Dentrix Ascend Voice Perio Getting Started Guide

You can use voice commands to chart a perio exam in Dentrix Ascend. This functionality requires the purchase of Dentrix Ascend Voice Perio licenses and the installation of a browser extension (for Chrome browsers only) powered by Bola AI. This guide provides instructions for purchasing, configuring, and using Voice Perio.

Prerequisites

Purchasing Voice Perio licenses

Contact your Henry Schein One account executive to inquire about purchasing Dentrix Ascend Voice Perio licenses. Each license that you purchase for your location is good for up to five computers.

Purchasing microphones

Consider the following types of microphones when purchasing a microphone:

Using a lapel-style microphone is recommended. You may want to purchase the following recommended microphones:

Configuring Voice Perio

After your order for Dentrix Ascend Voice Perio licenses is complete, Henry Schein One will send you a welcome email message. Then, you can install, register, and set up the browser extension and test your microphone:

  1. Install the extension:

    1. On a computer that you want to use Voice Perio, visit the link provided in the welcome email or https://chrome.google.com/webstore/detail/bola-ai-voice-perio-chrom/efcpoommkbigcpbekkjpmfcdbpgggfjg/related.

      The chrome web store page opens in your browser.

    2. Click (or tap) Add to Chrome.

      A confirmation message appears.

    3. Click (or tap) Add extension.

      When the extension has been added, a message appears.

    4. Click (or tap) the X to close the message.

    5. To pin the extension to the top of the browser, on the Extensions menu, click (or tap) the Pin icon next to Bola Dental Chrome.

      The Bola Dental icon now appears at the top of the browser for quick access.

  2. Register the extension:

    1. Click (or tap) the Bola Dental icon , and then click (or tap) Help on the menu that appears.

      The Bola.AI page appears.

    2. Select the Subscription (License) tab on the left.

    3. Copy the license key from the welcome email message that you received after purchasing a license, and then paste it into the License Key box.

      Tip: To make the box active so that you can paste in the license key, click (or tap) immediately after the words "License Key."

    4. Click (or tap) Register.

      A message appears.

    5. Click (or tap) OK.

      The extension is now registered on the computer.

  3. Set up the extension:

    1. On the Bola AI page, select the Configuration tab on the left.

    2. Set up the following default options for all exams:

      • Read Back to Me - With this check box selected, while you are charting pocket depths or gingival margins continuously, a voice repeats back to you what Voice Perio has heard and entered. This may help you stay on track.

        Note: When you start a new exam, or when you first open an existing exam to edit it, you can turn this functionality on or off for the exam.

      • Detect Missed Pocket Depths - With this check box selected, Voice Perio will automatically insert a zero (0) for any missing pocket depths it detects. This helps ensure that the rest of your chart is accurate and allows you to go back and correct the value after the charting is complete.

        Note: When you start a new exam, or when you first open an existing exam to edit it, you can turn this functionality on or off for the exam.

      • Midline Chime - To have a feedback sound (a click-pop) play when your charting has crossed the midline of the mouth, select this check box. To not have a sound play, clear this check box (click, or tap, the check mark to remove it).

      • Periodontal Index (PI) - To have Voice Perio display the periodontal index after you finish an exam, select this check box. To not have the periodontal index appear after an exam, clear this check box (click, or tap, the check mark to remove it).

  4. Verify if your microphone works with the extension:

    1. Plug in the USB connector of the microphone.

    2. On the Bola AI page, select the Training tab on the left, or visit https://prod-dental-web-app.bola.ai/.

    3. Click (or tap) the Check Mic button .

    4. If the Chrome browser prompts you to grant permission for the website to use your microphone, click (or tap) Allow.

      A volume indicator appears.

    5. Speak into your microphone. If you see a blue volume-indicator bar lengthen and shorten as you speak, your microphone is working.

    6. Click (or tap) Done.

    7. If the microphone check was not successful, verify if the microphone is being blocked by Chrome:

      • If you see a This page has been blocked from using your microphone icon, the microphone is being blocked.

        Do the following to unblock the microphone:

        1. Click (or tap) the icon to open a menu.

        2. Select the Always allow option, and then click (or tap) Done.

        3. Reload the page.

      • If you see a This page is accessing your microphone icon, the microphone is not being blocked.

    8. If the microphone is not being blocked but still does not work, try the following:

      1. Unplug and plug in the USB connector of the microphone, and then repeat steps 3-7 as needed.

      2. Close all open browser tabs and windows, and then restart the browser.

      3. Restart the computer.

Voice Commands

Entering perio exams

After the browser extension is installed and registered, and your microphone is working, Dentrix Ascend Voice Perio is ready for use in entering perio exams.

