Method and system for recording carious lesions

• US 20020178032A1
• Filed: 05/02/2002
• Published: 11/28/2002
• Est. Priority Date: 05/03/2001
• Status: Active Grant

• Current Assignee: Douglas D. Dankel II, Douglas K. Benn, Florida Research Foundation, Inc., Stephen H. Kostewicz
• Original Assignee: Florida Research Foundation, Inc.
• Inventors: Dankel, Douglas D. II, Kostewicz, Stephen H., Benn, Douglas K.
• Granted Patent: US 7,343,305 B2
• Time in Patent Office: Days
• US Class Current: 705/2
• CPC Class Codes: A61C 19/00 Dental auxiliary appliances dental chairs or accessories therefor, working stands whether or not combined with chairs A61G15/00
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 30/40 for processing medical images, e.g. editing
• CPC Class Codes: G16H 40/20 for the management or administration of healthcare resources or facilities, e.g. managing hospital staff or surgery rooms
• CPC Class Codes: G16H 40/63 for local operation
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems

Abstract

A method and system is provided for charting tooth decay to assist in caries management. Specifically, the invention provides a computer system, a Graphical User Interface(GUI), a method, and associated computer code for presenting an interactive tooth chart comprising selectable, anatomically correct tooth icons corresponding to a dental patient'"'"'s teeth. The invention allows a user to select regions of each individual tooth icon to record the condition of the selected region. According to the invention, a dental patient is selected from a patient data base, the patent'"'"'s teeth are examined, and the condition of each tooth region is recorded using selectable icons. The invention further provides automatic characterization of dental conditions based on standard values and previously recorded conditions to indicate progression of disease. In an alternative embodiment, the invention provides a recommended course of clinical management based on the information recorded. In another embodiment the invention automatically classifies patients into risk categories and provides suggested x-ray exam intervals. Thus, particular advantages of the current invention include ease of recording dental conditions, more accurate dental charting, and automatic analysis of recorded dental data, advantageously resulting in better patient care and more efficient use of a dental care provider'"'"'s time.

Claims

1. An interactive system for recording carious lesion information comprising:

a) a computing device comprising a display, a central processing unit (CPU), operating system software, memory for storing data, a user interface, and input/output capability for reading and writing data;

b) a patient database comprising patient dental records;

c) a graphical user interface (GUI) having at least one linked, interactive screen display, said display comprising;

1) a first display area comprising an anatomically correct diagram of a set of teeth, wherein said teeth represent a patient'"'"'s teeth according to the corresponding data stored for the patient in said patient information database, said teeth including indicia to indicate condition of a patient'"'"'s teeth, wherein said teeth are interactive icons, and each of said teeth can be selected to link to a representative diagram of a selected patient'"'"'s tooth;

2) a second display area, operatively linked to said first display area, comprising a representative diagram of the coronal morphology of a tooth selected from said teeth, wherein said tooth is an interactive tooth icon divided into selectable regions corresponding to the coronal morphology of said selected tooth, wherein said selectable regions are interactive region icons, each of said region icons having a region identifier to uniquely identify said selectable region;

3) a third display area having operable diagnostic icons, indicative of diagnostic information, wherein said diagnostic icons allow a user to input and record diagnostic information for each said region of said tooth selected and displayed in said second display area; and

4) a fourth display area, associated with said tooth icon displayed in said second display area, comprising a scrollable window to display diagnostic information recorded for the selected patient'"'"'s tooth, wherein said displayed diagnostic information corresponds to said diagnostic information input using said diagnostic icons in said third display area;

d) computer program code for;

1) providing the capability to allow navigating among elements of said linked, interactive screen display;

2) providing interactive icons to allow entering and editing of said carious lesion information;

3) allowing selection of a patient from said patient database;

4) recording the condition of a selected patient'"'"'s teeth by;

i) receiving one of said tooth icons selections from said diagram of a set of teeth;

ii) displaying said tooth icon;

iii) receiving one of said region icons selections of said selected tooth icon;

iv) receiving at least one of said diagnostic icons selections to record the condition of a patient'"'"'s tooth corresponding to said selected tooth region;

vi) displaying said recorded condition;

vii) providing the capability to allow verifying and editing of said recorded condition; and

viii) repeating steps i)-vii) until the condition of each region of each of the selected patient'"'"'s teeth has been received and recorded;

wherein said computing device executes said computer code and provides said GUI to allow a user to interactively record carious lesion information.

