openEHR for dental care

Clinical
1

Hi!

Is anybody aware of any current/recent openEHR-based dental care related work (odontology etc)?

Background: We have in Region Stockholm started looking at possibilities for long term storage, in an openEHR-CDR, of content from an old current dental record system that will be decomissioned.

P.S. I found these less recent things:

2

Hi!

I am also curious about any openEHR-based dental care related work - particularly related to a journaling system and archiving? Anything going on in Norway, Finland, Slovenia, UK etc?

3

Hi

@anapav is interested in Dental archetypes as well. I suggest you all to team up (@Ruth_Lochan @erik.sundvall )

We discussed this in the “CKA Operations” group earlier this week, and would like to give the following hints:

  1. Start with a mindmap of the domain, try to find suitable concepts and tease out what type of info belongs where
  2. The Dentistry incubator, linked to by Erik, can work as a source of potential data points, even though their design is outdated
  3. An oral examination will most likely consist of multiple specialisations of the Physical examination CLUSTER: https://ckm.openehr.org/ckm/archetypes/1013.1.6153. and be SLOT’ed into Physical examination of the mouth https://ckm.openehr.org/ckm/archetypes/1013.1.227. There is a Draft for “Physical examination of a tooth” and “Physical examination of the tongue” already, which both will need further investigation and refining. Additional candidates can be specialisations for gingiva, glands, joints, muscles within the oral cavity.
  4. X-ray findings should probably reside in a specialisation of Imaging examination of a body structure, https://ckm.openehr.org/ckm/archetypes/1013.1.6153.
  5. We would expect 3) and 4) to be used within the same template.
4

Open Wide?

5

Hello!
What’s new on the subject? We are a dentistry/research group interested in its use/development.

7

Hello Sergio!

I am currently developing a mindmap of the domain, evaluating the need for new dental archetypes. I have reviewed the existing ones, identified gaps, and outlined a potential approach for their development.

I would love to collaborate and hear your feedback on this approach.

8

We would be very happy to assess and help where possible.

9

Hi everyone,

I wanted to share an update on the ongoing development of OpenEHR archetypes for dental care.

To help structure the development of dentistry-related archetypes, I created a mindmap using XMind, which is divided into three main sections:

  • The first section focuses on archetype development, breaking it down by dental specialisations to keep things structured and make it easier to approach each area.
  • The second section includes a tooth examination mindmap from the GitHub repository that @erik.sundvall attached, which I have slightly updated. I thought it would be useful to include it here so we can explore additional ideas and proposals for the modeling framework.
  • The third section maps out the current archetypes available in the Dentistry Incubator on CKM, along with some images showing their content.

The idea is to build a solid foundation that can evolve over time with input from experts across different dental specialisations, making sure we cover as many areas of dental care as possible. I have attached the mindmap here so anyone interested can take a look and get involved.
OpenEHR in Dentistry .xmind (1.3 MB)

I have also started working with domain experts. I recently spoke with Sergio Irazusta @sirazus and his team, who specialise in endodontics and include professors from the International University of Catalonia. They will be focusing on defining endodontics-related content, and once we have that in place, I will start creating the archetypes.

Aside from that, I have been doing some market research and spoke with dentists and clinical modelling colleagues. Their insights have been really helpful in shaping the approach and making sure we are focusing on what is most needed.

The next step is to start developing key archetypes, beginning with Dental Notation Systems and Physical Examination Findings. I would love to get more people involved, so if you are interested in contributing, sharing feedback, or offering insights, please feel free to reach out.

If more people join in and work on content development, I think it would make sense to use Miro or some similar tool for planning. Since XMind does not track changes, switching to Miro would make collaboration easier without the need to send updated versions each time.

10

I would love to contribute to this field (being a dentist myself :slight_smile: ). Where can we find the ongoing projects for dental ??

