Transcript Diagnosis, Risk, and Treatment

The Oral Health Information Suite™
Its Use in the Management of
Periodontal Disease
The Oral Health Information Suite™

What is OHIS™?

When and How is it used?

Why should OHIS™ be used?

Benefits from OHIS™ use
What is OHIS™?

A patent protected Internet-accessed information system
that is comprised of a suite of related tools for the major
oral health conditions including:
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Caries
Periodontal disease
Oral cancer
Each tool includes:
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A scientifically derived mathematic algorithm using objective
quantitative measurements to determine risk level
A list of recommended interventions, stack-ranked by three
levels of effectiveness based on the published literature and
current standards of care for the patient’s unique conditions
What is OHIS™?, cont.


OHIS was designed to be easily incorporated
into the normal workflow utilizing information of
a traditional examination and accommodating
the unique characteristics and needs of the
patient, clinician, and treatment procedures.
Unique for clinical dentistry by virtue of
quantifying the risk for future disease in addition
to quantifying the current periodontal disease
state.

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Provides the means to measure oral health care and
determine its value
Facilitates quality care and continuous improvement
What is the Current Treatment
Flow and How Would it Change
with OHIS™?
Current Treatment Flow
Re-
Examination
Diagnosis
Treatment
Provided
Treatment Plan
Finalized
OHIS™ Treatment Flow
Re-
Analysis
Treatment
Provided
Report Returned to
Clinician’s Computer
OHIS™
Processing
Examination
Algorithm
Refinements
Diagnosis
Treatment Plan
Finalized
OHIS™ is an intelligent self-correcting system, as outcomes
information determined in “Analysis” is used to refine risk
assessment and appropriate treatment including the rank
order of effectiveness.
OHIS™ and HIPAA Compliance
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Compliance with HIPAA is accomplished by deidentifying the examination and treatment
information sent to OHIS™.
The clinician’s computer is the only site where
information that identifies the patient resides.
OHIS™ assigns a unique 32-character
identification number to locate the records of a
patient.
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This creates a secure means to transfer a patient’s
entire collection of records, as only the patient and
clinician have access to both the identification number
and identity of the patient.
Who Developed OHIS?
How is it Obtained?
www.previser.com
How Does OHIS™ Technology
Enhance Current Practice Methods?

Diagnosis

Risk Assessment


Disease and Risk
Treatment Plans
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Incorporating risk concepts
Current Diagnostic Method
Clinical Condition
Pocket depth
Tooth mobility
Recession
Furcations
Attached gingiva
Data Points
28 X 6
=
28 X 1
=
28 X 2
=
4X3+6X2 =
28 + 14
=
Plaque score
28 X 4
=
112
Bleeding points
Radiographic bone loss
TOTAL
28 X 4
28 X 2
=
=
112
56
598
168
28
56
24
42
The Basis for Text-Linguistic Diagnoses
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5 Severity States
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2 Extent States
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Health
Gingivitis
Beginning Periodontitis
Moderate Periodontitis
Severe Periodontitis
Localized
Generalized
Text-Linguistic Connections

