right?
Yes - these codes are entered in preceded by an N ie) N4001 - periapical pathology

2) So then I have to choose a paint type but my choices are the paint types for extractions, filling dark, rct, filling light etc. but there is no different color choice that I can use so conditions stick out right?..Can I define my own paint color type like create a paint type called caries? Can I somehow make a paint color that consists of red slash lines so It stands out on the chart as something being wrong that needs treatment? and even better can I make white slash lines that can be superimposed over say an amalgam restoration to show that it also has caries?

This is where the definition setup comes in. slash lines would be nice - I agree; I still find the best solution has been to set the watch area colors to yellow and the oddball stuff (ie) an odontoma, drawn in. Peronsally, i think when you codify everything, you will make yourself crazy. One swoop of the pen (or mouse) can say volumes. Again, search on the board and I believe somewhere back about two years ago is a great post on setting the colors up.

3) So once I have my code set up is there a way I can have some quickbutton on the chart screen to chart caries or do I need to go thru the procedure code list and hunt for my code for every tooth if 10 teeth have caries?

I have set up definitions for those in setup ->procedure button categories - this is the list you'll see in the box under the procedure button - Either here, or on Dental town are instructions on doing that.

4) So If I chart caries on the graphical chart then post a restoration on the tooth will OD know to overlay the filling over the caries color? (assuming that the caries were charted on an earlier date)

Yes

5) similiar to Question #2 can I make a different paint color for open margins?

Yes - setup the dummy code - N4001 - Open Margin - or simply draw it in. I may be repeating myself, but the way I would do it in my office would be to make an existing condition chart, save it, the treatment plan and all of the needed tx will turn red.


6) If I want to show a periapical lesion I guess I can use the drawing tool to draw a red circle at the apex of the root. Now in the future after the tooth is treated etc. If I erase the painted periapical lesion will OD remember that the paint was saved there in the past? (thinking ahead to someday when there is a slider bar to run thru past charts on a certain date)..or do I need to save an image of the chart to document what I charted?

Yup - hopefully answered. But, were we ever this obsessive in our paper notes? Hardly! Keep it simple or you won't make it a habit. The more complex you make the system, the crazier it will make you and your staff :wink:

It's a lot to learn, but once you have it setup, not only will you adore it, you'll also have teh ability to change things as you see what is and isn't working. Gradually, the custom menus will adapt to your style. So no two Open dental installations are likely the same.

And don't forget to call support when you're stymied. They're fabulous!
Another Happy Open Dental User!

Rick Liftig, DMD FAGD
University of CT 1979
West Hartford, CT 06110
srick@snet.net

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Re: Charting conditions

Post by Pruce Dental » Sun Jul 11, 2010 8:06 pm

Thanks Rick fo your thoughts...

I really don't want to have to resort to using the paint function and draw in the caries. I am hoping for a quick button that I hit for caries then I just click on the tooth surfaces on the graphical chart and the surfaces turn a different color/pattern for caries and a different pattern for open margins. Preferably I would like to be able to see the current exisiting restoration, open margins and caries if all three conditions exist on the same surface at the same time. Is this possible?...If so can somebody walk me thru the setup steps..I tried looking for an old thread but didn't find it..I just kept finding old outdated threads and my ADHD set in and I got too sidetracked...I setup a dummy procedure code in the no fee range but when I look at the paint types the only ones in my list are for filling, ext,RCT,IMP,crowns,bridges, veneers..if I choose one of these codes my caries are going to display the same color as procedures right?....Can I set up a different paint color for caries and a different paint color for open margins?....

Can anyone help..thanks!
Robert L. Pruce, DMD
www.prucedental.com

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Re: Charting conditions

Post by Rickliftig » Mon Jul 12, 2010 4:44 am

Sure Robert - you can easily do this.

1) set up a procedure code for example, "open margin" to be N4001
2) Set the paint type to "filling light"
3) make sure treatment area is set to "surface"
4) Override the standard color by clicking on the color box and choose what ever you like.

