METHOD OF ASSESSING ORAL HEALTH RISK

• US 20100227296A1
• Filed: 03/05/2010
• Published: 09/09/2010
• Est. Priority Date: 03/05/2009
• Status: Active Grant

• Current Assignee: Stephen Abrams
• Original Assignee: Quantum Dental Technologies Inc.
• Inventors: Abrams, Stephen, Mandelis, Andreas
• Granted Patent: US 8,439,681 B2
• Time in Patent Office: Days
• US Class Current: 433/215
• CPC Class Codes: A61C 19/04 Measuring instruments specially adapted for dentistry A61C5/44 takes precedence; testing vitality of teeth A61B5/0534; radiation diagnosis specially adapted for dentistry A61B6/51

Abstract

A method of oral health risk assessment is provided in which diagnostic data from an oral health detection device and patient risk factor data is processed to provide a integrated risk measure relating to a patient'"'"'s dental health. The patient risk factor data preferably includes risk factor data such as pathological risk factors, protective risk factors, historical factors, self care factors, behavioral factors, and extrinsic factors. The integrated risk assessment and patient data is preferably provided to a remote server for access by various authorized stakeholders.

Claims

1. A computer implemented method of determining an oral health risk status of a patient, said method comprising the steps of:

receiving diagnostic data pertaining to said patient from an oral health detection device;

receiving risk factor data pertaining to said patient;

processing said diagnostic data and said risk factor data on a processor to determine an oral health risk status of said patient, wherein said step of processing said diagnostic data and said risk factor data comprises;

determining one or more diagnostic risk measures based on said diagnostic data;

determining one or more patient risk measures based on said risk factor data; and

combining said risk measures to obtain an integrated risk measure associated with said oral health risk status of said patient.

2. The method according to claim 1 further comprising the step of storing said integrated risk measure with a patient-specific identifier.

3. The method according to claim 1 further comprising the step of storing said integrated risk measure in a patient record.

4. The method according to claim 1 wherein said diagnostic risk measures and said patient risk measures are stored with said integrated risk measure.

5. The method according to claim 1 wherein said integrated risk measure relates to one or more teeth, wherein said integrated risk measure is recorded with additional information identifying said one or more teeth.

6. The method according to claim 1 wherein said device detects one or more conditions selected from the group consisting of demineralization of teeth, remineralization of teeth, presence of dental caries on enamel, presence of dental caries on root surfaces, erosion, defects in restorations, defects and caries along the margins of restorations, dental caries, cracks, periodontal disease, diseases of the hard and soft tissues, and oral cancer.

7. The method according to claim 1 wherein said device detects changes associated with the dental health of a tooth.

8. The method according to claim 7 wherein said changes comprise one of demineralization of the enamel surface, demineralization of the root surface, remineralization of the root surface, remineralization of the enamel surface, restoration in and on the tooth, restoration of surrounding tissue of a tooth, and a combination thereof.

9. The method according to claim 1 wherein said device measures a signal comprising one of fluorescence, luminescence, photo-thermal radiometry, and a combination thereof.

10. The method according to claim 9 wherein said device comprises a phase-sensitive detection system which detects the phase change associated with one or more of said fluorescence, luminescence, photo-thermal radiometry signals.

11. The method according to claim 1 wherein said diagnostic data comprises signals measured by said device and wherein said processor processes said signals and compares said signals to reference values to determine a severity of an oral health condition prior to said step of determining said diagnostic risk measures.

12. The method according to claim 11 wherein said step of determining a severity of an oral health condition comprises determining one of a number of dental caries, a severity of one or more dental caries, a number or demineralization areas, a severity of one or more demineralization areas, a number of white spots, a number of brown spots, a severity of one or more white spots, a severity of one or more brown spots, and a combination thereof.

13. The method according to claim 1 wherein said diagnostic data comprises a determination of a severity of an oral health conditions based on measurements performed by said device.

14. The method according to claim 13 wherein said diagnostic data comprises one of a number of dental caries, a severity of one or more dental caries, a number or demineralization areas, a severity of one or more demineralization areas, a number of white spots, a number of brown spots, a severity of one or more white spots, a severity of one or more brown spots and a combination thereof.

15. The method according to claim 14 wherein said severity of an oral defect is determined according to one of a standard ranking scale and a scale developed for the device.

16. The method according to claim 1 wherein said risk factors are patient-specific risk factors predictive of risk of developing a deterioration in oral health.

17. The method according to claim 16 wherein one or more of said risk factors are obtained from a patient questionnaire.

18. The method according to claim 16 wherein said risk factors comprise one or more of pathological risk factors, protective risk factors, historical factors, self care factors, behavioral factors, and extrinsic factors.

19. The method according to claim 18 wherein one or more of said pathological risk factors are selected from the group consisting of a plaque index, quantity of existing tooth decay, size of existing tooth decay, distribution of existing tooth decay, presence of acidogenic bacteria, presence of pathologic bacteria, reduced salivary flow, bleeding of gums when brushed, bleeding of gums when flossed, number of decayed, missing teeth, filled teeth, crowding of the teeth, mal-alignment of the teeth, frequency of carbohydrate ingestion, and timing of carbohydrate ingestion.