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And
To
Yields
17 Text-Linguistic Diagnoses
Severity
Text Nomenclature
Health
Health
Gingivitis
Gingivitis
Beginning
Periodontitis
Localized Beginning Periodontitis
Generalized Beginning Periodontitis
Moderate
Periodontitis
Localized Beginning and Moderate Periodontitis
Localized Moderate Periodontitis
Generalized Beginning to Moderate Periodontitis
Generalized Beginning and Localized Moderate Periodontitis
Generalized Moderate Periodontitis
Severe
Periodontitis
Localized Beginning and Severe Periodontitis
Localized Moderate and Severe Periodontitis
Localized Severe Periodontitis
Generalized Beginning to Severe Periodontitis
Generalized Beginning and Localized Severe Periodontitis
Generalized Moderate to Severe Periodontitis
Generalized Moderate and Localized Severe Periodontitis
Generalized Severe Periodontitis
Can Clinicians Determine a
Periodontal Diagnosis Quickly and
With a High Level of Agreement?
Please determine a periodontal diagnosis
from the periodontal charting and full mouth
radiographs on the following slides.
Thank you.
What is Your Diagnosis?
OHIS™ Disease Score
=
21
Text-Linguistic Diagnosis = Localized Moderate Periodontitis
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Facial
Lingual
424
433
425
436
313
423
313
323
313
322
312
222
212
222
212
222
212
222
213
222
313
223
313
323
624
523
424
333
Lingual
Facial
333
424
333
424
333
423
323
313
312
313
312
312
212
212
212
212
212
212
212
213
322
313
324
313
324
414
433
414
31
30
29
28
27
26
25
24
23
22
21
20
19
18
Tooth#
Tooth#
1
32
16
17
170
What is Your Diagnosis?
OHIS™ Disease Score
=
36
Text-Linguistic Diagnosis = Generalized Moderate Periodontitis
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Facial
Lingual
315
335
525
535
525
535
415
535
513
524
313
333
315
334
514
534
414
434
414
434
414
435
415
535
525
535
524
544
Lingual
Facial
456
415
655
525
545
514
545
414
425
415
515
515
515
515
515
525
525
535
515
515
535
514
535
425
555
525
555
514
31
30
29
28
27
26
25
24
23
22
21
20
19
18
Tooth#
Tooth#
1
32
16
17
207
What is Your Diagnosis?
OHIS™ Disease Score
=
92
Text-Linguistic Diagnosis = Generalized Moderate to Severe Periodontitis
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Facial
Lingual
538
558
735
845
535
545
535
535
536
525
625
535
526
525
425
424
636
626
435
435
434
434
333
444
436
446
635
645
Lingual
Facial
545
535
545
535
545
535
444
434
434
424
333
424
333
424
333
424
333
424
333
424
333
424
333
424
335
426
635
635
31
30
29
28
27
26
25
24
23
22
21
20
19
18
Tooth#
Tooth#
1
32
16
17
111A
What is Your Diagnosis?
OHIS™ Disease Score
=
97
Text-Linguistic Diagnosis = Generalized Severe Periodontitis
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Facial
Lingual
537
537
735
635
535
534
535
435
536
535
625
535
526
535
425
435
636
635
435
434
434
434
333
333
437
337
735
735
Lingual
Facial
545
535
545
535
535
535
535
535
525
525
525
525
525
525
525
525
525
525
525
525
535
525
535
525
545
526
645
635
31
30
29
28
27
26
25
24
23
22
21
20
19
18
Tooth#
Tooth#
1
32
16
17
111B
Current Diagnostic Method Summary
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Time-consuming process to document
clinical findings, which at a minimum
consists of 168 pocket depth measurements
No standard and simple method exists to
describe one set of nearly 600 data points
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Wide variation exists in the determination of a
diagnosis
Current Diagnostic Method Summary
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Text nomenclature for diagnosis is
complicated and not very descriptive
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Text-based diagnoses are insufficiently
precise to compare a single patient over
time or multiple patients, as similar
conditions may be described by the same
diagnosis
OHIS™ Diagnostic Method
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OHIS™ presents a standardized, objective, and
simplified method for summarizing results of the
standard periodontal examination into a clear, 1
– 100 scale describing the disease state
No special tests are required, and only 13 data
points are needed to quantify a periodontal
diagnosis
A numeric and text periodontal diagnosis can be
obtained in seconds after the data is recorded
Martin JA et al. A numeric method to describe a periodontal disease state. In preparation
