Computers-in-the-Dental-IndustryChapter2.pptxvggtvv

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1. COMPUTERS IN THE DENTAL INDUSTRY

2. “ Time is like a river we made up of the events that happen and its current is strong; no sooner does anything appear than it is swept away, and another comes in its place, and will be swept away too.” Marcus Aurelius Antoninus, Meditations

3. Computer in Business The once rare computer is now the most ubiquitous tool in anywhere in the world. Computers have become prime tools for every aspect of business control, in particular for the accounting, receiving, comparing, recording and banking money. Computers allow today’s busy managers to monitor activity the very second it is happening. Elsewhere in business, researchers, designers, draftsmen and engineers use computers to develop and modify products. Today no business can effectively compete without computer power because computers supplement and multiply human output many times. For example, computers allow instant access to vital customer information about credit, client preferences, and shipping information, thus resulting in massive efficiency improvements in customer service. It has become routine in most businesses to enter customer orders into a computer programmed to use the information in diverse ways.

4. While the computer signals the plant to ship the product, it also updates accounting records for the value of the goods invoiced, calculates the weight and cost of shipping, prints a label and tells a postage meter to debit itself for the mailing expense. All this happens with one data entry. Elsewhere in the organization computers are updating marketing and sales statistics to record the sale. The computer calculates the business's profit on the transaction, and this data is added to all the other orders it processes to tabulate the company's overall results. This whole process, which once took hours, even days to complete, is now over in a matter of seconds using a computer.

5. Computer in Dental Industry Dental Dealers In the dental industry computers have been proliferating in offices, warehouses and factories during the last decade. Almost all dental dealers use mini-computers to control their buying and invoicing systems and many have graduated to very large scale systems to which their customers can gain direct access. In addition PCs are being used for letter writing and to create price lists and catalogs. Many managers use computers to measure hourly business activity, to monitor price changes and to control purchasing and inventory.

6. Dental Dealers When you call your local dental dealer there is a high chance that whoever answers the telephone is looking at your account details on a monitor as you speak to them. The screen will tell them who you are, what you buy and how much, what you owe and what you have paid and may even offer suggestions about what the customer service clerk should talk to you about. Many dealers have centralized customer records and can access your account details no matter who answers the call or where. When you place your order the clerk will be able to tell you if the item is in inventory, since most dealers have their inventory list on computer and can tell you the up-to-the-minute price for that item. It is vital for the dealer to stay up-to-date on pricing.

7. Dental Dealers International Dental Dealers Henry Schein Dental – one of the world’s largest distributors of dental supplies and equipment. Patterson Dental – U.S.-based dealer offering dental products, software, and services. Benco Dental – supplies dental materials, digital technology, and operatory equipment. Dentsply Sirona (through dealers) – provides equipment, instruments, and consumables.

8. Philippines Dental Dealers (Examples) Dental Domain Corp. – official distributor in the Philippines for brands like 3M ESPE, Belmont, and Vatech (imaging systems). Ormco Philippines – orthodontic products and supplies. GC Dental Asia – distributes restorative and preventive dental products. Unilab Dental Distribution – provides oral care and dental consumables. Metro Dental Supply companies (various local suppliers that provide clinics with consumables like gloves, masks, syringes, filling materials). Dental dealers are the middlemen between manufacturers and dental clinics , ensuring that dentists have access to materials (e.g., composites, cements), instruments (e.g., handpieces, forceps), and equipment (e.g., chairs, X-rays).

9. Bar-Coding You may have begun to notice that many dental packages now have the familiar black and white, variable width bar-code marks you see on other packaged goods. An agreement within the American Dental Trade led to the nationwide acceptance of a bar code standard. Ultimately bar-coding will be used by the dental industry for the same reason as your local supermarket, for digitally recording credits and debits to inventory. Computers and bar code readers can do this much more accurately than people. This Photo by Unknown Author is licensed under CC BY

10. Bar coding is the use of machine-readable codes (barcodes or QR codes) to identify and track items, patients, or instruments. How it works: A barcode scanner or even a smartphone reads the code, which is linked to data stored in a computer system.

11. Applications of Barcode a. Patient Identification Barcodes on patient ID cards or charts ensure correct identification. Reduces errors in treatment, billing, or record-keeping. b. Instrument Tracking and Sterilization Each dental instrument can be labeled with a barcode. After sterilization, scanning updates the system to confirm that the instrument is safe for use. Helps prevent cross-contamination and improves infection control .