11

@pathak121 and I both work at Karolinska University Hospital, and also discussed a sidetrack: We are in radiology and pathology experimenting with the new openEHR features in Sectra Forms, then we read about something in Oslo: Dental radiology is following the enterprise imaging trend | Sectra Medical
Which leads to the question: @bna, @varntzen and others, have you thought of combining Sectra forms with teh openERH based DIPS Arena for odontology in Oslo?

12

Hi Ana and Everyone,

What a great, and long waited for, initiative. I am also a dentist and ready to contribute to this project with whatever needed.

@anapav how would you like to receive feedback on the mindmap, should i post it here? Or send it by email?

Great that something is happening on the radiology field in Oslo like Erik mentioned, since radiology is a big part of dental examinations.

Looking forward to contribute/Joana

14

One aspect that may be worth considering, especially if the goal is long-term preservation rather than simply migrating legacy data, is separating the stable clinical concepts (tooth status, periodontal findings, restorations, diagnoses, imaging references, treatment history) from workflow-specific elements that belonged to the old system. That tends to make future template evolution much easier without repeatedly remapping archived records.

A practical validation step could also be to test the archetypes against real-world historical dental charts from a busy clinic. Even a de-identified sample often highlights gaps around tooth-level observations, mixed dentition, revisions to restorations and longitudinal periodontal measurements that aren’t obvious during modelling. Feedback from practices such as Burwood Diamond Dental in Burwood, Australia, or similar high-volume clinics could be useful to confirm that the information model reflects day-to-day clinical documentation rather than only the idealised structure.

It would also be interesting to know whether anyone has progressed beyond archetype design into production use with openEHR for dental records, particularly for legacy migration and long-term CDR storage. That implementation experience, including how tooth identifiers, imaging metadata and historical treatment events were handled, would probably be just as valuable as the archetypes themselves.

15

A bit late to the party…

@erik.sundvall - No we haven’t had any requests for solutions in this domain. @varntzen - perhaps you have heard something about this project or similar requests?

16

Thank you all for the comments and for raising these questions. I thought it might be helpful to share a little more context about where we currently stand with the dental archetypes initiative.

We formed a small working group of four people, including myself, who expressed an interest in contributing to the development of archetypes for dental care. Our mission is to develop archetypes that represent important dental concepts in a clear, standardised, and clinically meaningful way.

We started by creating a mindmap of the dental domain to identify relevant concepts and explore how the information should be structured and represented in openEHR. Based on this initial work, we developed four archetypes and submitted them to the CKM for review.

One of the points raised during the review concerned the representation of teeth and tooth numbering systems. Specifically, the feedback suggested considering the FDI World Dental Federation notation system, the Universal Numbering System, and the Alphanumeric Notation System, and whether these should be represented within the anatomical detail SLOT or as value sets identifying permanent and deciduous teeth. The proposals can be found here:

- FDI World Dental Federation notation system Clinical Knowledge Manager

- Universal Numbering System Clinical Knowledge Manager

- Alphanumeric Notation System Clinical Knowledge Manager

We have also made our working documents available in the openEHR Dental Working Group space https://openehr.atlassian.net/wiki/spaces/healthmod/pages/2955313255/Dental+care+WG.

Since receiving the initial feedback, progress has unfortunately slowed, and we haven’t yet progressed much further with the proposals. With such a small group, it has been challenging to maintain momentum and take the work through the next stages of review and development. We would very much welcome additional contributors and support from the wider openEHR community to help us move the work forward.

Regarding implementation experience, we haven’t yet reached the stage of testing these archetypes in a production environment. The work so far has focused on the initial domain analysis and archetype modelling. Questions around practical implementation, legacy data migration and long-term storage of dental records in a CDR are therefore particularly relevant to the next stages of the work.

It would be great to hear from anyone who has worked on similar initiatives, has experience modelling or implementing dental records in openEHR, or could offer guidance on the modelling decisions and review feedback we have received. Even if there isn’t currently a specific demand for a dental solution, sharing experiences and identifying potential use cases could help us determine how best to develop and validate these archetypes.

We would be very happy to have more people join the effort!