2. The system of claim 1, wherein said computing device is a Personal Digital Assistant (PDA).

3. The system of claim 1, wherein said teeth are human teeth.

4. The system of claim 1, further comprising a system for automatically analyzing said recorded condition for each selected patient'"'"'s tooth to provide a recommendation for clinical management of each selected patient'"'"'s tooth.

5. The system of claim 1, further comprising a system for computing and indicating a caries risk level for a dental patient based on said recorded conditions of the patient'"'"'s teeth and patient screening information maintained in said patient database.

6. The system of claim 5, further comprising a system for computing and indicating a dental x-ray interval for a dental patient based on the patient'"'"'s said risk level, the patient'"'"'s age, and the time interval elapsed since the patient'"'"'s last dental x-ray was taken.

7. The system of claim 1, further comprising a system for graphically capturing an image of the coronal morphology of at least one of a patient'"'"'s tooth, importing said image into said patient information database, creating an interactive image icon from said image, assigning interactive regions to said image icon corresponding to the morphology of said tooth, and providing said image icon on said GUI in said first and second display areas whenever the associated patient'"'"'s dental records are retrieved.

8. The system of claim 1, further comprising a region insertion tool to manually move and add interactive regions to said tooth icons.

9. The system of claim 1, further comprising a caries detection dental probe to determine the condition of said selected region of a patient'"'"'s tooth and provide a decay reading value for said selected region.

10. The system of claim 9, further comprising an interactive numeric display on said GUI to allow reporting of said decay reading value by selecting the corresponding value on said numeric display.

11. The system of claim 9, wherein said caries detection dental probe is in communication with said computer system and automatically updates said patient information database for the selected region of a patient'"'"'s tooth being probed.

12. The system of claim 11, wherein said computer system is remotely located with respect to said caries detection dental probe.

13. The system of claim 1, further comprising a system for characterizing and indicating tooth condition, comprising:

a) a caries database of standard carious lesion conditions;

b) b) computer code for automatically comparing said recorded condition to standard carious lesion conditions maintained in said caries database, comparing said recorded tooth condition to a previously stored tooth condition maintained in said patient database, for the same tooth, and recording and providing a characterization indication of present tooth condition based on said comparisons.

14. The system of claim 13, wherein said characterization indication further comprises a first graphical indicator for no difference between a recorded tooth condition value and a corresponding previously recorded tooth condition value and for a recorded tooth condition value less than a corresponding previously recorded tooth condition value, and a second graphical indicator for a recorded tooth condition value more than a corresponding previously recorded tooth condition value.

16. The system of claim 15, wherein said computing device is a PDA.

17. The system of claim 15, wherein said caries detection dental probe is in communication with said computer system and automatically updates said patient information database for the selected region being probed.

18. The system of claim 17, wherein said computer system is remotely located with respect to said caries detection dental probe.

19. The system of claim 15, further comprising a system for characterizing and indicating tooth condition based on said diagnostic information, comprising:

a) a caries database of standard carious lesion values;

b) computer code for automatically comparing a decay reading value to standard carious lesion values maintained in said caries database, comparing said decay reading value to a previously stored value, maintained in said patient database, for the same tooth, and recording and providing a characterization indication of present tooth condition based on said comparisons.