12. c. Inventory and Supply Management Barcodes on dental materials (composite resins, anesthetics, gloves, cements) help clinics track stock levels. Automates ordering and reduces waste or shortages. d. Radiographs and Imaging Barcodes can be used to label X-rays and imaging results, ensuring they are matched with the correct patient record. e. Billing and Insurance Barcoded forms and receipts speed up billing processes and reduce errors in claims.

13. Benefits of Bar Coding in Dentistry ✅ Reduces errors in patient identification ✅ Improves efficiency in record-keeping ✅ Enhances infection control by tracking sterilization ✅ Streamlines inventory and supply management ✅ Saves time and lowers administrative workload

14. Remote Order Entry During the last few years some dealers have begun to offer dentists and laboratories direct access to their mainframe computers. Typical of these program is Patterson Dental Company’s REMO(Remote Order System Entry). Instead of calling your local Patterson store to place an order, REMO allows you to order directly through your computer. REMO allows you to search the inventory of items for the product you want. REMO allows you to search Patterson’s inventory of 32,000 items for the product you want. A clever cross-reference system helps you find what you are looking for even if you do not know the brand name. You can place orders or check the status of your orders at any time of the day or night, seven days a week and receive a report each month which tells you if you are buying enough to qualify for the best prices.

15. REMO is Patterson Dental’s electronic ordering system that allows dental clinics and professionals to place supply orders remotely (without needing paper forms or phone calls). It is essentially an early form of e-commerce for dentistry , designed to make supply ordering faster and more accurate. How It Works Dentists or clinic staff use a computer-based interface (linked to Patterson’s database). They can search products , check availability, and submit orders directly to Patterson’s system. The system is connected to the clinic’s account, so it manages billing, delivery, and even purchase history.

16. Key Features Product Catalog Access: View thousands of dental supplies, equipment, and materials online. Order Accuracy: Reduces errors compared to handwritten or phoned-in orders. Time-Saving: Allows staff to quickly reorder routine supplies (gloves, cements, burs, anesthetics). Tracking: Clinics can track what was ordered, when, and how much. Integration: Can be linked with a clinic’s inventory system , so it automatically alerts when supplies are low. Benefits to Dental Practices ✅ Efficiency: Streamlines ordering, saving staff time. ✅ Accuracy: Reduces mistakes and stock shortages. ✅ Cost Control: Helps clinics monitor supply usage and spending. ✅ Convenience: Orders can be placed anytime, not limited to business hours. Patterson Dental’s REMO system is a remote electronic supply ordering tool that allows dental clinics to order products directly from Patterson’s catalog, improving accuracy, efficiency, and convenience in practice management.

17. Feature Patterson’s REMO (Early System) Modern Ordering Systems (Today) Platform Computer-based software (installed in clinic computers) Web-based portals & mobile apps (accessible anywhere, anytime) Access Only through clinic computers connected to Patterson’s system Accessible via internet, smartphones, tablets , laptops Catalog Digital product catalog, updated periodically Live online catalog with real-time stock availability & pricing Ordering Remote entry sent to Patterson’s servers Online shopping cart with instant confirmation & tracking Integration Could link with some practice management software Fully integrates with inventory systems, accounting, and EHR (Electronic Health Records) Tracking Basic order history and invoice review Advanced tracking with shipment updates, analytics, auto-reordering User Experience Functional but limited interface User-friendly dashboards, AI-based recommendations, 24/7 chat support Payment Invoicing through account Multiple options: credit card, PayPal, financing plans, auto-pay Innovation Early electronic ordering – replaced phone/fax orders Cloud-based, mobile-enabled, AI-driven supply chain management Comparison: REMO vs. Modern Dental Ordering Systems

18. Dental Manufacturers Manufacturers have been quick to adopt computers. Beginning first in the financial departments, both mainframes and PCs have spread into every aspect of business management in dental manufacturing. For example, a leading prosthetic tooth manufacturer has replaced an old ordering system with bar-coded re-order cards in dealer tooth inventories and has provided a bar code reader linked to a hand-held computer. The dealer merely records items "missing" from inventory by passing a bar code "wand" over the visible record cards. When the task is complete a telephone line is plugged into the hand-held computer and the stored bar code information is downloaded to a dedicated computer at the manufacturing plant.

19. What They Produce Dental Materials: Fillings, composites, bonding agents, cements, impression materials. Instruments: Handpieces, burs, forceps, scalers, curettes. Equipment: Dental chairs, imaging machines (X-rays, CBCT), sterilizers. Preventive Products: Toothpaste, fluoride varnish, sealants. Prosthetics & Orthodontics: Brackets, wires, aligners, crowns, implants. Examples of Major Dental Manufacturers (Global) 3M Oral Care (USA): Known for composites, adhesives, and dental materials. Dentsply Sirona (USA/Germany): One of the largest, producing equipment, instruments, and digital solutions. GC Corporation (Japan): Manufactures restorative and preventive products. Ivoclar Vivadent (Liechtenstein): Specializes in ceramics, composites, and prosthetic materials. Straumann (Switzerland): Focused on implants, prosthetics, and digital dentistry. Ormco (USA): Orthodontic appliances like brackets, wires, and aligners. Coltene (Switzerland): Consumables, endodontic products, and infection control. Carestream Dental (USA): Imaging systems and digital software.

