Customizing perio entry settings

Perio exam methods and philosophies differ from provider to provider. To facilitate different charting styles, Perio Chart allows a provider to set up scripts and paths that represent his or her preferred method of examination.

Note: Customizing perio entry settings requires the "Perio Chart, Setup" security right.

To customize perio entry settings

In Perio Chart, on the menu bar, click Setup.

If applicable, do one of the following:

If the Password - Perio Chart, Setup dialog box appears, user verification has been assigned to the "Perio Chart, Setup" task. Do one of the following:

If your user account has been granted the "Perio Chart, Setup" security right, enter your credentials in the User ID and Password boxes, and then click OK.

If your user account has not been granted the "Perio Chart, Setup" security right, have a user with permission temporarily override this restriction so you can customize perio entry settings this one time. The overriding user enters his or her credentials in the User ID and Password boxes and then clicks OK.

If a message appears, informing you that you do not have rights to this operation, your user account has not been granted the "Perio Chart, Setup" security right. To have a user with permission temporarily override this restriction so you can customize perio entry settings this one time, do the following:

On the message, click Yes.

In the Password- Perio Chart, Setup dialog box, the overriding user enters his or her credentials in the User ID and Password boxes and then clicks OK.

The Perio Entry Setup dialog box appears.

Set up the following options:

Auto Settings:

Path Advance - You can control the order of movement through the probing areas of each tooth. To enable the use of the Path Settings, select this option. If the checkbox is clear, the automatic path advance will not work, and you must press the ENTER key each time a measurement has been entered to advance to the next site.

Tooth Advance - You can control the order of movement from tooth to tooth. To enable the use of the Script Settings, select this option. If the checkbox is clear, the automatic tooth advance will not work, and you must move from tooth to tooth manually.

Calculation Options - When preforming a periodontal exam, it is important to remember that the pocket depth, gingival margin, and clinical attachment level measurements have a mathematical relationship. That relationship is such that, given any two of the three measurements, you can mathematically calculate the third. With that in mind, you can enter two measurements; and, based on your chosen calculation method, Dentrix Enterprise will automatically calculate and input the third measurement for you. Select one of the following calculation options:

CAL = PD + GM - Use if you plan to enter the pocket depth and gingival margin measurements. Once those measurements have been entered, Dentrix Enterprise will automatically calculate the clinical attachment level measurement.

GM = CAL - PD - Use if you plan to enter the clinical attachment level and pocket depth measurements. Once those measurements have been entered, Dentrix Enterprise will automatically calculate the gingival margin measurement.

PD = CAL - GM - Use if you plan to enter the clinical attachment level and gingival margin measurements. Once those measurements have been entered, Dentrix Enterprise will automatically calculate the pocket depth measurement.

No Calculation - Use if you will only be entering one measurement and do not want a calculation to be made.

If you select any one of the calculation methods, Perio Chart will make the measurement boxes on Perio Chart that are automatically calculated unavailable. For example, if you use the CAL calculation method, Perio Chart will make the Clinical Att. Level boxes unavailable. If you choose not to use a calculation, all of the boxes will be available.

Flag Red Limit - You can choose to have a certain degree of pocket depth and clinical attachment level be displayed in red. As measurements are entered, if the pocket depth or CAL is equal to or greater than the selected red flag limit, the measurement will be displayed in red on the data chart.

Select 4, 5, or 6 to set the probing depth/CAL maximum limit.

Select Probing Depth if you want to have probing depths be displayed in red if they meet or exceed the limit.

Select CAL if you want to have clinical attachment levels be displayed in red if they meet or exceed the limit.

Measurements can be flagged red in the graphic chart, as well. However, only the area on or above the selected limit is displayed in red. The area below the limit is displayed in green (the default color). If you want to display the area above and below the limit in red, select All Red in Graphic Chart, select this option to help you locate problem areas faster.