20. The system of claim 19, wherein said indication further comprises a first graphical indicator for no difference between a decay reading value and a corresponding previously stored decay reading value and for a decay reading less than a corresponding previously stored decay reading value, and a second graphical indicator for a decay reading more than a corresponding previously stored decay reading value.

21. The system of claim 15, further comprising a system for computing and indicating a caries risk level for a dental patient based on said recorded conditions of the patient'"'"'s teeth and patient screening information maintained in said patient database.

22. The system of claim 21, further comprising a system for computing and indicating a dental x-ray interval for a dental patient based on the patient'"'"'s said risk level, the patient'"'"'s age, and the time interval elapsed since the patient'"'"'s last dental x-ray was taken.

24. The method of claim 23, further comprising:

a) providing a fourth display area of said interactive screen display, associated with said tooth icon displayed in said second display area, comprising a scrollable window to display diagnostic information recorded for the selected patient'"'"'s tooth, wherein said displayed diagnostic information corresponds to said diagnostic information input using said diagnostic icons in said third display area;

b) displaying said recorded condition of each selected tooth region of each selected patient'"'"'s tooth in said fourth display area; and

c) allowing verifying and editing of said recorded conditions;

d) repeating steps (b) and (c) until the condition of each region of each of the selected patient'"'"'s teeth has been recorded.

25. The method of claim 23, wherein receiving data further comprises receiving data from a caries detection dental probe.

26. The method of claim 23, further comprising characterizing and indicating the condition of said selected region of the selected patient'"'"'s tooth by:

a) providing a caries database of standard carious lesion conditions;

b) comparing said recorded condition to standard carious lesion conditions maintained in said database to provide a first comparison;

c) determining, providing, and recording the extent of caries based on said first comparison;

d) comparing said recorded tooth condition to a previously recorded tooth condition maintained in said patient database for same said selected region of the selected patient'"'"'s tooth to provide a second comparison;

e) determining, providing, and recording an indication of present tooth condition based on said second comparison; and

d) repeating steps (b)-(e) until the condition of each region of each of the selected patient'"'"'s teeth has been characterized, indicated, and recorded.

27. The method of claim 23, further comprising automatically analyzing the recorded condition for each said selected region of the selected patient'"'"'s tooth and providing a recommendation for clinical management of each said selected region of the selected patient'"'"'s tooth.

28. The method of claim 23, further comprising computing and indicating a caries risk level for a dental patient based on said recorded conditions of the patient'"'"'s teeth and patient screening information maintained in said patient database.

29. The method of claim 28, further comprising a method for computing and indicating a dental x-ray interval for a dental patient based on the patient'"'"'s said risk level, the patient'"'"'s age, and the time interval elapsed since the patient'"'"'s last dental x-ray was taken.

30. The method of claim 23, further comprising receiving a graphically captured image of the coronal morphology of at least one of a patient'"'"'s tooth, importing said image into said patient information database, creating an interactive image icon from said image, assigning interactive regions to said image icon corresponding to the morphology of said tooth, and providing said image icon on said GUI in said first and second display areas whenever the associated patient'"'"'s dental records are retrieved.

31. The method of claim 23, further comprising allowing manual movement and addition of interactive regions to said tooth icons.

15. An interactive system for recording carious lesion information comprising:

a) a computing device comprising a display, a central processing unit (CPU), operating system software, memory for storing data, a user interface, and input/output capability for reading and writing data;

b) a patient database comprising patient dental records;

c) a caries detection dental probe providing decay reading values indicative of tooth condition;

d) a graphical user interface (GUI) having at least one linked, interactive screen display, said display comprising;

1) a first display area comprising an anatomically correct diagram of a set of teeth, wherein said teeth represent a patient'"'"'s teeth according to the corresponding data stored for the patient in said patient information database, said teeth including indicia to indicate condition of a patient'"'"'s teeth, wherein said teeth are interactive icons, and each of said teeth can be selected to link to a representative diagram of a selected patient'"'"'s tooth;