20. The method according to claim 18 wherein one or more of said protective risk factors are selected from the group consisting of use of remineralization agents, an amount of salivary flow, the presence of salivary components comprising one or more of proteins, calcium, phosphate, fluoride, immunoglobins, and antibacterials in saliva.

21. The method according to claim 18 wherein one or more of said behavioral risk factors are selected from use of selected chewing gums and consumption of dairy products, and tendency to grind teeth.

22. The method according to claim 18 wherein one or more of said self-care risk factors are selected from the group consisting of frequency of tooth brushing, timing of oral health maintenance including one or more of brushing and flossing, frequency of tooth flossing, manual dexterity and ability to properly use various oral health aids properly including a tooth brush, use of a fluoridated toothpaste, use of other oral health home care aids, and use of selected mouth rinses.

23. The method according to claim 18 wherein one or more of said historical risk factors are selected from the group consisting of an integrity of a tooth surface, a status of oral tissues, a history of grinding teeth, exposed root surfaces, number of years living in a fluoridated community, and a number within a prescribed period of fillings, root canals, crowns, bridges, partial dentures, tooth extractions, oral and periodontal surgical procedures and implants.

24. The method according to claim 18 wherein one or more of said extrinsic risk factors are selected from the group consisting of diet, sufficiency of home care, access to oral care, gender, age, geographic location, socio-economic status and one or more demographic factors.

25. The method according to claim 1 wherein said step of processing said diagnostic data and said risk factor data further comprises:

comparing said diagnostic data to pre-determined risk-associated diagnostic values to obtain said diagnostic risk measure; and

comparing said risk factor data to pre-determined risk-associated risk factor values to obtain said patient risk measures.

26. The method according to claim 1 wherein said step of processing said diagnostic data and said risk factor data further comprises:

comparing said diagnostic data to pre-determined diagnostic values, each said pre-determined diagnostic value having associated therewith a risk score, wherein said diagnostic risk measures are said risk scores associated with the pre-determined diagnostic values closest to said diagnostic data;

comparing said risk factor data to pre-determined risk factor values, each said pre-determined risk factor value having associated therewith a risk score, wherein said patient risk measures are risk scores associated with the pre-determined risk factor values closest to said risk factor data.

27. The method according to claim 26 wherein said step of combining said risk measures to obtain an integrated risk measure associated with said oral health risk status of said patient comprises:

multiplying each said risk measure by a pre-determined weighing factor to obtain weighed risk measures;

combining said weighed risk measures to obtain said integrated risk measure.

28. The method according to claim 27 wherein prior to said step of multiplying each said risk measure by a pre-determined weighing factor, said risk measures are multiplied by a confidence factor relating to a value of said risk measure.

29. The method according to claim 27 further comprising normalizing said integrated risk measure to a pre-determined value.

30. The method according to claim 27 wherein said step of combining said weighed risk measures comprises adding said weighed risk measures.

31. The method according to claim 1 further comprising comparing said integrated risk measure to a set of ranges, each range having associated therewith a qualitative risk assessment, and selecting the qualitative risk assessment corresponding to said integrated risk measure.

32. The method according to claim 31, further comprising displaying said selected qualitative risk assessment in one of a graphical format and a report format.

33. The method according to claim 1 further comprising providing a treatment recommendation based on one or more of said diagnostic risk measures, said patient risk measures, and said integrated risk measure.

34. The method according to claim 25 wherein said pre-determined diagnostic values comprise one or more previously measured diagnostic values for said patient, and wherein said diagnostic risk measures are obtained at least in part by relating a rate of change of said measured diagnostic value to a risk of developing a deterioration in oral health.

35. The method according to claim 1, further comprising the steps of:

repeating said steps for one or more additional patients and storing said integrated risk measures for each patient; and

performing one or more statistical analyses on said integrated risk measures.

36. The method according to claim 35 wherein said statistical analyses comprises one or more epidemiologic analyses of said integrated risk measures, said epidemiological analysis comprising an analysis according to one of age, location, tooth, site, tooth surface, therapy, groups of teeth, an entire dentition and a combination thereof.

37. The method according to claim 1 further comprising providing said integrated risk measure to any one or combination of pharmaceutical manufacturers, oral therapeutics manufacturer, oral therapeutics distributor, public health agencies, government agencies, oral health professionals, research scientists, academic institutions, insurers, and third party payors.

38. The method according to claim 1 wherein said steps are performed at a location that is local relative to said detection device.

39. The method according to claim 38 wherein one or more of said diagnostic data and said risk factor data is provided to said processor through a network.

40. The method according to claim 1 wherein said steps are performed at a location that is remote relative to said detection device.

41. The method according to claim 40 wherein one or more of said diagnostic data and said risk factor data is provided to said processor through a remote network.

42. The method according to claim 1 further comprising storing said integrated risk measure on one of a remote server, a cloud computing environment, and a combination thereof.

