Patent Publication Number: US-11037671-B2

Title: Dental charting system

Description:
The application claims priority to U.S. Provisional Application No. 61/113,822 which was filed on Nov. 12, 2008. 
    
    
     BACKGROUND OF THE INVENTION 
     This application relates to dentistry, and more specifically to periodontal and restorative dental charting. 
     Dentists and other dental professionals use dental charts to record information about their patients&#39; teeth. This data may include periodontal information, such as a pocket depth of a recess between a patient&#39;s gums and tooth for a outer, facial side of the tooth and a inner, lingual side of the tooth. This data may also include restorative information about tooth conditions (e.g. cavities) and tooth treatments (e.g. fillings). Recording this data has required two people: a first person to take measurements or make observations, and a second person to record those measurements or observations. 
     SUMMARY OF THE INVENTION 
     A computer-implemented dental charting system includes a computer storing tooth data for at least one patient and a display operable to display the tooth data. The computer is responsive to voice commands, and the display has a periodontal mode and a restorative mode. The display includes an exam overview window illustrating a plurality of tooth images, each tooth image corresponding to a patient tooth location, and an exam focus window. The exam focus window illustrates a magnified view of at least one of the plurality of tooth images, and illustrates data corresponding to the selected tooth location. The exam focus window may be displayed beside the exam overview window, as a floating window on top of the exam overview window, or on a physically separate display from the exam overview window. 
     A method of presenting dental data stored on a computer-readable medium includes displaying on a first display portion an exam overview window including a plurality of tooth images, each tooth image corresponding to a patient tooth location. An exam focus window is displayed on a second display portion. The exam focus window includes a magnified view of at least one tooth image corresponding to a selected tooth location, and includes data corresponding to the selected tooth location. The exam overview window and the exam focus window have a periodontal mode and a restorative mode. A tooth review window illustrates a history for the selected tooth location. The history includes previous tooth conditions, suggested treatments, and a status of the suggested treatments. The tooth review window is selectively displayed on the first display portion in response to actuation of a tooth review command. 
     These and other features of the present invention can be best understood from the following specification and drawings, the following of which is a brief description. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         FIG. 1  schematically illustrates a periodontal charting system. 
         FIG. 2  illustrates an example exam overview window and an example exam focus window of the periodontal charting system of  FIG. 1 . 
         FIG. 3  illustrates another example exam focus window. 
         FIG. 4  illustrates another exam overview window configured to display periodontal examination data. 
         FIG. 5  illustrates an example exam focus window in the restorative mode. 
         FIG. 6  illustrates another example of the exam overview window and exam focus window in the restorative mode. 
         FIG. 7  illustrates a default materials configuration view. 
         FIG. 8  illustrates an example tooth review window. 
         FIG. 9  illustrates an example “treatment plan” view in a teeth view. 
         FIG. 9 a    illustrates the example “treatment plan” view in a table view. 
         FIG. 10 a    illustrates an example “natural tooth” view in the restorative mode. 
         FIG. 10 b    illustrates an example “tooth treatment history” view in the restorative mode. 
     
    
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT 
       FIG. 1  schematically illustrates a dental charting system  100  for recording and retrieving periodontal and restorative data relating to teeth. The system  100  includes a computer  102   a . The computer includes a CPU  104 , a storage module  106 , a wireless communication module  108 , and a wired communication module  109 . The storage module may include a hard drive, a flash drive, an optical drive, or any other storage medium. In one example the wireless module  108  corresponds to a wireless Ethernet card capable of communicating over WiFi, or a Bluetooth card. The computer  102   a  is connected to a first display  110  and an optional second display  112 . The computer  102   a  communicates with the displays  110 ,  112  to illustrate an exam overview window  12  and an exam focus window  14  (see  FIG. 2 ). In one example the system only includes the first display  110 , and both of the windows  12 ,  14  are shown on the first display  110 . In this example, the windows  12 ,  14  could be shown side-by-side, or the window  14  could be floating on top of the window  12 . In one example, the system  100  shows the exam overview window  12  on the first display  110 , and shows the exam focus window  14  on the second display  112 . 