2) a second display area, operatively linked to said first display area, comprising a representative diagram of the coronal morphology of a tooth selected from said teeth, wherein said tooth is an interactive tooth icon divided into selectable regions corresponding to the coronal morphology of said selected tooth, wherein said selectable regions are interactive region icons, each of said region icons having a region identifier to uniquely identify said selectable region;

3) a third display area having operable diagnostic icons, indicative of diagnostic information, wherein said diagnostic icons allow a user to input and record diagnostic information for each said region of said tooth selected and displayed in said second display area;

e) computer program code for;

1) providing the capability to allow navigating among elements of said linked, interactive screen display;

2) providing interactive icons to allow entering and editing of said carious lesion information;

3) allowing selection of a patient from said patient database;

4) recording the condition of a selected patient'"'"'s teeth by;

i) receiving one of said tooth icons selections from said diagram of a set of teeth;

ii) displaying said tooth icon;

iii) receiving one of said region icons selections of said selected tooth icon;

iv) receiving at least one of said diagnostic icons selections to record the condition of a patient'"'"'s tooth corresponding to said selected tooth region;

vi) displaying said recorded condition;

vii) providing the capability to allow verifying and editing of said recorded condition; and

viii) repeating steps i)-vii) until the condition of each region of each of the selected patient'"'"'s teeth has been received and recorded;

wherein said computing device executes said computer code and provides said GUI to allow a user to interactively record carious lesion information using said caries detection dental probe.

23. A method for recording carious lesion information comprising:

a) providing a computing device comprising a display, a central processing unit (CPU), operating system software, memory for storing data, a user interface, and input/output capability for reading and writing data;

b) providing a patient database comprising patient dental records;

c) providing a graphical user interface (GUI) having at least one linked, interactive screen display;

d) selectively displaying an anatomically correct diagram of a set of teeth, wherein said teeth represent a patient'"'"'s teeth according to the corresponding data stored for the patient in said patient information database, said teeth including indicia to indicate condition of a patient'"'"'s teeth, wherein said teeth are interactive icons, and each of said teeth can be selected to link to a representative diagram of a selected patient'"'"'s tooth;

e) selectively displaying a representative diagram of the coronal morphology of a tooth selected from said teeth, wherein said tooth is an interactive tooth icon divided into selectable regions corresponding to the coronal morphology of said selected tooth, wherein said selectable regions are interactive region icons, each of said region icons having a region identifier to uniquely identify said selectable region;

f) selectively displaying operable diagnostic icons, indicative of diagnostic information, wherein said diagnostic icons allow a user to input and record diagnostic information for each said region of said tooth selected and displayed;

g) receiving a patient selection and retrieving requested patient data from said patient database;

h) receiving data to record the condition of a selected patient'"'"'s teeth by;

1) receiving one of said tooth icons selections of said diagram of a set of teeth;

2) displaying said tooth icon;

3) receiving one of said region icon selections of said selected tooth icon;

4)receiving at least one of said diagnostic icons selections to record the condition of a patient'"'"'s tooth corresponding said selected tooth region; and

5) repeating steps 1)-4) until the condition of each region of each of the selected patient'"'"'s teeth has been received and recorded.

32. A method for recording carious lesion information comprising:

a) providing a computing device comprising a display, a central processing unit (CPU), operating system software, memory for storing data, a user interface, and input/output capability for reading and writing data;

b) providing a patient database comprising patient dental records;

c) providing a graphical user interface (GUI) having at least one linked, interactive screen display;

d) selectively displaying an anatomically correct diagram of a set of teeth, wherein said teeth represent a patient'"'"'s teeth according to the corresponding data stored for the patient in said patient information database, said teeth including indicia to indicate condition of a patient'"'"'s teeth, wherein said teeth are interactive icons, and each of said teeth can be selected to link to a representative diagram of a selected patient'"'"'s tooth;

e) selectively displaying a representative diagram of the coronal morphology of a tooth selected from said teeth, wherein said tooth is an interactive tooth icon divided into selectable regions corresponding to the coronal morphology of said selected tooth, wherein said selectable regions are interactive region icons, each of said region icons having a region identifier to uniquely identify said selectable region;

f) selectively displaying operable diagnostic icons, indicative of diagnostic information, wherein said diagnostic icons allow a user to input and record diagnostic information for each said region of said tooth selected and displayed;

g) selecting a patient from said patient database;

h) recording the condition of a selected patient'"'"'s teeth by;