OHIS™ Diagnostic Method, cont.
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The method uses the combination of sextant
severity diagnoses, which includes:
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Health, Gingivitis, and Beginning, Moderate, and
Severe Periodontitis, and where
Sextant severity diagnosis is based on:
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Deepest pocket
Greatest radiographic bone height distance from the
cemento-enamel junction
Bleeding on probing
3 level scale
3 level scale
Bitewings are
minimally required
although some loss of
accuracy will occur
Assignment of a
Sextant Severity Diagnosis
Bone Height Distance from CEJ
Pocket
Depth
<2mm
2-4mm
>4mm
<5mm
Gingivitis*
Beginning
Periodontitis
Moderate
Periodontitis
5-7mm
Beginning
Periodontitis
Moderate
Periodontitis
Severe
Periodontitis
>7mm
Moderate
Periodontitis
Severe
Periodontitis
Severe
Periodontitis
* Bleeding on probing exists
Assignment of a
Sextant Severity Diagnosis
Bone Height Distance from CEJ
Pocket
Depth
<2mm
2-4mm
>4mm
<5mm
Health*
Beginning
Periodontitis
Moderate
Periodontitis
5-7mm
Beginning
Periodontitis
Moderate
Periodontitis
Severe
Periodontitis
>7mm
Moderate
Periodontitis
Severe
Periodontitis
Severe
Periodontitis
* Bleeding on probing does not exist
Why Sextant Diagnosis is Used
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28 teeth listed in order of their diagnosis is
528=3.7x1019 permutations
28 teeth grouped and counted by diagnosis is
35,960 combinations
Sextants listed in order of their diagnosis is
56=15,625 permutations
Sextants grouped and counted by diagnosis is
210 combinations
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Approximately 2 combinations of sextant diagnosis
correspond to 1 disease score in the 1-100 scale
The non-uniformity of the scale occurs as a condition
of combinations
OHIS™
Disease
Score
1
Severity
Text Nomenclature
Health
Health
Gingivitis
Gingivitis
4-10
Beginning
Periodontitis
Localized Beginning Periodontitis
Generalized Beginning Periodontitis
11-36
Moderate
Periodontitis
Localized Beginning and Moderate Periodontitis
Localized Moderate Periodontitis
Generalized Beginning to Moderate Periodontitis
Generalized Beginning and Localized Moderate Periodontitis
Generalized Moderate Periodontitis
37-100
Severe
Periodontitis
Localized Beginning and Severe Periodontitis
Localized Moderate and Severe Periodontitis
Localized Severe Periodontitis
Generalized Beginning to Severe Periodontitis
Generalized Beginning and Localized Severe Periodontitis
Generalized Moderate to Severe Periodontitis
Generalized Moderate and Localized Severe Periodontitis
Generalized Severe Periodontitis
2-3
What Diagnosis Would You Assign?
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4 sextants have severe periodontitis and 2 have
gingivitis
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3 sextants have severe periodontitis and 3 have
gingivitis
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94 disease score and Generalized severe periodontitis
84 disease score and Generalized severe periodontitis
2 sextants have severe periodontitis, 2 have
beginning periodontitis, and 2 have gingivitis
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71 disease score and Generalized beginning to severe
periodontitis
Disease Score and its History
OHIS™ Diagnostic
Method Summary
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Streamlines the diagnostic process into a more
efficient and effective clinical practice
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The disease score and its history are more readily
comprehended than the typical periodontal charting,
radiographs, and text nomenclature
Establishes a standard and objective means that
can be applied to all patients
A change in the disease score reflects an
improving, stable or worsening health condition
Is an Accurate Diagnosis All that is
Required to Determine Treatment?
The Health-Disease Continuum
Health-Disease
Continuum
Diagnosis
Disease
Health
Loss
Progression
Limited or
No Signs
Invisible
Signs and Symptoms
Visible
Stages
Initiation
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Beginning
Disease Severity
Moderate
Severe
Diagnosis is the determination of the existence of disease
Disease does not exist until tissue destruction occurs