Remember that buccal abfractions and many of your open margins would be set by selecting 'V' instead of 'B' for the surface.

As far as caries, what I do is

1) on a virgin surface, I would just treatment plan for the restoration or sealant - it will show in red
2) for an existing restoration, I would chart the restoration, perhaps select a diagnosis, and then I often will enter a tooth note (Abbrev "ztoth") with an explanation ie: crown placed in 1981 has decay on DL line angle - pt informed about R/B and need to replace restoration

best,

Rick
Another Happy Open Dental User!

Rick Liftig, DMD FAGD
University of CT 1979
West Hartford, CT 06110
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Re: Charting conditions

Post by Pruce Dental » Mon Jul 12, 2010 8:00 am

Thanks!!

Ok..for another charting question...

under the "enter treatment" tab in the chart..the "referred" tab...you use this AFTER? the work has been completed right?...you don't use this to track what is currently referred out right?...if you want to look up stuff outstanding in the chart you use only the sheets referral in the progress notes right?
Robert L. Pruce, DMD
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Re: Charting conditions

Post by Rickliftig » Mon Jul 12, 2010 8:15 am

Pruce Dental wrote:Thanks!!

Ok..for another charting question...

under the "enter treatment" tab in the chart..the "referred" tab...you use this AFTER? the work has been completed right?...you don't use this to track what is currently referred out right?...if you want to look up stuff outstanding in the chart you use only the sheets referral in the progress notes right?
Let's say I refer out endo on #19:
1)- I'll set it as referred and it (the rct symbol) will show up as orange.
2) I generate a referral slip (using referral sheets) and e-mail it and the radiograph to the endodontist
3) After it's complete, I can then change the rct to "existing other" (The rct will change color to green and I'll know it's no longer pending.
4) I'll scan the endodontists form and radiograph into the images folder for the patient

Answering your questions: a) I don't use it to track what is currently referred out. There is a report for that.
b) yes - the sheets referral will show you what's outstanding.

There are a lot of other ways to keep track of what is currently referred out. You can set up a special query to generate a report or you can simply keep track manually by using the "task lists"
Another Happy Open Dental User!

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Re: Charting conditions

Post by Pruce Dental » Mon Jul 12, 2010 8:56 am

If I post the referred work after it is completed in the specialist office as 'exisiting other" then the procedure does not record the correct date that the procedure was completed in the specialist office and the endo on tooth #19 in your example would be listed at the top of the list in the progess notes because it doesn't have a date attached to it? Is this correct or is the "exisiting other" only intended to be used where first charting a new patient into OD?

Is this how other OD users are tracking referred work?
Robert L. Pruce, DMD
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Re: Charting conditions

Post by Rickliftig » Mon Jul 12, 2010 10:08 am

Pruce Dental wrote:If I post the referred work after it is completed in the specialist office as 'exisiting other" then the procedure does not record the correct date that the procedure was completed in the specialist office and the endo on tooth #19 in your example would be listed at the top of the list in the progess notes because it doesn't have a date attached to it? Is this correct or is the "exisiting other" only intended to be used where first charting a new patient into OD?

Is this how other OD users are tracking referred work?
Robert - that's right - no date is attached. i probably would get that from the scanned form. But it's easy enough to enter in a "tooth note" attached to the tooth (it's a chart entry) that says,"RCT fininshed by Dr. Mengele"
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Re: Charting conditions

Post by Pruce Dental » Mon Jul 12, 2010 10:10 am

Ok..I am confused with charting conditions....maybe Jordan can chime in and end my confusion when you have some time...