1) selecting one of said tooth icons from said diagram of a set of teeth;

2) displaying said tooth icon;

3) selecting one of said region icons of said selected tooth icon;

4) examining the corresponding region of the selected patient'"'"'s tooth;

5) recording the condition of a patient'"'"'s tooth corresponding to said selected tooth region by selecting the appropriate diagnostic icons displayed; and

6) repeating steps 1)-5) until the condition of each region of each of the selected patient'"'"'s teeth has been recorded.

33. The method of claim 32, wherein examining the corresponding region of the selected patient'"'"'s tooth further comprises using a caries detection dental probe to automatically determine the condition of said selected region of the selected patient'"'"'s tooth.

34. The method of claim 32 further comprising graphically capturing an image of the coronal morphology of at least one of a patient'"'"'s tooth, importing said image into said patient information database, creating an interactive image icon from said image, assigning interactive regions to said image icon corresponding to the morphology of said tooth, and providing said image icon on said GUI in said first and second display areas whenever the associated patient'"'"'s dental records are retrieved.

35. The method of claim 32, further comprising manually moving and adding interactive regions to said tooth icons.

37. The method of claim 36, wherin said risk values comprise law, medium and high risk levels.

38. The method of claim 36, further comprising a method for system for computing and indicating a dental x-ray interval for a dental patient based on the patient'"'"'s said risk level, the patient'"'"'s age, and the time interval elapsed since the patient'"'"'s last dental x-ray was taken.

39. The method of claim 38, further comprising;

a) determining, based on said risk level, whether a patient is in a low risk, or medium or high risk category;

b) if the patient is in a medium or high risk category, recommending a six month x-ray exam interval and skipping to step n);

c) if the patient is in a low risk category, determining if the patient is a child;

d) if the patient is a child, determining if a last x-ray was taken at a baseline examination;

e) if the last x-ray was taken at a baseline examination, recommending a 12 month x-ray exam interval and skipping to step n);

f) if no x-ray was taken at a baseline examination, determining if the last x-ray was taken between a 12 to 24 month period;

g) if the last x-ray was taken between a 12 to 24 month period, recommending an 18 month x-ray interval and skipping to step n);

h) if the last x-ray was not taken between a 12 to 24 month period, recommending a 12 month x-ray exam interval and skipping to step n);

i) if the patient is not a child, determining if the last x-ray was taken at a baseline examination;

j) if an x-ray was taken at a baseline examination, recommending a 12 month x-ray exam interval and skipping to step n);

k) if no x-ray was taken at a baseline examination, the system determines if the last x-ray was taken between a 12 to 24 month period;

l) ifthe last x-ray was taken between a 12 to 24 month period, recommending a 24 month interval and skipping to step n);

m) if the last x-ray was not taken between a 12 to 24 month period, recommending a 36 month x-ray exam interval; and

n) outputting the recommended x-ray exam interval.

36. A method for computing and indicating a caries risk level for a dental patient, comprising:

a) receiving patient screening information;

b) assigning screening risk factors based on said patient screening information;

c) applying numerical screening values to said screening risk factors;

d) recieiving tooth caries diagnosis values;

e) adding said screening values and said diagnosis values and generating an overall risk value;

f) applying a threshold to said overall risk value and genratinfg a risk level.