Lesions must exceed the threshold of measurement for a
diagnosis to be made
The Health-Disease Continuum
Health-Disease
Continuum
Diagnosis
Disease
Health
Loss
Progression
Limited or
No Signs
Signs and Symptoms
Invisible
Visible
Stages
Initiation
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Beginning
Disease Severity
Moderate
Severe
Diagnosis identifies severity; drives reparative treatment
A diagnosis describes the current, static, disease state
However,……..
The Health-Disease Continuum
Health-Disease
Continuum
Diagnosis
Disease
Health
Loss
Progression
Limited or
No Signs
Invisible
Signs and Symptoms
Visible
Stages
Initiation
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Beginning
Disease Severity
Moderate
Severe
Disease is a dynamic non-linear process that can cycle
between breakdown and healing
During the earliest stages of the disease process,
reversibility or healing may be possible
•
•
•
•
Tooth demineralization
---------------------->
Sub-clinical inflammatory lesion --------------->
Abnormal cell division --------------------------->
Coronary artery plaque and inflammation --->
Caries
Gingivitis
Cancer
Myocardial Infarction
The Health-Disease Continuum
Health-Disease
Continuum
Diagnosis
Disease
Health
Loss
Progression
Limited or
No Signs
Invisible
Signs and Symptoms
Visible
Stages
Initiation
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Beginning
Disease Severity
Moderate
Severe
Diagnosis of a lesion at its earliest stage will be after the
initiation of the disease process
Risk predicts the future disease state; drives preventative
treatment
A healthy patient at-risk for disease would be denied the
opportunity to prevent disease if interventions are
withheld until a diagnosis is obtained
What is Required to Determine
Treatment Needs?
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Accurate diagnosis
Accurate risk determination
Understanding patient desires
Knowledge of the likelihood that
treatment interventions will result in
the desired outcome
Is the OHIS™ Risk Assessment
Method Valid and Accurate?
Validity and Accuracy of OHIS™
Determined Risk
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523 subjects enrolled in the Veterans Affairs
Dental Longitudinal Study who had only routine
care
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Periodontal pocket depth measurements
Digitized full-mouth radiographs with bitewings
Medical and dental histories
Risk was assessed at baseline using OHIS™
Page et al. Validity and accuracy of a risk calculator in predicting
periodontal disease. J Am Dent Assoc 2002
Page et al. Longitudinal validation of a risk calculator for
periodontal disease. J Clin Periodontol 2003
Validity and Accuracy of OHIS™
Determined Risk, cont.
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Changes in periodontal status determined by
comparing baseline data to data at 3, 9, and 15
years
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Alveolar bone loss (mean bone loss, percentage of
sites with bone loss per subject)
Tooth loss (mean percent tooth loss, percentage of
subjects with tooth loss in each risk group)
Mean Bone Loss
Mean Percent (±SE) Alveolar Bone Loss
8.0%
7.0%
A measure of disease severity
Risk 5
6.0%
Risk 4
5.0%
Risk 3
4.0%
Risk 2
3.0%
2.0%
1.0%
0.0%
Year 3
Year 9
Year 15
Percentage of Sites with Bone Loss
70%
65%
A measure of disease extent
Risk 5
Risk 4
% Sites with Bone Loss
60%
Risk 3
55%
Risk 2
50%
45%
40%
35%
30%
25%
20%
15%
Year 3
Year 9
Year 15
Mean Tooth Loss
30.0%
Mean % (±SE) Tooth Loss
25.0%
Risk 5
20.0%
15.0%
Risk 4
10.0%
Risk 3
5.0%
Risk 2
0.0%
Year 3
Year 9
Year 15
Percentage of Subjects with Tooth Loss
100%
90%
Risk 5
80%
Risk 4
% of subjects
70%
Risk 3
60%
50%
40%
Risk 2
30%
20%
10%
0%
Year 3
Year 9
Year 15
Mean Number of Teeth Lost
7
6
Risk 5
Number of teeth lost
5
Risk 4
4
Risk 3
3
Risk 2
Only 26% did not have
periodontal disease at
baseline
2
1
0
Total teeth
Periodontally affected
Periodontally unaffected
How is Risk Distinguished from
Diagnosis?
Diagnosis vs. Risk
Diagnosis
describes
Risk
predicts
Disease State
Severe Periodontitis
Worse
Moderate Periodontitis
Same
Beginning Periodontitis
Better
Gingivitis
Based on:
Signs and Symptoms
Risk Factors
Current
Future
Time
Health
Signs and Symptoms vs. Risk Factors
Signs and Symptoms
 Bleeding on probing
 Pockets
 Bone loss
 Pain
 Swelling