     In one example the system  100  includes a second computer  102   b  that communicates with the first computer  102   a  via a network  103 . The network  103  may correspond to the Internet or another wide area network, or may correspond to a local area network, for example. The computers  102   a - b  may be configured in a client-server relationship such that computer  102   b  hosts a “data layer” and the computer  102   a  stores an “application layer” and a “graphical user interface” (“GUI”) layer. The computers  102   a - b  may be configured in a “software as a service” (“Saas”) relationship such that the computer  102   b  hosts a data layer and an application layer and the computer  102   a  stores an additional application layer for receiving voice commands and a presentation layer. The presentation layer may be implemented through a web browser, for example. 
     The system  100  (see  FIG. 1 ) is responsive to a plurality of input modes, such as mouse  116 , keyboard  114 , Dental R.A.T.  118 , Florida probe  120 , and voice (via microphone  122 ). Of course, other input modes could be used. For example, the displays  110 ,  112  could be configured to be touchscreens responsive to touch commands. Certain entry modes, such as voice, enable a single user to take tooth measurements, and to efficiently record the measurements without requiring manual data entry through the mouse  116  or keyboard  114 . Throughout this application, the term “user” is used to refer to an individual who would use the system  100 , such as a dentist, a dental hygienist, etc., and the term “patient” is used to refer to an individual whose teeth are represented in the system  100 . 
     The input devices  114 - 122  may communicate with the computer  102   a  via the wireless communication module  108  or the wired communication module  109 . Although a plurality of the input devices  114 - 122  could be used to communicate with the computer  102   a , it is understood that a single input device would suffice. It is also understood that a combination of these devices  114 - 122  can be used at the same time to enter data. 
     The system  100  has both a “periodontal” mode and a “restorative” mode. These modes may be toggled using periodontal button  130  or restorative button  132 .  FIG. 2  illustrates the windows  12 ,  14  of the system  100  in a side-by-side configuration in the periodontal mode. The exam overview window  12  includes a plurality of lingual tooth images  16  representing a lingual side of each of a patient&#39;s teeth, and a plurality of facial tooth images  18  representing a facial side of each of the patient&#39;s teeth. A first set  20  of facial and lingual tooth images corresponds to the patient&#39;s upper jaw, and a second set  22  of facial and lingual tooth images corresponds to the patient&#39;s lower jaw. Each tooth  16 , 18  is illustrated with respect to a gum line  17  and a ruler  21 . 
     The exam overview window  12  includes a PerioExam tab  26 , a Notes tab  28 , a History/Compare tab  30 , and a Configuration tab  32 . Each of the tabs  26 - 32  correspond to different views in the exam overview window  12 , and selecting a tab  26 - 32  activates a corresponding view. As shown in  FIG. 2 , the PerioExam tab  26  is active and the exam overview window  12  is in the PerioExam view. The PerioExam view includes a first toolbar  24  that offers the user a plurality of buttons and radio buttons to perform various functions, and a second toolbar  25  that offers additional options to the user. An administrative area  34  illustrates administrative data, such as a patient name  36 , dentist name  38 , hygienist name  40 , date  42 , etc. A selected tooth may be represented by a frame  19 . The frame  19  may also be used to highlight several teeth at once (see  FIG. 4 ). For example, a frame  19  could be used to indicate teeth that have deteriorated more than a predefined threshold. The exam focus window  14  illustrates the selected tooth. As described above, the exam focus window  14  could be illustrated on the first display  110  or the second display  112 . 
     Various commands and features of the system  100  will now be described in detail. 
     Flag Command 
     The system  100  allows a user to flag a tooth to remind the user about a certain condition. In the example of  FIG. 2 , a user has flagged a third tooth  16 , as indicated by the flags  44  in the exam overview window  12  and in the exam focus window  14 . Different colors, shapes and styles may be used for the flags  44  to indicate various periodontal and restorative conditions, and to provide a reminder to a user between patient examinations. 
