Why Dentists Look for Hands Free Perio Charting
Computerized periodontal charting creates a built-in conflict. The hands that hold the probe are gloved and in the patient's mouth, but the data must go into a keyboard or mouse. Most offices solve this by assigning an assistant to sit and record, or by having the clinician repeatedly de-glove, type and re-glove. Both options cost time and money, and the second adds a cross-contamination risk at every contact with a shared keyboard or mouse.
Hands free perio charting removes the conflict by moving computer control to the foot. Improved office productivity is central to the continued success of a practice, and freeing dental assistants from charting duty lets the office run more efficiently.
What the Independent Research Found
Dr. Gordon Christensen reviewed the various dental software programs in the February 2003 edition of CRA. His independent research found that the number one concern with all of the top eight software packages was that they did not reduce staff costs. One of the top features desired was "hands-free periodontal charting." The Dental R.A.T. was built to address that gap, so one person can do a job that previously took two.
How the Dental R.A.T. Works at the Chair
The Dental R.A.T. is a foot-operated mouse that gives hands free access to perio charting, intraoral cameras and digital x-rays. It requires no additional software for this function. You plug it into a USB port and it operates as an input device, so the computer treats it as a mouse. The Dental R.A.T. 2.0 can be wireless (radio frequency) or wired by USB cord. Its controls are laid out as follows:
- Toe button: moves the arrow on the screen, like a regular mouse.
- Four input buttons: enter charting numbers 1 through 8, and provide the right click.
- Heel button: works as the left click.
- Audio feedback: numbers are repeated through computer speakers or a headset as they are entered.
Because the unit also works as a full mouse, it can do anything your hand mouse does. Open x-rays, run the intraoral camera, check the schedule, and zoom in on images and pictures. For bleeding, recession and similar entries, you park the cursor in the right place and tap your heel, though the exact steps depend on your software. In the 2.0, mouse speed is adjustable across 1,000 speeds. Holding buttons 1 and 2 together while moving the joystick away from you speeds the cursor up, and moving it toward you slows it down. The longer you hold, the greater the change, so a short bump is a good way to start.
Compatibility With Your Existing Software
The Dental R.A.T. is not tied to one charting platform. It works with practice management and periodontal charting programs including Dentrix, EagleSoft, PracticeWorks, Softdent, PerioExec, Open Dental and MacPractice. It has also been tested with Florida Probe software and runs other packages such as Daisy Dental, Alta, Genesis, Dentech, Maxim, Panda Perio and XL Dent. In practice, any software that can be operated with a hand mouse can be operated with the Dental R.A.T. This is why most offices need no hardware or software upgrade to adopt it. Software-specific training videos are available for the most commonly requested brands.
Foot Control Compared With Voice Recognition and Automated Probes
Dentists weighing hands free options usually compare three approaches: voice-activated charting, automated periodontal probes, and a foot-controlled interface. Each fails in a different way for different offices.
- Voice recognition: It depends on the software correctly interpreting spoken numbers, and operatories are noisy. Suction, handpieces and conversation all interfere. Dr. Keith Asarkof described his experience as "extremely finicky," and the system eventually failed altogether.
- Automated probes: Dr. Asarkof found this technology too complex for his needs and extremely expensive.
- Foot-controlled input: Each press is a discrete, deliberate action, so there is no speech to misinterpret. It needs no subscription and no additional software to operate.
A foot-controlled device does not depend on ambient noise. The clinician decides when each number is entered, and the audio readback confirms it.
Audio Feedback for Patient Education
The Dental R.A.T. makes your software "talk." As each number is entered, the computer says it aloud, which lets the clinician confirm values without looking at the screen. It also lets the patient hear their own periodontal status, supporting patient education and, for hygiene appointments, increased production. A headset that plugs into the computer's speakers is included for privacy. If you prefer no audio, you can turn the speakers off. The audio feedback utility is available on the downloads page for both Mac and Windows.
Infection Control and Privacy
Because data entry happens with the foot, the clinician does not have to touch a shared keyboard or mouse mid-procedure. That reduces the de-gloving and re-gloving cycle and keeps the chain of asepsis intact. With a headset, the readings stay between the operator and the patient, which supports privacy compliance.
The Financial Case
The system pays for itself in several ways. One person can do a job that used to take two staff members. Recording periodontal depths supports more accurate billing for periodontal maintenance appointments. A full, accurate perio chart can often be billed to insurance. Documenting accurately at every appointment also helps avoid legal ramifications tied to failure to diagnose periodontal disease. There are no ongoing subscription fees, which improves return on investment over time. An ROI calculator is available on the site to estimate the numbers for your office.
What Doctors Say
Dr. Scott A. Wright reported that three terminals in his office freed his staff for more productive work, that patients appreciated the technology, and that hygienists were more satisfied.
Dr. Asarkof called it a useful patient education tool when connected to a speaker. He also said it made it simple to stay in compliance with periodontal record-keeping standards.
See It in Your Office
A free demo of the Dental R.A.T. foot mouse is available. Call 877-278-0061, Monday through Friday, 9am to 5pm, or email bky.logue@gmail.com.
Frequently Asked Questions
Can a hygienist do perio charting without an assistant?
Yes. The Dental R.A.T. lets a hygienist run the operatory software and enter periodontal data alone, using the foot controls. This removes the need for an assistant to sit in the room and record, and it avoids the cross-contamination risk of touching the keyboard.
Does hands free perio charting work with Dentrix, Eaglesoft and Open Dental?
Yes. The Dental R.A.T. works with Dentrix, EagleSoft and Open Dental, as well as PracticeWorks, Softdent, PerioExec, MacPractice and Florida Probe. Any software that can be operated with a hand mouse can be operated with the Dental R.A.T.
Is a foot-controlled perio charting device better than voice recognition?
Many clinicians find it more dependable. Voice systems can struggle in busy operatories and have been described as finicky. A foot-controlled device uses deliberate button presses, so there is no speech to misinterpret, and the audio readback lets you verify each entry.
Does it take longer to chart with the foot than with an assistant?
No. Charting with the Dental R.A.T. takes about the same time as charting with an assistant, but the assistant does not have to be in the room at all.
How long does it take to learn?
The learning curve is short. About 30 minutes spent learning the buttons and cursor control is typically enough to get started, and speed improves with each use. The toe and heel taps are simple, and the cursor control takes the most practice.
Do I need to install software?
The device itself needs none. You plug it into a USB port and it works as a mouse. The optional audio feedback is a separate download, available for Mac and Windows.
Can it be used for more than perio charting?
Yes. Because it is a full mouse, it can open and zoom x-rays, run intraoral cameras, capture images with a heel click, and navigate the schedule. It is useful in general offices as well as periodontal offices.
Is it wireless?
The Dental R.A.T. 2.0 can be wireless (radio frequency) or wired with a USB cord. It also has a plug for a private headset.
What warranty is included?
The Dental R.A.T. 2.0 comes with a one-year warranty, and additional years can be purchased. The original metal unit carries a three-year warranty.
Can I try it before I buy?
Yes. A free demo is available. Call 877-278-0061 during business hours, Monday through Friday, 9am to 5pm, to arrange one.