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

Risk Factors
Smoking
Diabetes
Pathogenic
bacteria
Pockets
What is a Risk Factor?

Risk factor is often used as a general term
meaning those characteristics that strongly
associate with groups of individuals who have
disease compared to those who do not. Risk
terminology includes:
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

Risk Factor
Background Characteristic
Risk Indicator
Risk Markers or Risk Predictors
Risk Factor Definition
An environmental, behavioral, or biologic factor
confirmed by temporal sequence, usually in
longitudinal studies, which if present directly
increases the probability of a disease occurring,
and if absent or removed reduces the probability.
Risk factors are part of the causal chain, or expose
the host to the causal chain. Once disease occurs,
removal of a risk factor may not result in a cure.
Beck JD. Community Dent Oral Epidemiol 1998
Background Characteristics Definition
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Associated with a higher probability of
disease, but cannot be modified. Also
referred to as a determinant.

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Age
Gender
Socioeconomic Status
Familial history and genetic factors
Risk Indicator Definition

A possible risk factor not yet confirmed in
published studies. A plausible correlate of
disease identified in cross-sectional
studies.

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
Osteoporosis
HIV and AIDS
Frequency of visits to the dentist
Risk Markers and Predictors Definition

A characteristic strongly correlated with an
increased probability of future disease but
is not part of the causal chain.

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Bleeding on probing
Clinical attachment loss
Risk Assessment

Risk cannot be determined from disease severity

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Every patient who has disease was, at a prior time,
healthy, hence It is possible to be high risk AND low disease severity
Risk assessment is used to develop a preventive
intervention program to prevent disease before
it occurs
Risk Level modulates the aggressiveness and
frequency of treatment
OHIS™ Risk Assessment
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A future disease state is effected when
treatment is applied or withheld
OHIS™ risk assessment predicts the on-set and
progression of periodontal disease for patients
who have no more than routine dental care
Predicting treatment effectiveness is a different
type of risk assessment not currently determined
by OHIS™
The OHIS™ risk score ranges from 1 for very
low risk to 5 for very high risk
Current Risk Assessment Method
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By subjective judgment
Based primarily on disease severity and
extent
This is understandable, as the literature only
provides a laundry list of risk factors with no
guidance how to determine risk
It is not surprising that the current method of
risk assessment is generally an unreliable
predictor of the future disease state
OHIS™ Risk Assessment Criteria



Accurate and valid predictor of a future disease state
when no more than routine dental care is provided
Time required for data collection and input must add no
more than 5 minutes to a traditional periodontal
examination and the procedure must be easily
incorporated into the normal pattern of work flow
Risk assessment information must be useful to create
treatment recommendations that reduce risk and
prevent disease incidence and progression
Martin et al. The development and utility of an assessment tool for risk of
periodontal disease. In preparation.
OHIS™ Criteria for Use of Factors

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Scientific basis supported by publication in
refereed scientific journal
Information obtainable during traditional
periodontal examination without use of special
or laboratory testing
Sufficiently high weight to impact risk score
Useful to create treatment recommendations
that reduce risk and prevent disease incidence
and progression
Factors Used by OHIS™ to Determine
Risk and Recommend Treatment
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Smoking
Diabetes
Subgingival calculus
Subgingival restorations
Pockets
Furcation involvements
Vertical bone lesions

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
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
Age
Radiographic bone height
History of periodontal
surgery for pockets
Oral hygiene
Dental care frequency
Why Were Some Factors
Not Used?
Scientific Basis Not Supported
by a Refereed Publication
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Race
Gender
Gingival crevicular components
Bleeding points
Oral hygiene indices
Suppuration
Gingival redness
Lamina dura
Information Not Typically Obtained

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
Genetic testing (PST®)
Polymorphoneuclear leucocyte disorders
Gingival crevicular components
Bleeding points
Oral hygiene indices
Clinical attachment loss
Bacteria Culturing
Low Prevalence, Which Would Not
Affect Accuracy of the Risk Score
for a Large Population