To enter a perio exam and use voice commands

  1. If the correct patient is not already selected, use the Patient Search box to access the patient's record.

  2. On the Patient menu, under Clinical, click (or tap) Perio.

    The patient's clinical record opens with the Perio tab selected.

  3. Click (or tap) New Perio Exam.

    The New Perio Exam dialog box appears.

  4. Set up the main options as needed:

    • Date - Verify that the date is correct. If necessary, you can change it.

    • Provider - Verify that the correct provider is associated with the exam. If necessary, select a different provider. Only providers who have access to the current location are available.

    • Script - Select the sequence of movement between teeth and arches that you want to use to enter perio measurements.

    • Skip conditions - Select the conditions that will cause teeth with those conditions to be skipped automatically. A tooth is considered to have one of the selected conditions if an applicable charting symbol is associated with an existing or a completed procedure that was posted for that tooth. However, if Missing is selected, but Implant or Implant & Crown is not selected, a tooth that was replaced with an implant or with an implant and a crown will not be skipped.

    • Tooth navigation script - Select whether you want to enter primarily pocket depths, primarily gingival margins, or the pocket depth and then the gingival margin at each measurement site. A selection frame will appear next to the applicable measure (PD or GM) during the exam.

    • Enter BOP and Sup - Specify if you want to delay the marking of bleeding and suppuration:

      • Enter the number of teeth that you must measure before you can start entering bleeding and suppuration (for example, if you enter four, you must enter measurements for Distal, Center, and Mesial on the Facial side of teeth 1-4) unless you click (or tap) a different area of the exam than where the script starts. Also, as you follow the script to continue charting, the BOP/Sup selection frame trails behind the current tooth by the specified number of teeth (as with our example of four, if the current position is tooth 10, the BOP/Sup selection frame is on tooth 6).

      • Zero indicates that you can start entering bleeding and suppuration immediately upon starting the exam.

      Important note for Voice Perio:

      • Use zero (0) if you want the flexibility to use voice commands to chart bleeding and suppuration on any tooth regardless of which tooth has the BOP/Sup selection frame.

      • Use a number greater than zero if you will use voice commands to chart bleeding and suppuration only for the tooth that has the BOP/Sup selection frame. If you attempt to use a voice command to apply bleeding or suppuration on a different tooth, Voice Perio will apply it to the wrong tooth.

  5. Set up the following Bola Configuration options:

    • Detect Missed Pocket Depths - With this check box selected, Voice Perio will automatically insert a zero (0) for any missing pocket depths it detects. This helps ensure that the rest of your chart is accurate and allows you to go back and correct the value after the charting is complete.

    • Read Back to Me - With this check box selected, while you are charting pocket depths or gingival margins continuously, a voice repeats back to you what Voice Perio has heard and entered. This may help you stay on track.

    Note: These options are available only if the Bola AI browser extension is installed and registered on the computer.

  6. Click (or tap) Start Exam.

    The options for entering a perio exam become available.

  7. To start voice recognition, click (or tap) the blue Voice Perio icon  (in the lower-right corner). This icon is available only if the Bola AI browser extension is installed and registered on the computer.

  8. If the Chrome browser prompts you to grant permission for the website to use your microphone, click (or tap) Allow.

  9. Dictate the exam with voice commands, and use your mouse and keyboard as needed to chart conditions that are not supported by Voice Perio.

    As you chart, the positions of the Tooth selection frame, the PD and GM selection frames, and the BOP/Sup selection frame change according to the exam options (from the New Perio Exam dialog box).

    The following examples illustrate where the selection frames are as you chart pocket depths, gingival margins, and bleeding and suppuration according to both the tooth navigation script and the delay for charting bleeding and suppuration:

    • Tooth navigation script = Pocket Depth:

      • Enter BOP and Sup = 0 (no delay):

        On the current tooth, the PD selection frame is at the first position, and the BOP/Sup selection frame is available.

        On the current tooth, the PD selection frame is at the third position, and the BOP/Sup selection frame is available.

        The PD selection frame and the BOP/Sup selection frame stay inside the Tooth selection frame.

        Notes for Voice Perio:

        • You can use a voice command to mark bleeding or suppuration on the current tooth without having to specify a tooth number, but you must do so before you specify the third pocket depth value, upon which the Tooth selection frame advances to the next tooth automatically.

        • You can use a voice command to mark bleeding or suppuration on any tooth that does not have the BOP/Sup selection frame, but you must specify a tooth number as part of the command.

