Here’s a question to ask dental leaders in your state or community:
Does dentistry need a uniform, commonly accepted system of diagnostic codes?
I had the chance to listen in on a daylong conference that focused on the topic and to write about it for DrBicuspid.com, an online publication that serves the dental profession. The question is one more way to think about the gap between dentistry and medicine.
Dentists have long used procedure or treatment codes for billing and for keeping patient records. But, in terms of diagnostic terminology, “we’re behind medicine by a lot,” said Joel White D.D.S., M.S., at the conference.
“Back in the days of the bubonic plague, medicine captured why people die. We don’t capture why teeth die. We’re centuries behind,” said White, a professor at the University of California, San Francisco, School of Dentistry and a member of an international academic workgroup focused upon developing a useful vocabulary of dental diagnostic terms.
To that end, the team has come up with the EZCodes Dental Diagnostic Terminology, a system of 1,358 terms organized into 91 subcategories under 15 major headings.
Team members said their system, being tested in 17 dental schools and institutions in America and in Europe, will help dentists in providing care for patients and in tracking clinical outcomes as well as assist in mapping disease patterns, monitoring community oral health status and identifying best practices.
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The use of diagnostic terms represents “a move from treatment-centric to diagnostic-centric,” dentistry according to EZCodes lead developer Elsbeth Kalenderian, D.D.S., M.P.H., chair of oral health policy and epidemiology at the Harvard School of Dental Medicine. With the growing importance of electronic health records (EHRs), diagnostic coding will become increasingly important, many at the conference pointed out. Developers of the EZCode system say they set to work on the diagnostic vocabulary because other efforts to standardize dental diagnostic terms have failed to gain wide usage. The World Health Organization’s International Classification of Disease coding system, or ICD, includes some oral and dental diagnoses, but lacks sufficient specificity in its dental terminology, they said. They criticized as too cumbersome a second system of more than 7,000 terms called SNODENT which is contained within the Systematized Nomenclature of Medicine Clinical Terms (SNOMED-CT.)
For its part, the American Dental Association, developer of SNODENT says EZCodes is an “interface terminology” that is useful for capturing health problems but which is not a replacement for SNODENT in terms of storing information in electronic health records.
The Nov. 28 conference at the Harvard School of Dental Medicine did not end the discussion, as Dental Informatics blogger Titus Schleyer, D.M.D., Ph.D., pointed out in ”Does Dentistry Need More than One Diagnostic Vocabulary?”