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

Occlusion-related pathology
HIV and AIDS
Medications
Pregnancy
Osteoporosis
Not Useful to Create Treatment
Recommendations



Race
Socio-economic status
Clinical attachment loss
OHIS™ Risk Assessment
Method Summary

OHIS™ presents a standardized, valid, and
accurate method to determine risk level



Risk levels range from 1 for very low risk to 5 for
very high risk
The time required for data collection and input
adds no more than 5 minutes to a traditional
periodontal examination and is easily
incorporated into the normal work flow
Risk level and disease state are determined from
only 23 data points
What Data does OHIS™ Require
and How is it Entered into the
System?
Data points 1 to 4
Data points 5 to 11
Data points 12 to 23
Incorporating Risk Concepts into
Treatment Planning

Risk is the fundamental principle that should
justify treatment




Low risk means that disease is unlikely to progress
and justification for treatment is minimally supported
High risk means that disease is likely to progress and
justification for treatment is maximally supported
Risk is used to determine preventive
interventions
Risk is also used to modulate the intensity and
aggressiveness of reparative treatment
Risk and Treatment





Treating disease generally involves repair
Repair may increase the risk of new
disease
Risk should drive preventive treatment
Reduction in risk is accomplished by
managing risk factors
Risk reduction can intercept invisible
disease processes
Both Risk and Disease are Important



The severity of disease is used to determine how
much and what type of treatment is needed
Risk is used to determine how conservative or
aggressive treatment should be
With or without disease, risk is used to
determine the best treatment to prevent new
disease from occurring
Treatment Needs Increase with
Advancing Risk and Disease State
Disease State
Treatment Intensity
and Aggressiveness
Severe Periodontitis
Moderate Periodontitis
Treatment Intensity
and Aggressiveness
Very
Low
Low
Moderate
Risk Level
Beginning Periodontitis
Gingivitis
Health
High
Very
High
Current vs. OHIS™ Method of
Identifying Treatment Need
Current
Method
OHIS™
Method
Severity and
Extent of Disease
Reparative Treatment
Standard Preventative Treatment
Severity and
Extent of Disease
Reparative Treatment
Risk factors and
risk level
Preventative Treatment
How Can a Clinician Correlate
Diagnosis, Risk, and
Treatment Needs
Treatment Stratification Matrix
Health
Very high risk
Gingivitis
Cannot be currently
measured
Beginning
Periodontitis
Moderate
Periodontitis
Severe
Periodontitis
Risk = 5
Disease = 4-10
Risk = 5
Disease = 11-36
Risk = 5
Disease = 37-100
High risk
Risk = 4
Disease = 1
Risk = 4
Disease = 2-3
Risk = 4
Disease = 4-10
Risk = 4
Disease = 11-36
Risk = 4
Disease = 37-100
Moderate risk
Risk = 3
Disease = 1
Risk = 3
Disease = 2-3
Risk = 3
Disease = 4-10
Risk = 3
Disease = 11-36
Risk = 3
Disease = 37-100
Low risk
Risk = 2
Disease = 1
Risk = 2
Disease = 2-3
Risk = 2
Disease = 4-10
Risk = 2
Disease = 11-36
Risk = 2
Disease = 37-100
Very low risk
Risk = 1
Disease = 1
Risk = 1
Disease = 2-3
Risk = 1
Disease = 4-10
Risk = 1
Disease = 11-36
Cannot occur
Patients in these categories have the most complex needs generally requiring
advanced clinical skills and experience
Patients in these categories are borderline for treatment complexity
It is possible but unlikely to observe patients with these disease and risk
profiles
Patients in these categories have routine needs generally requiring basic
clinical skills and experience
How Can OHIS™ Assist in the
Determination of Treatment?
OHIS™ Assisted Treatment Planning

A list of commonly used treatment procedures
for the patient’s risk factors and conditions
grouped by three levels of expected
effectiveness is provided as an aid to the dentist
in decision making

Treatment should be targeted to the existing
factors and conditions

Risk is used to modify treatment intensity and
aggressiveness
Using the Scores in Treatment
Planning