      • Enter BOP and Sup = 1 (one-tooth delay):

        On the current tooth, the PD selection frame is at the first position.

        On the previous tooth, the BOP/Sup selection frame is available.

        The PD selection frame stays inside the Tooth selection frame. The BOP/Sup selection frame advances with the Tooth selection frame but stays one tooth behind, so you cannot mark bleeding or suppuration while the first tooth is selected.

        Notes for Voice Perio:

        • You can use a voice command to mark bleeding or suppuration on the previous tooth without having to specify a tooth number, but you must do so before you specify the third pocket depth value on the current tooth, upon which the Tooth selection frame and the BOP/Sup selection frame advance to the next applicable teeth automatically.

        • Do not use a voice command to mark bleeding or suppuration on any tooth that that does not have the BOP/Sup selection frame.

    • Tooth navigation script = Gingival Margin:

      • Enter BOP and Sup = 0 (no delay):

        On the current tooth, the GM selection frame is at the first position, and the BOP/Sup selection frame is available.

        On the current tooth, the GM selection frame is at the third position, and the BOP/Sup selection frame is available.

        The GM selection frame and the BOP/Sup selection frame stay inside the Tooth selection frame.

        Notes for Voice Perio:

        • You can use a voice command to mark bleeding or suppuration on the current tooth without having to specify a tooth number, but you must do so before you specify the third gingival margin value, upon which the Tooth selection frame advances to the next tooth automatically.

        • You can use a voice command to mark bleeding or suppuration on any tooth that that does not have the BOP/Sup selection frame, but you must specify the tooth number as part of the command.

      • Enter BOP and Sup = 1 (one-tooth delay):

        On the current tooth, the GM selection frame is at the first position.

        On the previous tooth, the BOP/Sup selection frame is available.

        The GM selection frame stays inside the Tooth selection frame. The BOP/Sup selection frame advances with the Tooth selection frame but stays one tooth behind, so you cannot mark bleeding or suppuration while the first tooth is selected.

        Notes for Voice Perio:

        • You can use a voice command to mark bleeding or suppuration on the previous tooth without having to specify a tooth number, but you must do so before you specify the third gingival margin value on the current tooth, upon which the Tooth selection frame and the BOP/Sup selection frame advance to the next applicable teeth automatically.

        • Do not use a voice command to mark bleeding or suppuration on any tooth that that does not have the BOP/Sup selection frame.

    • Tooth navigation script = Pocket Depth and Gingival Margin:

      • Enter BOP and Sup = 0 (no delay):

        On the current tooth, the PD selection frame is at the first position, and the BOP/Sup selection frame is available.

        On the current tooth, the GM selection frame is at the first position, and the BOP/Sup selection frame is available.

        On the current tooth, the GM selection frame is at the third position, and the BOP/Sup selection frame is available.

        The PD and GM selection frames, and the BOP/Sup selection frame stay inside the Tooth selection frame.

        Notes for Voice Perio:

        • You can use a voice command to mark bleeding or suppuration on the current tooth without having to specify a tooth number, but you must do so before you specify the third gingival margin value, upon which the Tooth selection frame advances to the next tooth automatically.

        • You can use a voice command to mark bleeding or suppuration on any tooth that that does not have the BOP/Sup selection frame, but you must specify the tooth number as part of the command.

      • Enter BOP and Sup = 1 (one-tooth delay):

        On the current tooth, the PD selection frame is at the first position.

        On the current tooth, the GM selection frame is at the first position.

        On the previous tooth, the BOP/Sup selection frame is available.

        The PD and GM selection frames stay inside the Tooth selection frame. The BOP/Sup selection frame advances with the Tooth selection frame but stays one tooth behind, so you cannot mark bleeding or suppuration while the first tooth is selected.

        Notes for Voice Perio:

        • You can use a voice command to mark bleeding or suppuration on the previous tooth without having to specify a tooth number, but you must do so before you specify the third gingival margin value on the current tooth, upon which the Tooth selection frame and the BOP/Sup selection frame advance to the next applicable teeth automatically.

        • Do not use a voice command to mark bleeding or suppuration on any tooth that that does not have the BOP/Sup selection frame.

  10. To pause or stop voice recognition at any time, click (or tap) the red Voice Perio icon  (in the lower-right corner).

  11. When you have finished the exam, click (or tap) Finish Exam.

  12. If the Bola AI: Periodontal Index dialog box appears, to print the summary, click (or tap) Print. Then, click (or tap) Close.

  13. If the Finish Perio Exam dialog box appears, click (or tap) Save Exam with the Previous Values or Save Only New Values.