     The system  100  may display hints over a tooth. For example, if a user flagged a tooth three years ago for a specific condition, the hint above the flag  44  would indicate when the tooth was originally flagged, and unless the user removes the flag  44 , the flag  44  will remain throughout the examination lifecycle for the specific patient. Also, the system  100  logs who set the flag, the date of the flag, the date the flag was cleared, etc. 
     The system  100  also allows users to print flags  44  on reports, and allows users to clear all flags  44 . Flags  44  can also be captured as transactions to mark pre-existing and completed restorative conditions (e.g. implant, dentures, crowns) and clinical conditions (e.g. missing tooth, impacted), as will be described below in reference to the tooth review window  150  (see  FIG. 8 ). The system  100  treats a flag  44  as a transaction that can be tracked through time. 
     Auto Advance/Resume 
     In the periodontal mode, the system  100  includes an “auto advance” function to automatically advance to successive teeth so that a user can speak measurements, and once all measurements for a teeth are recorded the system  100  automatically advances to the next tooth. 
     At times a user may want to override the auto advance function. For example, if certain comments or additional notes need to be made for a specific tooth, a user may wish to temporarily stop the auto advance in order to perform a task, such as having a side conversation with another user (e.g. a hygienist may wish to speak to a dentist). Also, it is possible that a user may need to make a note about a tooth out of sequence. For example, a user may be recording data about the seventh tooth when the second tooth starts bleeding. The user may wish to select the delayed bleeding button  50  for the second tooth (see  FIG. 3 ). The user could say “Auto advance ON/OFF” (or another command to override the auto advance), say “Tooth two,” say “delayed bleeding,” and then say “resume.” The system  100  could then say “seventh tooth” and the system  100  could resume recording data on the seventh tooth. In one example the system  100  resumes at the beginning of the seventh tooth. In another example the system  100  resumes on the measurement of the seventh tooth that was being recorded when the override occurred. 
     The resume command allows the user to return back to a tooth and exam that was selected at the time the auto advance override occurred. The resume command may be initiated by selecting the resume button  54  (see  FIG. 3 ), or, for example, by speaking “resume.” The resume command remembers not only an active tooth number at the time of interruption, but also remembers the specific exam that was administered at the time of override. This allows users to effectively start where they left off, saving time and increasing productivity. 
     History/Compare 
       FIG. 4  illustrates the exam overview window  12  of the system  100  in the History/Compare view (note the History/Compare tab  30  is active) of the periodontal mode. The History/Compare view enables a user to instantly see what teeth are deteriorating or improving by comparing data from multiple exams using graphical indications. 
     Arrows may be used to indicate a gum improvement (e.g. arrow  63  from root of tooth  16  to gum line  17  to indicate depth reduction) or a gum deterioration (e.g. arrow  64  from gum line  17  to root of tooth  16  to indicate depth increase). In one example arrows are only used if the improvement or deterioration exceeds a predetermined threshold (such as two units). The predetermined threshold may be adjusted on an administrative or per-user level (as described in the Configuration section below). Different colors may be used for the arrows, such as a green arrow for an improvement and a red arrow for deterioration. Of course, other colors could be used. The arrows are explained in a first legend  61 . A second legend  62  indicates symbols used to indicate various examinations. In the example of  FIG. 4  lines having different weights or styles (e.g. solid, dashed, etc.) are used in the second legend  62  to indicate various previous examinations. However, color could also be used to distinguish the different indicators. 
     A comparison window  65  may be used to provide the various measurements corresponding to the multiple exams. In one example, the comparison window  64  is activated by hovering over the selected teeth (upper jaw lingual teeth nine, ten, and eleven in  FIG. 4 ) and hovering over them with a pointer. Although the comparison window  64  of  FIG. 4  illustrates data from four previous tests, it is understood that more or less data could be shown in the window  65 . Also, although pocket depth, FGM, and attachment data is shown, it is understood that different data could be shown in the window  65 . In one example the comparison window  35  could be shown as a separate window floating on top of the window  12 . 