Identifies the effectiveness of treatment




Lower scores are indicative of improvement and the
possibility that the current condition can be maintained
or continue to improve with the current treatment plan
Higher scores are indicative of a worse situation and the
need for different treatment
While a lower risk score is desirable, it is possible for a
patient’s risk to remain high without the disease
worsening
Risk score change corresponds to an increase or
decrease of more than 20% making it less sensitive than
the 100-point disease score
Guidelines for Referral to a Periodontist




Most patients are referred when disease is
severe resulting in more tooth loss and
treatment that is complex and expensive
When treatment is initiated during the early
stages of disease, success is more likely,
treatment is more conservative, and fewer teeth
are lost
Risk predicts the future severity of disease
Referral to a periodontist should be based on
Risk and Disease
Guidelines for Referral to a
Periodontist, cont.

Establish protocol for your practice such as:




A threshold for risk regardless of disease state score
(e.g. risk ≥4)
A threshold for an increase in risk (e.g. risk change
≥1)
A threshold for the disease state score (e.g. disease
state ≥11)
A threshold for an increase in the disease state score
(e.g. disease state score change ≥10)
Is OHIS™ Needed?



The need and value of OHIS™ is not intuitively
apparent, as clinicians routinely diagnose,
formulate treatment plans, and predict
outcomes.
Furthermore there is evidence that oral health
has improved.
However, wide variation and inaccuracy exists
for diagnosis and risk assessment, suggestive
that some patients receive un-needed care and
others fail to receive needed care.
Is OHIS™ Needed?, cont.


An information system that determines
outcomes is non-existent, which denies the
clinician and patient from an accurate
understanding of oral health changes, favorable
and unfavorable, that are attributable to
treatment and behavioral decisions.
Dentistry has been practiced within this
information void for decades resulting in the
deterioration of the authority and profitability of
dentists.
Is OHIS™ Needed?, cont.




Periodontal treatment can prevent tooth loss
A standard uniform application of treatment
procedures harms some patients
A decision to determine treatment that does not
include an accurate assessment of risk harms
patients
Risk assessment is distinctly different from
diagnosis and is not determined with consistent
accuracy by a clinician using subjective judgment
Acceptance of the validity of these statements means
you believe quality care requires use of OHIS™
OHIS™ Benefits


OHIS™ creates an opportunity for clinicians to
establish their method of determining oral health
care excellence and the development of practice
policies based on actual clinical outcomes, which
might prevent organizations from imposing
conflicting standards.
Dentists who provide exceptional care measured
by outcomes could justify higher fees and use
the information to market their expertise.
OHIS™ Benefits, cont.

Numeric scores



Simplify the clinician’s explanation of disease
and risk
Are more easily and readily understood by the
patient compared to traditional text-linguistic
descriptions
The enhanced understanding would be
expected to result in a higher commitment to
treatment and greater participation by the
patient in their own disease prevention and
health improvement.
OHIS™ Benefits, cont.


A patient traditionally determines oral care
excellence from their subjective
interpretation of the clinical facility, service
experience, resolution of symptoms or
changes perceived with the senses, and
the whiteness of their teeth.
A patient could, for the first time,
determine quality care by the change from
pre-treatment to post-treatment scores.
Summary
OHIS™ is an efficient, effective, and
accurate method to:
 Document a periodontal condition
 Diagnose periodontal disease
 Predict a future periodontal disease state
 Determine treatment dynamically
 Communicate with a patient
Summary, cont.

OHIS™ was designed for clinical utility by:




Providing accurate and valid diagnostic, risk,
and treatment information
Utilization takes little time and fits within
normal procedures and work flow.
OHIS™ should be used routinely
OHIS™ can improve oral health care
quality and preserve the status of the
private practice clinician
www.previser.com
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Contact Information
Web site URL
www.previser.com
Online support
http://support.previser.com
Support by phone
360.661.5763
Support by email
[email protected]
Corporate address
PreViser Corporation
20849 Cascade Ridge Drive
Mount Vernon, WA 98274
Corporate phone
360.941.4715