Information Technology in Dentistry Chapter 9

Education Online education for professionals Computer-generated treatment plans for patients Virtual reality simulations to help train dentists

Figure 9.1 Treatment plan. Source: Courtesy of DentiMax.

Administrative Applications Electronic appointment book (scheduling), accounting, and record- keeping

Figure 9.2A Electronic scheduling: day’s view Source: Courtesy of DentiMax.

Figure 9.2B Electronic scheduling: week's view Source: Courtesy of DentiMax.

Figure 9.2C Electronic scheduling: month's view Source: Courtesy of DentiMax.

Administrative Applications Electronic dental record

Figure 9.3a Insurance claim. Source: Courtesy of DentiMax.

Figure 9.3b Dental claim form.

Figure 9.3c Insurance claims can be sent electronically. Source: Courtesy of DentiMax.

Demographics and the Transformation of Dentistry Early 20th century, poor care of teeth led to tooth loss by middle age. Late 20th century, fluoridated water and better care allowed most people to keep their teeth.

Demographics and the Transformation of Dentistry Epidemic of decay among poor children  In 2010, 108 million people in the United States, including 25 million children, go without dental insurance. Aging population leads to new specialties in dentistry.

Demographics and the Transformation of Dentistry According to the CDC in 2010, oral health problems are common:  Tooth decay affects more than one- fourth of U.S. children aged 2–5 and half of those aged 12–15. About half of all children and two-thirds of children aged 12–19 from low-income families have had decay.

Demographics and the Transformation of Dentistry According to the CDC in 2010, oral health problems are common:  Children and adolescents of some racial and ethnic groups and those from lower-income families have more untreated decay. For example, 40% of Mexican American children aged 6–8 have untreated decay, compared with 25% of non-Hispanic whites.

Demographics and the Transformation of Dentistry According to the CDC in 2010, oral health problems are common:  Children and adolescents of some racial and ethnic groups and those from lower-income families have more untreated decay. Twenty percent of all adolescents aged 12–19 years currently have untreated tooth decay.

Demographics and the Transformation of Dentistry According to the CDC in 2010, oral health problems are common:  Advanced gum disease affects 4%–12% of adults. Half of the cases of severe gum disease in the United States are the result of cigarette smoking. Three times as many smokers have gum disease as people who have never smoked.

Demographics and the Transformation of Dentistry According to the CDC in 2010, oral health problems are common:  One-fourth of U.S. adults aged 65 and older have lost all of their teeth.  African American and Mexican American adults have twice the amount of untreated decay as non-Hispanic whites.

Computerized Instruments in Dentistry Fiber optic camera Electronic periodontal probe CAD/CAM to create crowns Digital X-ray

Endodontics Diagnoses and treats diseases of the pulp Use of fiber optics to take pictures of the root canal that the dentist and patient can see Ultrasonic instruments help in root canal therapy

Periodontics Diagnoses and treats diseases of the gums and other structures supporting the teeth Periodontal disease is more prevalent in older people Periodontal disease may be an early warning of heart disease Use of electronic probe and electronic charting

Figure 9.5a Perio charting. Source: Courtesy of DentiMax.

Figure 9.5b Perio charting. Source: Courtesy of DentiMax.

Cosmetic Dentistry Attempts to create more attractive smiles using:  Bonding  Dental implants Dentists can use three-dimensional CT scans. This allows dentists to visualize the bone and visualize the teeth to make a three-dimensional model of the mouth

Cosmetic Dentistry Attempts to create more attractive smiles using:  Dental implants The technique also involves making the surface of the implant porous with an acid solution and an electronic charge. The implant can then be more quickly fixed to the bone. A biomaterial of titanium is used as a bonding agent

Cosmetic Dentistry Attempts to create more attractive smiles using:  Digital cameras and graphics software to show before and after

Diagnosis and Expert Systems Collections of evidence-based articles Databases of articles such as MedLine Expert systems can be used as an aid in diagnosis

Diagnostic Tools X-rays  Used for more than 100 years  More effective than clinical examination  May not detect cavities at an early stage Clinical examination

Diagnostic Tools Digital radiography  Takes less time than traditional X-rays  Uses 90% less radiation  Images can be immediately seen and shared on a computer monitor  Can be scanned into a patient's digital chart

Figure 9.6a Digital image of patient’s teeth. Source: Courtesy of DentiMax.

Figure 9.6b Digital image of patient’s teeth. Source: Courtesy of DentiMax.

Figure 9.6c Digital image of patient’s teeth. Source: Courtesy of DentiMax.

Diagnostic Tools Electrical conductance  Electrical current passed through the tooth and the resistance measured  Accurate in the diagnosis of large cavities, not early lesions

Diagnostic Tools Cone Beam CT Scanner (CBCT)  CBCT scanners produce accurate three- dimensional images

Diagnostic Tools Cone Beam CT Scanner (CBCT)  Although the use of CBCT is controversial— critics maintain that all the positive reviews are from people and groups with a financial interest in the technology—some dentists are using CBCT scanners for planning dental implants, planning extractions, orthodontia, to find periodontal defects, and, in endodontics, to measure root canals and their configuration

Diagnostic Tools Cone Beam CT Scanner (CBCT)  Those who support the use of CBCT scanners point to lower cost, more patients served in less time, and better images, and that the patient is exposed to less radiation than in conventional scans.

Diagnostic Tools Cone Beam CT Scanner (CBCT)  However, A report in the British Journal of Radiology last year concluded that cone-beam CT scans produced significantly higher levels of radiation than conventional dental imaging.

Other Methods Light illumination  A bright light illuminates tooth; decay looks darker. Fiber optic transillumination  Finds early lesions in enamel

Other Methods DIFOTI ®  Takes images of teeth illuminated by lasers; shows direct correlation between loss of flourescence and cavities Intraoral fiber optic camera  Gives dentist and patient a close-up view of mouth

Lasers in Dentistry Lasers deliver light energy. Depending on the target, the light travels at different wavelengths. Different lasers have different uses:  Drilling and filling cavities  Reshaping gums  Minimal use in root canal therapy  Whitening teeth in cosmetic dentistry

Minimally Invasive Dentistry Prevention  Antibacterial rinses  Fluoride  Sealants  Healthy diet  Sugarless gum Minimal intervention  Air abrasion  Lasers

Computers in Dental Surgery Planning surgery using virtual simulations Delivery of anesthesia Creation and planning of dental implants Monitoring of vital signs

The Growth of Specialization The percentage of dentists who are specialists is expected to rise from 10% to 30%. The aging population may seek cosmetic dentistry. The possibility of early diagnosis may result in dentists who specialize in diagnostics.

Teledentistry Teledentistry links dentists with dental specialists via telecommunications lines. Images and records can be ed to the specialist, giving patients access to expert advice.