Voice-activated periodontal charting systems have been available for some time. The big question is: how can they benefit the practice? When the pandemic struck, it was clear that a voice-activated charting system would reduce the need for an additional charting person in the operatory and limit the number of contaminated surfaces when the hygienist was charting alone. The author, a hygienist prior to becoming a prosthodontist, opted for VoiceWorks by Oral Science (Brossard, QC), manufactured by Florida Probe (Gainesville FL) because the product had excellent brand recognition and a long-term positive reputation among clinicians. It was not anticipated that this simple decision would spark a revolution in the dental hygiene department. The initiative to reduce surface contamination and operatory personnel evolved into so much more.
It is important to be aware that nearly 50% of all Americans over 30 years old1 and 20-50% of the global population2 are affected by periodontal disease. Moreover, gingivitis affects approximately 75% of American adults3. In the adult practice, it is very prudent to re-evaluate the existing periodontal classification demographic. Prior to implementing technologies that prioritize the diagnosis, treatment, and management of periodontal disease, the author’s practice classified only 5.7% of patients as “perio clients”. This represented a significant opportunity within the existing client list to improve the level of delivered care and productivity within the hygiene department. There were significant changes to the dental team, and voice-activated periodontal charting and Guided Biofilm Therapy were implemented. While the resulting practice success was attributable to the implementation of innovative systems and the introduction of a highly motivated and skilled dental hygienist to the practice, voice-activated periodontal charting was proven to be extremely advantageous. Clients, clinicians, and the practice all benefit from this documentation technology.
Clinician Benefits
A voice-activated periodontal charting system has obvious advantages when documenting the periodontal chart, including:
Infection Control
This technology minimizes surfaces that are in contact with saliva and other contaminants and eliminates the need for additional personnel to assist in recording the dental hygienist’s clinical findings. The software can interpret the hygienist’s voice through masks (Level 3, KN95, N95), through a faceshield, and despite environmental noise (telephones, other conversations, and background music).
Ergonomics
The headset is light and comfortable. VoiceWorks eliminates the repetitive movements that a dental hygienist must make when alternating between gathering probing data and transferring the information to a manually written periodontal chart.
Efficiency
This system is easy to integrate into the dental hygiene workflow. Once the software is installed, the dental hygienist is trained on the software and their voice is recognized by the software in less than an hour, and the system is ready for clients. The software can understand and interpret various accents precisely. The dental hygienist can utilize their preferred periodontal probe and the entire charting can be completed quickly and accurately. This software integrates with most practice management/electronic health record software systems.
Complete Documentation
This system allows for all aspects of the periodontal chart to be recorded, including, but not limited to, risk assessment, staging and grading, plaque charting, periodontal probing depths, bleeding on probing, furcation involvement, mobility, mucogingival defects, gingival recession, gingival hypertrophy, missing teeth, implants, suppuration, and PSR scoring. Moreover, previous periodontal chartings are easily accessible with one mouse click, so the clinician can readily assess the progression or improvement of a client’s periodontal condition.
Client Engagement
The client can listen to everything as it is being charted! Giving them a head’s up about what the probing depths mean prior to charting simplifies the conversation once charting is complete. Clients can understand where the problem areas are and will be more likely to follow recommendations for periodontal therapies and at-home oral care.
The software contains educational information about gingivitis, periodontal disease and oral hygiene instructions that can be printed and given to clients.
Client Benefits
A major advantage of a voice-activated periodontal charting is that the client hears every probing measurement, bleeding point, and other clinical finding as they are called out. This inherently stimulates the curiosity of clients and ultimately a discussion of their periodontal condition. Clients look forward to subsequent chartings, as once they understand what the probing values and bleeding points represent, they endeavor to improve their periodontal condition. This initiates a fruitful discussion between the dental hygienist and the client, with topics that include biofilm, periodontal health, oral-systemic health, recommendations for homecare, non-surgical perio, and adjunct periodontal therapies, as well as recall frequency. Many clinicians are challenged by the sentiment that they are “selling” treatment to clients. When clients have a deeper understanding of their own periodontal condition, they are more open to care recommendations, treatment acceptance is enhanced and ultimately their periodontal condition improves.
The periodontal chart can be printed and sent to specialists or 3rd party payers for pre-approvals or for reimbursement for rendered services.
Practice Benefits
When clients are treated appropriately in the typical dental practice, the practice flourishes. Many clients are on a 3–4-month dental hygiene schedule. In the author’s practice, since the introduction of a voice-activated periodontal charting system a few years ago, it has been extremely rewarding to witness the engagement of clients in their own oral health. It is now common to see clients with significant improvements in their periodontal health, including no bleeding points during probing (Fig 1).
Fig. 1
This striking improvement in communication has significantly improved treatment acceptance, client retention, and ultimately office production (Table 1). It is very rewarding to have a practice that provides appropriate preventive therapies. (Figs 2, 3)
Table 1: Dental hygiene practice metrics.4
| Number of Hygienists/Year | 2019- 1 RDH | 2021- 1 RDH | 2022- 2 RDH |
| Fluoride Varnish Applications | 78 | 556 | 968 |
| % Perio Patients | 5.7% | 27% | 26.6% |
| Total Production | $105,305 | $188,863 | $306,345 |
Fig. 2
Fig. 3
Summary
A voice-activated periodontal charting system offers numerous advantages to not only clinicians and clients, but to dental practices. This is a technology that is easy to integrate, can be easily utilized throughout the day, and benefits clients, clinicians, and the practice.
Oral Health welcomes this original article.
References
- Eke, PI., Dye, BA., Wei, L., Slade, GD., Thronton-Evans, GO., Borgnakke, WS., Taylor, GW., Page, RC., Beck, JD., Genco, RJ. Update on prevalence of periodontitis in adults in the United States: NHANES 2009 to 2012. J Periodontol. 2015 May;86(5):611-22.
- Nazir, MA., Prevalence of periodontal disease, its association with systemic diseases and prevention. Int J Health Sci. 2017 Apr-Jun;11(2):72-80.
- Kim, J., Amar, S. Periodontal disease and systemic conditions: a bidirectional relationship. Odontology. 2006 Sep: 94(1); 10-21.
- https://www.dentaleconomics.com/practice/article/14290684/strategies-to-triple-your-dental-hygiene-revenues-in-3-years
About the Author
Dr. Maragliano-Muniz was a dental hygienist before earning her DMD (Tufts) and her certificate in Advanced Prosthodontics (UCLA). A board-certified prosthodontist, and Chief Editor, Dental Economics, she maintains a private practice in Salem, MA. She lectures internationally and publishes extensively. Dr. Maragliano-Muniz was awarded the American Dental Association’s 2010 Adult Preventive Care Practice of the Year.