40. A Graphical User Interface (GUI) comprising a linked screen display, said display comprising:

a) a first display area comprising an anatomically correct diagram of a set of teeth, wherein said teeth represent a patient'"'"'s teeth according to the corresponding data stored for the patient in said patient information database, said teeth including indicia to indicate condition of a patient'"'"'s teeth, wherein said teeth are interactive icons, and each of said teeth can be selected to link to a representative diagram of a selected patient'"'"'s tooth;

b) a second display area, operatively linked to said first display area, comprising a representative diagram of the coronal morphology of a tooth selected from said teeth, wherein said tooth is an interactive tooth icon divided into selectable regions corresponding to the coronal morphology of said selected tooth, wherein said selectable regions are interactive region icons, each of said region icons having a region identifier to uniquely identify said selectable region; and

c) a third display area having operable diagnostic icons, indicative of diagnostic information, wherein said diagnostic icons allow a user to input and record diagnostic information for each said region of said tooth selected and displayed in said second display area.

41. The GUI of claim 40, further comprising a fourth display area, associated with said tooth icon displayed in said second display area, comprising a scrollable window to display diagnostic information recorded for the selected patient'"'"'s tooth, wherein said displayed diagnostic information corresponds to said diagnostic information input using said diagnostic icons in said third display area.

42. A computer program product recorded on computer readable media for recording carious lesion information comprising:

a) computer readable media for providing a patient database comprising patient dental records;

b) computer readable media for providing a graphical user interface (GUI) having at least one linked, interactive screen display, said screen display comprising;

1) a first display area comprising an anatomically correct diagram of a set of teeth, wherein said teeth represent a patient'"'"'s teeth according to the corresponding data stored for the patient in said patient information database, said teeth including indicia to indicate condition of a patient'"'"'s teeth, wherein said teeth are interactive icons, and each of said teeth can be selected to link to a representative diagram of a selected patient'"'"'s tooth;

2) a second display area, operatively linked to said first display area, comprising a representative diagram of the coronal morphology of a tooth selected from said teeth, wherein said tooth is an interactive tooth icon divided into selectable regions corresponding to the coronal morphology of said selected tooth, wherein said selectable regions are interactive region icons, each of said region icons having a region identifier to uniquely identify said selectable region;

3) a third display area having operable diagnostic icons, indicative of diagnostic information, wherein said diagnostic icons allow a user to input and record diagnostic information for each said region of said tooth selected and displayed in said second display area;

c) computer readable media for providing the capability to allow navigating among elements of said linked, interactive screen display;

d) computer readable media for providing interactive icons to allow entering and editing of said carious lesion information;

e) computer readable media for allowing selection of a patient from said patient database;

f) computer readable media for recording the condition of a selected patient'"'"'s teeth by;

i) receiving one of said tooth icons selections from said diagram of a set of teeth;

ii) displaying said tooth icon;

iii) receiving one of said region icons selections of said selected tooth icon;

iv) receiving at least one of said diagnostic icons selections to record the condition of a patient'"'"'s tooth corresponding to said selected tooth region;

vi) displaying said recorded condition;

vii) providing the capability to allow verifying and editing of said recorded condition; and

viii) repeating steps i)-vii) until the condition of each region of each of the selected patient'"'"'s teeth has been received and recorded;

43. The computer program product recorded on computer readable media of claim 42, further comprising:

a) computer readable media for providing a fourth display area of said interactive screen display, associated with said tooth icon displayed in said second display area, comprising a scrollable window to display diagnostic information recorded for the selected patient'"'"'s tooth, wherein said displayed diagnostic information corresponds to said diagnostic information input using said diagnostic icons in said third display area;

b) computer readable media for displaying said recorded condition of each selected tooth region of each selected patient'"'"'s tooth in said fourth display area;

c) computer readable media for allowing verifying and editing of said recorded conditions; and

d) computer readable media for repeating steps (b) and (c) until the condition of each region of each of the selected patient'"'"'s teeth has been received and recorded.