     Configuration 
     The system  100  provides extended configuration at administrative user (“admin”) level and at the non-administrative user (“non-admin”) level in both the periodontal and restorative modes. One way to enter configuration preferences is to select the configuration tab  32  (see  FIG. 2 ). Some example configurable features include a preferred sequence of teeth to use for the auto advance feature, the predetermined threshold associated with the gum improvement and deterioration arrows  63 ,  64 , and report templates. An admin user can choose to either permit or prevent non-admin users from overriding the admin user&#39;s predefined settings. 
     Also, as will be described below in connection with  FIG. 6 , default materials may be selected in the restorative mode as a configuration feature. 
     Exam Focus Window: Periodontal Mode 
       FIG. 3  illustrates an example exam focus window  14  in the periodontal mode. The exam focus window  14  is a dedicated window that provides detailed information about an active tooth. For example, in the example of  FIG. 3  the upper jaw seventh tooth is active. 
     The exam focus window includes a plurality of options in the periodontal mode. A user may select any of a plurality of depths  46 . A bleeding button  48  may be used to indicate bleeding of a tooth  16 ,  18 . A delayed bleeding button  50  may be used to indicate delayed bleeding of a tooth  16 ,  18 . A voice activation button  52  may be selected to turn voice control ON of OFF. The auto advance checkbox  56  may be selected to toggle the auto advance feature ON or OFF. Also the flip button  58  may be used, as will be described below. 
     The exam focus window  14  can be sized and moved by a user as desired, and although the exam overview window  12  and the exam focus window  14  are illustrated side-by-side on the first display  110  in  FIG. 2 , different viewing configurations would be possible. For example, the exam focus window  14  could be a floating window that is displayed on top of the exam overview window  12 . Also, the exam overview window  12  could be shown on the first display  110  and the exam focus window  14  could be shown on the second display  112 . In one example the exam focus window  14  is illustrated on the second display  112 , and the second display  112  is a widescreen display that may be rotated to have a portrait as opposed to a landscape orientation. In one example the displays  110 ,  112  are visible from a distance (e.g. 5-6 feet away), and provide visual feedback to a user using the system  100 , such that the user can be taking measurements and interacting with the system  100  at a distance. 
     The exam focus window  14  includes display style buttons  86   a - c  that may be selected to change how the exam focus window  14  is displayed. 
     Flip Command 
     The Flip command enables a user to switch between lingual and facial side of a tooth with a single command. This command may be entered either vocally (e.g. saying “Flip”) or by clicking the Flip button  58 . 
     One method of conducting a periodontal exam is to follow a sequence by taking measurements for a first side (facial or lingual) of a first tooth, proceeding to a next tooth in the sequence, taking measurements for the first side of that next tooth, and so on. A measurement of the second side of the first tooth is not taken until the sequence returns to the first tooth. However, some users may desire to take measurements for both sides of the first tooth before proceeding. Such a user may use the Flip command to achieve this by taking measurements for a first side of the first tooth, speaking “Flip” (or clicking the Flip button  58 ), taking measurements for the second side of the first tooth, speaking “Flip” (or clicking the button  58 ) and then proceeding to the next tooth. The system  100  is therefore able to accommodate a wide variety of examination preferences. 
     Voice Triplet Command 
     The voice triplet feature allows a user to provide multiple commands or measurements in a single spoken entry. For example when taking measurements in the periodontal mode, instead of a user saying “two” and waiting to hear audio feedback, saying “one” and waiting for audio feedback, and then saying “two” and waiting for audio feedback, the user could simply say “two one two” and the system  100  would parse those measurements simultaneously and repeat back “two one two” to the user. This enables a user to quickly record three pocket depths for one full side of a tooth. The system  100  is operable to process the words “two one two” as a single entry in a voice recognition dictionary, as opposed to the method described above of speaking a first measurement, receiving feedback, speaking a second measurement, receiving feedback, etc., which would be processed as multiple entries in the voice recognition dictionary. Thus, entry speeds can be improved on the order of three times. The voice triplet feature is also applicable to other exam types, including Free Gingival Margin (“FGM”) and Muco-Gingival Junction (“MGJ”), etc. 
