The role of computers in dental practice has dramatically changed over the past 30 years. We have witnessed the progression from administrative roles to complete integration leading to chartless offices. As the dental community gradually adopts this contemporary development, the move to electronic health records is imminent because of upcoming changes in the health care system. The past, present, and future of dental office computer systems is explored in this article. An understanding of the benefits and current challenges of contemporary dental practice software is also reviewed.
Traditionally, the practicing dentist has had to act as bookkeeper, accountant, marketing and promotions expert, and in countless other capacities in addition to clinician. The profession has always had its innate challenges if any measure of success was to be achieved. Of course, delegating some of these responsibilities to competent team members has helped to relieve the impossible load of the average practitioner. However, disorganized and frenzied team dynamics can add to the overall stresses.
Over the years, the pressures associated with dentistry have been well documented. Practice management has been consistently identified as a major factor. Fortunately, impressive technological advances have alleviated much of the strain that running a flourishing practice can create. The fields of dental informatics and information technology have since presented us with options to assuage management concerns and, more recently, clinical issues.
Over the past 25 years, the growing field of dental informatics has played a significant role in the evolution of dentistry. Succinctly stated, “Dental informatics is the application of computer and information sciences to improve dental practice, research, education and management.” (p61) Intersection of this field with that of information technology has affected us in a variety of ways. For example, it has resulted in the extensive database MEDLINE, clinical simulation programs, and distance learning. It has also resulted in the array of dental office computer systems that are now in use. There exists a plethora of hardware and software that today’s practitioner can customize to the needs of any type of practice.
As in the past, there remains a relatively slow acceptance for computers to take on increasing responsibility. Many practitioners own software but use it in a limited capacity. The associated expenses and time-consuming training may act as deterrents for many. However, dentistry, as all other professions, finds itself in the tide of the new digital world. It is estimated that approximately a third of practitioners currently have computers within their operatories. Because computers have become a part of everyday life, it is expected that we shall see further integration into what is considered mainstream practice.
History of computers and dentistry
Over the past 4 decades, we have witnessed the integration of computers into various functions of the dental office. The emergence, however, had to overcome initial resistance. The cost of computer analysis was deemed “bad for productivity” (p659) and that “computers should be reserved for more challenging tasks.” (p660) Employees were considered far more efficient than the unfamiliar processing units.
Granted, the relative expense of the option was high compared with what it would cost now. Extravagant costs prohibited small practices from purchasing their own units. Acquiring computer data would have been a considerable expense. Fortunately, the appearance of the microchip in the early 1980s soon made computers for the household and small businesses a possibility. However, the heavy reliance on human labor was indicative of a traditional mindset in which computers were considered unnecessary for “simple” tasks.
During the 1980s, a growing interest in technology for the dental office developed. Practitioners realized how the incorporation of computers could lighten the load of busy practices while affecting productivity in substantial ways. They acted as centralized databases mainly used by front desk personnel. Administrative tasks such as compiling production reports, patient recalls, and accessing transaction information no longer encumbered overworked staff.
As popularity was gained, traditional use of the computers grew to include additional bookkeeping and accounting duties, handling of insurance claims, and patient scheduling. During the mid to late 1980s, promotion and marketing efforts had become a prevalent part of the dental community. Software companies became conscious of the marketing aspect of dental practices. Subsequently, letter-writing functions and demographic analyses were featured as part of their offerings.
In 1984, only 11% of dentists reported having computers in their offices. By 1991, 48% of dentists had computers in their offices. The dental world had been firmly infiltrated. Within the following 10 years, the number rose to 85%.
During that decade, technology started to include clinical features in addition to data and financial management functions. Areas such as periodontal charting, voice activation, and imaging capabilities were actively being explored; however, these features were largely independent of each other. A divide existed between practice management software and clinical technology. Perhaps this was because, despite the innovations in clinical applications, the overwhelming majority of dentists were still using computers mainly for administrative tasks. However, the concept of a fully functioning intraoffice network was budding. Major innovations were about to further redefine the manner in which dentistry was practiced.