Voice Perio microphone icon colors

The Dentrix Ascend Voice Perio microphone icon appears in the lower-right corner of the browser window when you are entering a new perio exam or editing an existing one. The microphone icon has three states:

Voice command syntax

You can use the syntax examples in this section to help you understand how to structure voice commands for charting perio exams.


Navigating and Selecting Teeth

While charting pocket depths or gingival margins continuously (according to the selected script), after you say the values for the three positions on a tooth, the tooth selector advances to the next tooth automatically; you do not specify a tooth number. However, if you need to chart a periodontal condition, such as bleeding, elsewhere in the mouth or on previous teeth, you must specify the applicable teeth. Also, you can deviate from the script and navigate teeth as needed.

To specify a tooth, say:

To specify multiple teeth, say:

To move to another tooth, say:


Specifying Positions and Surfaces

To specify the position on a tooth, say:

Note: If a position is not specified, Middle is assumed.

To specify multiple positions on a tooth, say:

To specify the surface (inward- or outward-facing side) of a tooth, say:

To move to a specific side of another tooth, say:

To move to a specific position on the same side of another tooth, say:

To move to a specific position and side of another tooth, say:


Switching between Pocket Depths and Gingival Margins

When you start a new exam, or when you first open an existing exam to edit it, the initial charting mode (pocket depths or gingival margins) depends on the selected tooth navigation script.


Charting Pocket Depths or Gingival Margins Continuously

While charting pocket depths or gingival margins continuously, to indicate a pocket depth or gingival margin:

While charting pocket depths or gingival margins continuously, you can say any number of pocket depth or gingival margin values without stopping, but the voice recognition of Dentrix Ascend Voice Perio works best if you pause slightly after saying the three values for each tooth. For example, say:

While charting pocket depths or gingival margins continuously, you may hear the following sounds:

Tip: You may want to say values for one, two, or three teeth at a time and then wait for the feedback sound (voice, ding, or click-pop) before proceeding.


Charting Gingival Margins

For recession, you can use the "Recession," "Gingival Margin," and "GM" commands interchangeably. Recession commands use must include "plus" or "with."

To mark recession:

Notes:


Charting Bleeding

For bleeding, you can use the "Bleeding" and "BOP" commands interchangeably.

To mark bleeding:

Notes:


Charting Suppuration

For suppuration, use the "Suppuration" command.

To mark suppuration:

Notes:


Charting Furcation

For furcation, use the "Furcation" command. Furcation commands must include "grade" or "class." Furcation applies to only the following teeth: 1-3, 14-16, 17-19, and 30-32.

To mark furcation:

Notes:


Charting Mobility

For mobility, use the "Mobility" command. Mobility commands must include "plus" or "class."

To mark mobility:


Undoing Commands

To undo the last command, say:

Note: You can repeat "Undo" as needed to continue undoing commands in reverse order.


Unsupported Commands

Voice commands for the following conditions are not available with Dentrix Ascend Voice Perio:

Troubleshooting

Inaccurate recognition

Make sure to follow these recommendations:

Slow response

Issues with Voice Perio responding to or processing commands slowly are often due to poor Wi-Fi speed or the processing power of the machine. Please contact your IT professional for help improving these conditions.

Microphone is not working

If your microphone is not working at all (or Voice Perio is not hearing anything) in Dentrix Ascend, complete the following steps as needed to resolve the issue:

  1. Check that your license key is still active on the Subscription (License) tab of the Bola AI page. The license is active if the word "Registered" and a check mark appear in green near the top of the page.

  2. Make sure that google.com has permission to access the microphone and that the microphone works on that website:

    1. Click (or tap) the microphone icon in the search box.

    2. If the Chrome browser prompts you to grant permission for the website to use your microphone, click (or tap) Allow. Then, click (or tap) the microphone icon again.

      The page displays "Listening..." and a microphone icon.

    3. Say something to search for.

  3. Unplug and plug in the USB connector of the microphone, and then repeat step 2.

  4. Make sure that Dentrix Ascend has permission to access the microphone by clicking (or tapping) the View site information icon next to the Dentrix Ascend website address. On the menu that appears, check the microphone permission:

    • If Block is selected in the list next to Microphone, the microphone is blocked.

      To unblock the microphone, do the following:

      1. Select Allow from the list next to Microphone.

      2. Click (or tap) Reload to reload the website and apply the change.

    • If Allow is selected in the list next to Microphone, the microphone is not blocked.

  5. Close all open browser tabs and windows, and then restart the browser.

  6. Restart the computer.