     The voice triplet command feature provides an opportunity for reducing the duration of a periodontal exam. For example, when entering data using a keyboard, a data entry speed may be between 70-90 tests/numbers per minute as compared to 30-40 tests/numbers per minute for voice commands. With this feature, the voice command speed may be between 80-110 tests/numbers per minute, making voice entry as fast as, if not faster than, the keyboard entry. 
     Feedback 
     The system  100  is operable to provide feedback in response to voice commands. As described above, in the periodontal mode a user could record measurements by speaking, for example, “two three two” and the system  100  could repeat back to the user “two three two” to confirm that the measurements were correctly received. The feedback speed could be altered to provide feedback as quickly or as long as desired. For example, a user could configure the system  100  to accept 30 measurements per minute. The feedback provides immediate validation to all modes of entry, and helps prevent data entry errors prevalent in the prior art. 
     Sample Voice Commands 
     The following is a sample series of voice commands in the periodontal mode: “Auto Advance ON, Pocket, 2, 1, 2, Flip, 2, 3, 1, Flip, FGM.” This series of commands would turn ON the auto advance feature (see button  56 ), would indicate a pocket examination (see exam type selector  94 ), would indicate measurements “2 1 2” for a first side of a tooth, and would indicate would flip the tooth, and would then indicate measurements “2 3 1” for a second side of the tooth. The FGM type examination would then be selected. 
     Other Periodontal Features 
     The exam focus window  14  includes a plurality of other options and features that will now be described. Referring to  FIG. 3 , the percussion button  70 , the clefting button  72 , the MAG button  74 , and the suppuration button  76  may be used to indicate percussion, clefting, MAG, or suppuration of a tooth. 
     The tooth reset button  84  resets all measurements for a tooth so that a user may provide a new set of measurements or clear an erroneous set of measurements. The stop button  78 , pause button  79 , and continue button  80  may be used to interrupt a session, or to continue the session. The previous button  59  and next button  60  may be used to advance to a consecutive or previous tooth. The tooth display area  82  illustrates a magnified active tooth  16  and gum line  17 . The note button  84  may be actuated if a user wants to make a note about an active tooth. A directional arrow  92  may be used to indicate a direction of the sequence (i.e. which tooth is to be measured next). A marker  93  may be used to indicate which of the three measurements on the tooth is the current measurement (i.e. the measurement currently being recorded). In the example of  FIG. 2 , the marker  93  indicates that the third measurement is the current measurement. In the example of  FIG. 3 , the marker  93  indicates that the first measurement is the current measurement. 
     A visual numeric feedback display  88  visually indicates a recorded measurement or plurality of measurements of the active tooth. Tooth rotation buttons  90 ,  92  may be used to indicate that a tooth is angled (which can affect depth measurements). If a user rotates a tooth using the buttons  90 ,  92 , the rotation would also be shown in the exam overview window  12 . A user can also indicate if a tooth is impacted using the user interface. If a user indicated that a tooth was impacted, the tooth would be illustrated as impacted in both the exam overview window  12  and the exam focus window  14 . In one example, if a user designates a tooth as impacted that tooth is omitted from the auto advance sequence, as no depth measurements can be made for an impacted tooth. A user could also zoom, pan, or move a tooth. For example, a user could click and drag a tooth to move the tooth in either the exam overview window  12  or the exam focus window  14 . Also, a user could magnify a tooth, and then click and drag the tooth to pan the tooth in the magnified view. An exam type selector  94  may be used to choose different types of examinations. 
     As discussed above, the frame  19  is a border around a tooth  16 ,  18  that enables the user to quickly locate the tooth. The frame  19  helps to avoid misnumbering (e.g. a user is less likely to be mistaken about what tooth is active). The frame  19  is particularly useful when a user is not particularly close to the display  110 ,  112  and when a patient has teeth are moved and/or rotated. 
     Users have the ability to turn ON or OFF the gum line  17 , the ruler  21 , and the frame  19 . Users also have the ability to print any screen and save it as a PDF report. 
     The system  100  provides key reports and associated structure and ability to select any combination to print or save, including reports with the PSR score. 