20. Examples of Dental Manufacturers in the Philippines (Often through local distributors or regional offices) Dental Domain Corp. – distributes Belmont (chairs), Vatech (imaging), and 3M products. Unilab (Philippines-based): Manufactures oral care products and pharmaceuticals. Metro Dental Supply Co. (local suppliers often rebrand or distribute international manufacturers’ products). Role in Dentistry ✅ Provide tools and materials essential for daily clinical practice. ✅ Innovate new technologies (digital scanners, CAD/CAM systems, aligners). ✅ Ensure product safety through quality standards (ISO, FDA, CE). ✅ Support dental research and education by supplying training materials.

21. Dental Manufacturers Widely used by dental manufacturers are computer systems for controlling production and for managing in-coming raw and processed materials. Such programs as IBM's Materials Processing Inventory Control System (MAPICS) have become standards in the dental industry. Using linked modules these programs can systematize almost every aspect of production, coupling actual output to demand as orders are received and processed by the computer. This Photo by Unknown Author is licensed under CC BY-SA

22. Dental Manufacturers This in-coming order data begins the chain of information processing, and everything else is cross-referenced back to that original entry. These highly sophisticated programs produce detailed reports, prompting managers to make key decisions concerning inventory investment, purchasing, production choices between different products, and many other vital elements of manufacturing control . This Photo by Unknown Author is licensed under CC BY-SA

23. Dental manufacturers often use CAD/CAM systems, at least in the "CAD" mode. In less than a generation hand drafting skills have begun to disappear as engineers turn more and more to computers to help develop designs and to produce drawings from which machine shops can turn out the finished products. Many of the machining devices themselves are also computer driven. This Photo by Unknown Author is licensed under CC BY-SA This Photo by Unknown Author is licensed under CC BY-SA

24. Dental Manufacturers These Computer/Numerical Control (CNC) devices use digitally stored information to control tool and raw material choice and then to guide fine cutting tools to produce the finished product. These machines can also be more easily reprogrammed than earlier machinery so even short "runs" can be economical. In fact they allow manufacturers to begin to make components as they are needed instead of producing large quantities each time the machinery is reset.

25. In the more advance manufacturing plants, especially those repetitively making complex components, digitally controlled robots can be seen loading and unloading machines, twisting and turning components for machining and cross checking that the machine output conforms to the required quality standards. Far from eliminating jobs in manufacturing plants, CAD/CAM, CNC DEVICES and robots have generated a need for new, highly trained workers whose jobs are more challenging and rewarding.

26. Dental Office Software Programs for dental office management system are available for IBM and Macintosh as well as other computers. Developers of dental office software have shown the same ingenuity as others in this dynamic new industry and offer dozens of features in their dedicated dental office software. Software developers spend thousands of hours scrutinizing dental offices to determine how they operate and discuss their needs with hundreds of dentists.

27. Electronic Health Records in Dentistry: Clinical Challenges and Ethical Issues 1.1 Introduction Electronic Health Records (EHRs) have become a common practice management tool for most of today’s dental offices and dental clinics. EHRs facilitate the management of large amounts of data and allow the practitioner a means with which to control what used to be a mountain of paper that made up the patient’s record. This Photo by Unknown Author is licensed under CC BY

28. Healthcare in general has embraced EHR technology for many obvious advantages: less paper to manage frees up storage space better tracking and management of patient data digital imaging electronic claims accounting and reporting functionality

29. Other driving forces in the widespread adoption of the EHRs in dentistry are the changes that are occurring in health care on a national level. The American Recovery and Reinvestment Act (ARRA) put pressure on hospitals to comply with implementation of EHRs or face penalties in Medicaid payment. The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 provided further incentives to health care providers to adopt EHRs and in 2011 the Medicare Electronic Health Records Incentive Program for the Centers for Medicare and Medicaid Services began providing incentive payments for the “meaningful” use of EHRs. IN 2009, president Obama signed into law the ARRA, which was aided in the expansion of broadband and wireless service and mandated that by 2015, all medical records, including dental, must be converted to an EHR.