I see two ways to chart conditions....way #1

create a dummy procedure code....So I made one for caries and one for open margins...I can post them and all but my problem is that I can only select the paint types of fillings light or filling dark....why don't I have the option in setting up a procedure code to select the paint type as "condition light" or "condition dark" so I can assign one to caries (the dark so caries always trumps open margins) and the condition light to open margins...if I select fillings light and fillings dark for my caries procedure code all my future posted filling show up in my caries color...am I doing something wrong or is this how the program behaves?


option #2 to chart conditions....I set up a light and dark conditions paint in the definitions...then I went into the chart and selected "enter treatment"..selected "conditions" but I can only post this conditon if I use the posterior composite, anterior composite and amalgam surface keys on the right..and then it posts a posterior composite condition using the conditions light and an amalgam using the conditions dark...why can't I select conditions and the tooth surfaces above in the "enter treatment" box and get my surfaces to chart without the posterior composite and or amalgam condition generated?...maybe my patient hasn't decided which restoration they want yet..maybe they want a porcelain inlay or gold onlay too?...I do like in this option for entering conditions that you can filter out your conditions in the "show" window....


Jordan...using my outlined way above is there anyway that paint light and paint dark could be easily added to the procedure code setup for conditions too?....also can the "show" tab be setup to filter out the conditions if one wants to check for instance to see if there was a restoraton etc. on the tooth that the condition was overlapping?

Jordan...sorry that my post is sooo long winded...I am still working with a trial conversion so I cannot vote on enhancements if this is not possible to setup now. I know that you have a different philosophy about charting than I do and you just like to treatment plan an item but I want to chart caries too... I love Open Dental but this is my one stumbling block with making the switch and it might be for some others too....

Thanks for you patience with me....
Robert L. Pruce, DMD
www.prucedental.com

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Re: Charting conditions

Post by Pruce Dental » Mon Jul 12, 2010 10:43 am

umm..ignore my ramblings..in my example #1 I had the conditions still checked when I tried posting an existing composite :oops:

so I guess I can make the charting work for me...


Jordan...do you have an enhancements planned in the near or distant future as to how conditions are charted that you care to share? Anything that can save me some grief later after I reenter all the caries and open margins etc that won't come across in my conversion?
Robert L. Pruce, DMD
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Re: Charting conditions

Post by Jorgebon » Mon Jul 12, 2010 10:58 am

Using the conditions option the way you describe is too much work. We just chart existing dental work and needed dental work. If there is anything I would like to add like open margin or whatever, it becomes part of the note for the procedure. For example, if a patient comes in with a fractured restoration, I chart Existing Other, surfaces, and restoration type and then I chart Treatment Plan , surfaces, defective restoration, and restoration type. Then if I want to add a note to that I can just double click the procedure in the progress notes and enter something like "Patient fractured existing restoration on tooth ## while lifting weights with his mouth". I leave the Conditions option for things a patient might have that will not get any treatment, so I really don't use it much.
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Re: Charting conditions

Post by Rickliftig » Mon Jul 12, 2010 11:18 am

I'm in agreement with Jorge - keep it simple. These electronic records are far better than your paper records could ever have been.

One thing I have started to do is on new patients, is take photos of the arches, smile and face - very handy. I am using a Pentax Optio W80 which cost about $175 (Lester Dine sells the same camera for $775 with accessories!) It has a fabulous macro focus and flash. With 12 megapixels, it's extremely easy to zoom in on a single restoration in the arch. One enhancement I may get is a wireless SD card so you don't even have to plug in a USB cable - incredible stuff! can't wait till the Cerec drops down to $99.95! (or was that $99,995).
Another Happy Open Dental User!

Rick Liftig, DMD FAGD
University of CT 1979
West Hartford, CT 06110
srick@snet.net

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Re: Charting conditions

Post by enamelrod » Mon Jul 12, 2010 8:06 pm

*

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Re: Charting conditions

Post by fishdrzig » Tue Jul 13, 2010 1:04 pm

Rick

How do you get the pics from the Pentax Optio W80 into OD? Sounds like something I would like to do, figured I'd ask

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Re: Charting conditions

Post by Rickliftig » Tue Jul 13, 2010 1:39 pm

fishdrzig wrote:Rick

How do you get the pics from the Pentax Optio W80 into OD? Sounds like something I would like to do, figured I'd ask
Super -easy - Import into images through the USB cable - The camera looks like a removable drive to the computer. Even easier would be a wireless SD card.
Another Happy Open Dental User!

Rick Liftig, DMD FAGD
University of CT 1979
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