     Restorative Mode 
     As discussed above, the system  100  has both a periodontal mode and a restorative mode, and these modes may be toggled by selecting buttons  130 ,  132  (see, e.g.,  FIG. 2 ). In the restorative mode a user may enter data regarding tooth treatments (e.g., root canals, bridges, dentures, etc.) and conditions (e.g., missing teeth, impacted teeth, cracked teeth, etc.) Various features of the restorative mode will now be discussed. 
     Restorative Mode Features 
     Referring to  FIG. 5 , in the restorative mode, areas of concern may be indicated using a marker  150 . Thus, if a user is concerned about a particular area of a tooth and wants that area to be monitored, button  152  can be selected to create a tooth watch marker  150 . 
       FIG. 6  illustrates examples of the windows  12 ,  14  in the restorative mode. As shown in  FIG. 6 , if a missing tooth  143  in the window  12  may be shown as a missing tooth  143  in the exam focus window  14 . 
       FIG. 6  also illustrates a root selector  146 . In the restorative mode, it may be necessary to indicate a relevant root of a tooth. For example, if a dentist performs a root canal, it would be desirable to indicate which root of a tooth was operated on. The root selector  146  enables a user to perform such an indication. In one example the root selector  146  dynamically changes in response to which tooth is actively selected. 
     In response to a single-rooted tooth, the root selector  146  indicates only an “R” for root. In response to a two-rooted tooth, the root selector  146  indicates either L and F buttons (for a tooth having a lingual/facial orientation), or M and D buttons (for a tooth having a mesial/distal orientation). In response to a three-rooted tooth, the root selector  146  indicates M and D and L buttons (for mesial, distal, lingual). 
     As shown in  FIG. 6 , a user may select buttons  160 ,  162 ,  164  to switch between a “pre-existing” view in which pre-existing teeth treatments can be viewed, a “treatment plan” view in which proposed treatments can be viewed, and “completed work” view in which completed procedures can be viewed. The “pre-existing” view may be used to reflect patient tooth information as it exists when the patient sits in the dental chair. That is, this view may include work performed in previous dental visits to a dentist using the system  100  or to previous visits to other unknown dentists. 
     Exam Focus Window: Restorative Mode 
     Referring again to  FIG. 5 , the exam focus window  14  is illustrated in the restorative mode. In this mode a plurality of treatments  134  (e.g., restore, crown, extract, root canal, bridge, etc.) and a plurality of conditions  136  (e.g., missing, impacted, cracked, etc.) can be selected. A tooth selector  138  may be used to select an active tooth. A tooth material selector  140  may be used to select a material. For example, if a dentist was creating a filling the material of the filling could be indicated. 
     Default materials may be entered in a material selection window  142  (see  FIG. 7 ). This can save considerable time for a user of the system  100 . For example, if a user was entering a crown, the system  100  could lookup the default crown material and enter that material without requiring a user to select the material during entry. This could save time if the user was entering data using voice commands. For example, if a default crown material was gold, a user could enter a crown on tooth  3  by simply saying “crown, tooth  2 , tooth  4 ” and the system would automatically know that gold was being used. This is in contrast to the prior art where a user would have to manually enter the crown by using a mouse to click “crown, tooth  2 , gold, tooth  3 , gold, tooth  4 , gold.” 
     As shown in  FIG. 5 , the exam focus window  14  in the restorative view includes a plurality of magnified tooth images: a facial tooth image  144 , an occlusal tooth image  146 , and a lingual tooth image  148   
     Tooth Review 
       FIG. 8  illustrates an example tooth review window  150 . The tooth review window  150  displays a restorative mode history for a selected tooth location. The history includes previous tooth conditions  153 , suggested treatments and a status of the suggested treatments  154 . The tooth review window also indicates dates  156  of previous conditions. In one example the tooth review window  150  is actuated in response to selecting a button  158  in proximity to an active tooth (see  FIG. 6 ). The tooth review window enables a user to quickly obtain a history for a specific tooth. This feature is quite helpful, as it avoids the need for a user to parse through data for all teeth when only a single tooth is of concern. 