30. EHR AND THE SNODENT In 2007 the American Dental Association(ADA) created a taskforce which worked towards creating an individual online database system called SYSTEMISED NOMENCLATURE OF DENTISTRY. An internationally recognized system of vocabulary and codes designed to use in the electronic environment for electronic health and dental records globally. Its purpose is to provide standardized terms for describing dental disease; capture clinical dental and patient characteristics; permit analysis of patient care services and outcomes; and to be interoperable with EHR.

31. 1.2 . Chairside Use of the EHR in Dentistry Today there are a multitude of EHRs on the market all of which offer sophisticated administrative functionality along with all of the clinical features that should be a part of a comprehensive EHR. All of these systems can capture and store images. The American Dental Association is working on a dental component that will be integrated into medical EHRs, so that dentistry will be represented in future EHR development so that all health care disciplines will be represented in a comprehensive health record. With 2015 fast approaching the concept of interconnectivity will likely drive the evolution of EHRs to be inclusive of all aspects of health care, including dentistry.

32. Computers in Patient Treatment Areas 1.2 . Chairside Use of the EHR in Dentistry With the advent of EHRs convenience has driven the movement of the computer to a chair-side location due to the need to enter patient information such as tooth charting, access to a patient’s health information including the medical history, development and display of the treatment plan, radiographic capture and display, intraoral photography, prescription writing and patient education to name just a few of the chair-side computing functions that are critical to patient treatment. Schleyer in 2004 reported that about 25 % of the nation’s general dentists employed a computer in the dental operatory. As of 2006 the American Dental Association reported that this percentage had more than doubled in a 2 year span.

33. Computer made their first appearance in the dental operatory in the 1980s with the advent of intraoral cameras. These proprietary applications where stand alone and did not offer the benefit of integration with other patient record functions. The first truly integrated patient record system for dentistry arrived at 1990 and offered a complement to patient record functionality. However, most dental practice maintained hybrid records during this time because many functions, such as radiographs, had not been integrated into the EHR. The 2000s bought further evolution of the EHR which allowed for dental offices to become paperless for the first time.

34. 1.2.2 Impact of the EHR on the Doctor-Patient Relationship The effects of the EHR in the operatory on the doctor-patient relationship has been investigated and it has been found that providers show three distinct types of practice styles when using an EHR as they interact with patients. They position themselves at the computer monitor and concentrate on computer monitor displayed data, or they stand or sit away from the computer and face the patient, or they alternate their attention in defined intervals between the patient and the computer. Especially when the computer is not within the immediate treatment area the provider must divert his/her attention from the patient or as show in Fig 1.1 a second person is needed to enter patient data during an examination. Fig 1.1

35. 1.2.2 Impact of the EHR on the Doctor-Patient Relationship Placement of the computer within the immediate treatment area does allow for better interaction with the patient, but in any of these positions, regardless of the amount of attention paid to the patient, the computer effectively pulls the doctor away from being fully attentive to the patient ( Fig. 1.2 ). Patients want to be involved in their own care and the ability to display patient information on a monitor helps to keep the patient engaged, but there is also a fine line between holding patient interest and alienating the patient through interaction with the computer. Fig 1.2

36. 1.3 Privacy, Security and Confidentiality Issues with EHR Use in Dentistry The patient record, whether it is a paper copy or an electronic version, is the business record of the health care system. Patients have the right to keep information about themselves from being disclosed to others. Computer systems that house EHRs must be encrypted for security purposes and only those providers that participate in some phase of treatment or management of the patient should be allowed access to the patient record according to long standing HIPAA (Health Insurance and Portability and Accountability Act) guidelines.

37. 1.3 Privacy, Security and Confidentiality Issues with EHR Use in Dentistry The EHR is the communication tool that support clinical decision making and encompasses many aspects of patient treatment. The physician, dentist, practice or organization is the owner of the patient record, but the patient owns the information in the record. The HITECH ACT mandates that the Department of Health and Human services conduct periodic security audits of health care providers, as well as their business associates .

38. 1.4 Ethics and the EHR Privacy and confidentiality remain core components of patient rights, but evidence does suggest that the extent of the respect for these rights may be declining. Violations of patient privacy may be easier than ever before because of the efficiency of computerized systems.

39. 1.4 Ethics and the EHR Thus the potential for a confidentiality breach is increased due to the ease with which data can be replicated and distributed via the computer. Additionally, protecting the privacy of a patient’s Protected Health Information (PHI) can be challenging in an electronic environment. These measures often involve the use of unique user IDs and passwords, encryption, remote access controls and computer privacy screens.