62. The method according to claim 1 wherein said diagnostic data further comprises one or more images of an examined tooth surface.

63. The method according to claim 32 wherein said one of a graphical format and a report format comprises one or more images of an examined tooth surface.

43. A computer implemented method of obtaining data relating to a clinical trial for an oral product, therapy or treatment, said method comprising the steps of:

obtaining diagnostic data pertaining to a plurality of patients in said clinical trial from an oral detection device;

obtaining risk factor data pertaining to each patient of said plurality of patients;

processing said diagnostic data and said risk factor data on a processor to determine an oral health risk status of said each patient, wherein said step of processing said diagnostic data and said risk factor data comprises;

determining one or more diagnostic risk measures based on said diagnostic data;

determining one or more patient risk measures based on said risk factor data; and

combining said risk measures to obtain an integrated risk measure associated with said oral health risk status of said each patient;

administering one of a product, therapy and oral treatment to said patients; and

h) performing steps a)-f) to obtain post-treatment integrated risk measures associated with said oral health risk status of each patient.

44. A computer implemented method of determining an oral health risk assessment for a patient population, said method comprising the steps of:

obtaining diagnostic data pertaining to each patient in said patient population with an oral health detection device;

obtaining risk factor data pertaining to each patient;

processing said diagnostic data and said risk factor data on a processor to determine an oral health risk status of said each patient, wherein said step of processing said diagnostic data and said risk factor data comprises;

determining one or more diagnostic risk measure based on said diagnostic data;

determining one or more patient risk measures based on said risk factor data; and

combining said risk measures to obtain an integrated risk measure associated with said oral health risk status of said each patient.

45. The method according to claim 44 further comprising providing said integrated risk measure of said each patient to any one or combination of pharmaceutical manufacturers, oral therapeutics manufacturer, oral therapeutics distributor, public health agencies, government agencies, oral health professionals, research scientists, academic institutions, health care insurance companies, and third party payors.

46. A system for determining an oral health risk status of a patient, said system comprising:

a data interface for receiving diagnostic data from an oral detection device and risk factor data, wherein said diagnostic data and said risk factor data pertains to said patient;

a processor for processing said diagnostic data and said risk factor data to determine an oral health risk status of said patient, said processor programmed with computer-readable instructions to;

determine one or more diagnostic risk measures based on said diagnostic data;

determine one or more patient risk measure based on said risk factor data; and

combine said risk measures to obtain an integrated risk measure associated with said oral health risk status of said patient; and

an output means for one of displaying, recording, and exporting said integrated risk measure.

47. The system according to claim 46 wherein said output means comprises a local memory for storing said integrated risk measure.

48. The system according to claim 46 wherein said output means comprises a display device for displaying said integrated risk measure.

49. The system according to claim 46 wherein said output means comprises an additional interface for providing said integrated risk measure to one of an external computer, server, memory, and a combination thereof.

50. The system according to claim 49 wherein said additional interface is configured to convey said integrated risk measure to one or more remote work stations.

51. The system according to claim 46 further comprising said oral detection device.

52. The system according to claim 46 further comprising a data entry means for providing said risk factor data.

53. The system according to claim 46 wherein said processor is programmed with computer-readable instructions to:

compare said diagnostic data to pre-determined risk-associated diagnostic values to obtain said diagnostic risk measure; and

compare said risk factor data to pre-determined risk-associated risk factor values to obtain said patient risk measure.

54. The system according to claim 46 wherein said processor is programmed with computer-readable instructions to:

compare said diagnostic data to pre-determined diagnostic values, each said pre-determined diagnostic value having associated therewith a risk score, wherein said diagnostic risk measure is said risk score associated with the pre-determined diagnostic value closest to said diagnostic data;

compare said risk factor data to pre-determined risk factor values, each said pre-determined risk factor value having associated therewith a risk score, wherein said patient risk measures are risk scores associated with the pre-determined risk factor values closest to said risk factor data.

55. A method of determining a health status of an oral tissue, said method comprising the steps of:

a) irradiating said tissue with an optical beam;

b) measuring a photothermal signal comprising an amplitude and phase signal from said tissue;

c) measuring a luminescence signal comprising an amplitude and phase signal from said tissue;

d) comparing said signals with reference signals; and

e) determining a health status measure based one said comparison.

56. The method according to claim 55 wherein said step of determining a health status measure based one said comparison comprises:

determining a health ranking score for each signal based on said comparison; and

combining said health ranking scores to obtain said health status measure.

57. The method according to claim 56 wherein said step of combining said signals to obtain said health status measure comprises:

multiplying each health ranking score by a weighing factor to obtain weighted health ranking scores; and

summing said weighted health ranking scores.

58. The method according to claim 57 further comprising the step of normalizing said health status measure.

59. The method according to claim 55 wherein said reference signals correspond to one of healthy tissues and a reading taken at the same location at a different time.

60. The method according to claim 59 wherein said healthy tissue comprises one of dental enamel, root surface, and a combination thereof.

61. The method according to claim 55 wherein said signals are measured at one or more frequencies, and wherein a health ranking score is obtained for each frequency.