Path Settings - Path settings dictate the sequential order of movement through the probing areas of each individual tooth. Since each care provider will not take the same measurements in the same order, Dentrix Enterprise allows the path settings to be customized.

By default, Dentrix Enterprise has two paths: P1 and P2. Both paths move you through entering pocket depths, bleeding, and suppuration measurements. P1 charts from left (the provider's left) to right, and P2 charts from right (the provider's right) to left.

To customize the default paths or create up to two more paths, do the following as needed:

For a given path, in the Name box, enter the name of the path to represent the measurements the will be charted (for example, PBSL might indicate Pocket Depth Bleeding Suppuration from Left to Right.) The name can be up to six characters in length.

Before customizing an existing path or creating a new path, keep the following in mind:

While dentistry encourages you to work from the patient's point of view, when setting up perio scripts you will work from the provider's point of view (for example, starting on tooth one and moving to tooth eight is right to left in the patient's mouth; however, from the provider's perspective, it is left to right).

Because mesial and distal surfaces switch sides at the midline, for the purposes of this documentation, left, center, and right will be used to avoid confusion. (Remember this is the provider's left and right.)

For a given path, in the Path box, enter the number that corresponds to the measurement site you want to chart first. Use the following table to determine which number to enter.

Next, type a comma and then the number for the next site that you want to chart. Repeat this process for all measurements and sites to be charted.

Sample Path 1:

Situation: You want to enter pocket depths, moving from left to right.

Path: P1 = 1,2,3

Explanation: This path starts you in the pocket depth on the left side of the tooth. Once a number is entered, the path advances to the pocket depth center. Once a number is entered here, the path advances to the pocket depth on the right side of the tooth.

Sample Path 2:

Situation: You want to enter pocket depths, then bleeding and suppuration, moving from left to right.

Path: P1 = 1,4,2,5,3,6

Explanation: This path starts you in the pocket depth on the left side of the tooth. Once a number is entered here, the path advances to the bleeding/suppuration site on the left side of the tooth. Once a B, S, or ENTER is input, the path advances to the pocket depth center. The path continues to advance through B/S center, PD right, and then B/S right.

Sample Path 3:

Situation: You want to enter pocket depth measurements, gingival margin measurements, and bleeding and suppuration from left to right.

Path: P1 = 1,7,4,2,8,5,3,9,6

Explanation: This path starts you in the pocket depth on the left side of the tooth. Once a number is entered, the path advances to the gingival margin on the left side of the tooth. Once a number is entered here, the path advances to the bleeding/suppuration site on the left side of the tooth. Once a B, S, or ENTER is input, the path advances to the pocket depth center. The path continues to advance through the GM center, B/S center, PD right, GM right, and then B/S right.

Script Settings - Whereas path settings determine the entry method for the measurements, direction, and processes that will occur on each tooth that is examined, script settings dictate the sequential order of movement from tooth to tooth with the ability to designate the facial and lingual surfaces.

The default Dentrix Enterprise script starts you on tooth number 1 on the facial side. The script advances from left to right, advancing from tooth 1 until reaching the end of the arch at tooth 16. At the end of the arch, the script reverses direction, advancing from tooth 16 back to tooth 1 on the lingual side. Next, the script drops down to the lower arch and advances from tooth 32 to 17 on the facial side. Finally, the script reverses again and advances from tooth 17 to tooth 32 on the lingual side.

To customize the default script or create up to two more scripts, do the following as needed:

If the script that you want to customize is the one you will be using, select that number (1, 2, or 3).

Note: The selected script will be used during the examination.

In the box, do one of the following:

Type F to begin on the facial side of the tooth.

Type L to begin on the lingual side of the tooth.

Type P1, P2, P3, or P4 to specify which path you want to use. (Your path choice should match the direction that you will be moving in the mouth. If you are going to start on tooth 8 and work back to tooth 1, you should use your right to left path.)

Enter the tooth numbers, separated by commas, in the order that you want to examine them (for example, 1,2,3,4,5,6,7,8).