     Treatment and Insurance Plans 
       FIG. 9  illustrates an example “treatment plan” view (note that button  162  is selected) in the restorative mode. In this view, a first portion  166  of the exam overview window  12  illustrates a first proposed treatment, and a second portion  168  of the exam overview window  12  illustrates at least one of a second proposed treatment or existing conditions. A frame  19  having a dotted line border may be used to indicate teeth which have proposed or planned procedures. 
     The treatment plan view may be used to discuss potential and performed treatments with a patient, and to help a patient understand the costs associated with a treatment. Each portion  166 ,  168  includes a total cost  170 , an insurance cost  172 , and a patient out-of-pocket cost  174 . As shown in  FIG. 7 , a dentist is recommending that a patient perform work on teeth  6 - 7  and  12 - 13  in a first plan (see portion  166 ) and is recommending that the patient have tooth  2  removed and have work performed on teeth  7  and  12  in a second plan (see portion  168 ). In one example, when a user enters a proposed treatment the user enters a predefined treatment code that can be submitted to an insurance company or an insurance database to determine an insurance coverage amount. In this example, codes put forth by the American Dental Association (“ADA”) or equivalent codes may be used. 
     Within the treatment plan view, a user may select between a “teeth view”  500  (see  FIG. 9 ) or a “table view”  502  (see  FIG. 9 a   ). The teeth view, as shown in  FIG. 9 , graphically illustrates treatment information using tooth images. The table view, as shown in  FIG. 9 a   , illustrates treatment information using one or more tables. 
       FIG. 10 a    illustrates a natural tooth view  176 , and  FIG. 10 b    illustrates a tooth treatment history view  178 , each of which could be viewable in the “pre-existing” or “completed work” views (see buttons  160 ,  164 ). The natural tooth view  176  uses tooth images to indicate what a tooth looks like. For example, the shading  186  on tooth  31  indicates that an amalgam filling has been created. The shading  188  on tooth  2  indicates that a gold filling has been created. Of course, instead of shading  186  a grey coloring could be used and instead of shading  188  a gold coloring could be used. The tooth treatment history view  178  using a first shading  190  to indicate procedures performed by a current dentist and uses a second shading  184  to indicate procedures performed by a previous dentist. Of course, coloring could be used in conjunction with or instead of shading. This feature could be useful for certain procedures, such as crowns, which many dentists warrant will last for a number of years (e.g. 5 years). If the procedure was performed by a previous dentist, a current dentist would not be obligated to fix the tooth for free, for example. 
       FIG. 10 b    illustrates an example completed work view  178  which illustrates work performed on a patient&#39;s teeth. The shading on  190  on tooth  31  illustrates that an external treatment has been performed. Symbol  182  indicates a defective condition on a tooth. The shading  194  on tooth  2  indicates that an internal treatment has been performed. Of course, instead of or to supplement the shading  190 ,  194 , color could be used. 
     Zooming and Panning 
     A user may zoom or pan within the exam overview window  12  if desired. In one example, if the user zooms in the exam overview window  12  and then selects a tooth in the exam focus window  14 , the exam overview window  12  will maintain a zoom level and will pan or scroll to the selected tooth such that the selected tooth may be viewed simultaneously in both windows  12 ,  14 . 
     Scalability 
     The system  100  is scalable, and may be expanded to include multiple machines operating across a wide area network. For example, a doctor could create a proposed treatment on a first computer (e.g., in the doctor&#39;s office or home). The doctor could then present the treatment on a first computer in a dental office. An administrative assistant could then transmit treatment information to an insurance company on a second computer in the dental office. Of course this configuration is only exemplary, and it is understood that other configurations would be possible. 
     Although many features of the system  100  have been described in the context of a button that may be selected, it is understood that these features and options could be activated by any of the aforementioned input modes, including, but not limited to, mouse, keyboard, Dental R.A.T., Florida probe, and voice. 
     Although a preferred embodiment of this invention has been disclosed, a worker of ordinary skill in this art would recognize that certain modifications would come within the scope of this invention. For that reason, the following claims should be studied to determine the true scope and content of this invention.