40. 1.4 Ethics and the EHR Example of Ethical Breach: Inappropriate access to PHI( lost or stolen passwords, not logging out of computers, not using privacy screens in high patient traffic areas and improper sharing of PHI through e-mail

41. 1.5 Challenges with the Use of the EHR and Potential Solutions Along with the proliferation of EHRs have come some challenges that must be met and solutions that must be devised. EHRs provide a way to electronically enter, manage and retrieve large amounts of patient data. Along with the ease of operations in using EHRs comes the ease with which users can create ethical challenges in the way in which patient data is managed.

42. The ability to enter patient data into the EHR chair-side now also makes record entry so much more efficient. Real time data entry, although convenient for the provider, may cause a break in the attention given to the patient. The clinician must constantly divert his or her attention from the patient and onto the computer screen. This break can be perceived by the patient as a lack of attentiveness to their health issues, and secondly the clinician must use his observation skills when asking a patient about his health to see his or her non-verbal reactions.

43. 1.6 EHRs and Research While the potential benefits of re-using EHR data are nearly limitless, there are several major challenges. EHR data that are collected as part of the milieu of providing care may not be in a usable format to undergo the rigors of scientific inquiry. Unlike data that are collected as part of clinical trials, EHR data will likely contain differences in both the language and format used by the clinical providers to document patient care. This type of search allows the researcher to collect information contained within member institutions EHR databases and provides information on use of treatment codes along with a breakdown of patient demographics.

44. CONSORTIUM OF ORAL HEALTH RESEARCH AND INFORMATICS(COHRI)-founded to provide standardization for how large dental institutions such dental school document in an EHR. As a result many COHRI member institutions now use a consistent medical and dental history form, as well as a standardized dental diagnostic terminology. BIGMOUTH- large dental data repository has been developed based on data from members of the consortium.

45. COHRI is a collaborative network of U.S. and international dental schools that work together to improve oral health education, research, and patient care through informatics and data sharing . It was founded in the mid-2000s to encourage dental schools to use electronic health records (EHRs) and share data in standardized formats. Goals of COHRI Standardization: Develop common data formats and coding systems so dental schools can share and compare patient data. Research Collaboration: Combine large amounts of clinical data from different schools for multi-center studies. Education: Use shared data to improve teaching in dental education and promote evidence-based dentistry. Patient Care Improvement: Apply informatics to improve diagnostics, treatment planning, and outcomes.

46. How It Works Participating dental schools contribute anonymized patient data (from systems like axiUm EHR). Data includes: demographics, medical and dental history, diagnoses, treatments, and outcomes. Researchers can query the database to look for trends and patterns. No personal identifiers are included, ensuring patient privacy . Benefits ✅ Large-scale research: Researchers can analyze tens of thousands of patient records. ✅ Improved education: Dental students can use real-world data for case studies. ✅ Evidence-based practice: Helps identify best practices in treatments. ✅ Collaboration: Connects multiple dental schools in one research effort.

47. Example in Action A study on caries risk assessment could use BigMouth data to compare outcomes across several dental schools. Another study might examine the relationship between periodontal disease and systemic health using thousands of records. BigMouth is a shared dental data repository created by COHRI that combines anonymized patient data from multiple dental schools . It is a powerful tool for research, education, and evidence-based improvements in oral healthcare.

48. Secondary use- the use of EHR data for the purpose other than for treating and caring for an individual patient

49. 1.7 Cloud-Based EHRs and the Future of the Technology Cloud-based EHRs have become a viable option for health care practices, clinics and even schools and have become an effective method to manage PHI. Not only do cloud-based systems provide a very efficient method to share PHI between and among practitioners, but is also much more cost effective because it reduces hardware costs and licensing fees that are common with client-server software EHRs.

50. Types of Dental EHRs Dentrix PracticeWorks Eaglesoft Mogo To allow for more efficient communication and reduction of a paper trail among providers, specialists, and telehealth sites in rural areas. These software applications allow for electronic dental claims management; sending electronic prescriptions; incorporation of patients medical history, dental radiographs; periodontal charting; dental charting; the ability for patients to complete their registration and medical histories online; taking patients picture with webcam; records findings verbally; importing and exporting images into the patients files; using digital signatures or fingerprint technology to identify users; backing up patients records virtually; and more recently using smartphone, mobile device; or tablet to access current patient information.

51. Conclusion In the era of paper(which is still in present), patient information is stored in their medical records. Results of laboratory analysis, recording the radiologic devices, findings and opinions of dentists, anamnestic data, recorded in the material and inserted into folders. Presented solution for electronic dental record is part of a medical information system intended for use and primary care and as such meet the needs of both dental clinics and dental offices. This Photo by Unknown Author is licensed under CC BY-NC-ND