If you need to switch to the opposite surface, type either F for facial or L for lingual. You can also switch paths if you will be charting in the reverse direction. Type P1, P2, P3, or P4 to specify a new path setting.

Enter the next sequence of teeth, separated by commas, in the order that you want to examine them (for example, 8,7,6,5,4,3,2,1).

Repeat steps e-f as needed to complete your script.

Sample Script 1:

Situation: You want to enter measurements, starting on tooth 1 and moving to tooth 16 on the facial side. At the end of the arch, the script should reverse and move from tooth 16 to 1 on the lingual side. Next, the script will drop to the lower arch and beginning on tooth 32 advance to tooth 17 on the facial side. Finally, the script will advance from tooth 17 to tooth 32 on the lingual side.

Script: F,P1,1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,L,P2,16,15,14,13,12,11,10,9,8, 7,6,5,4,3,2,1,F,P1,32,31,30,29,28,27,26,25,24,23,22,21,20,19,18,17,L,P2,17,18,19, 20,21,22,23, 24,25,26,27,28,29,30,31,32

Explanation: The "F" indicates the facial side. "P1" tells Dentrix Enterprise to use the first path. The individual numbers indicate how Enterprise will advance. At the end of the arch, the script switches surfaces and reverses directions, indicated by the "L" and "P2." The same sequence is repeated on the lower arch.

Sample Script 2:

Situation: You want to enter measurements by quadrants, starting in the upper right quadrant entering facial and lingual measurements. Next, you want to drop to the lower right quadrant entering facial and lingual measurements. This sequence should be repeated in the upper-left then lower-left quadrants.

Script: F,P1,1,2,3,4,5,6,7,8,L,P2,8,7,6,5,4,3,2,1,F,P1,32,31,30,29,28,27,26,25,L,P2, 25,26,27,28,29,30,31,32,F,P1,9,10,11,12,13,14,15,16,L,P2,16,15,14,13,12,11,10,9, F,P1,24,23,22,21,20,19,18,17,L,P2,17,18,19,20,21,22,23,24

Explanation: The "F" indicates the facial side. "P1" tells Dentrix Enterprise to use the first path. The individual numbers indicate how Dentrix Enterprise will advance. At the end of the quadrant, the script switches surfaces and reverses directions, indicated by the "L" and "P2." The same sequence is repeated for each quadrant.

Path and script overrides - You can have Dentrix Enterprise override scripts and paths and use a pre-defined script that records only specific measurements. Under Script Settings are five override choices: Probing Depth, Gingival Margin, Clinical Att. Level, MGJ, and None. Each override ignores any path or script settings and follows a pre-defined script. The pre-defined script begins on the facial side of tooth 1 and continues to tooth 16. The script then switches to the lingual side of tooth 16 and continues to tooth 1. Upon completion of the lingual side of tooth one, the script jumps to tooth 32 on the facial side and continues to tooth 17. It then switches to the lingual side of tooth 17 and returns to tooth 32 to complete the script. If None is selected, the script will jump from tooth-to-tooth sequentially, ending on tooth 32.

Skip Teeth with Selected Conditions - Teeth with certain conditions can be skipped when entering perio data. To have Dentrix Enterprise automatically skip these teeth, select the desired conditions: Crown, Implant, Implant & Crown, Missing, Impacted - Mesial, Impacted - Distal, Pontic, Unerupted, Impacted, and/or Root Tip. In order for Dentrix Enterprise to skip these teeth, the condition must first be assigned to the tooth in the patient's chart.

Click OK.

Note: The settings in the Perio Entry Setup dialog box are stored in the database. Most settings apply to all users, but one is saved per user:

All users - The Auto Settings, Calculation Options, Flag Red Limit, Path Settings, Skip Teeth with Selected Conditions, and data in boxes 1, 2, and 3 under Script Settings.

User-specific - The selected default script under Script Settings. You can also select your default script from the Options menu.