Research abstract


British Dental Journal 206, E1 (2009)
Published online: 2 January 2009 | doi:10.1038/sj.bdj.2008.1151

Subject Categories: Computers in dentistry | Primary dental care | Team work

A preliminary model of work during initial examination and treatment planning appointments

J. Y. Irwin1, M. H. Torres-Urquidy2, T. Schleyer3 & V. Monaco4

  • Dental team members have multiple, often overlapping roles. They use a large and varied collection of equipment and technology to complete complex tasks.
  • Technology often interrupts the workflow, causes rework and increases the number of steps in work processes.
  • Current dental software could be greatly improved with regard to its support for all areas of the workflow process.


Objective This study's objective was to formally describe the work process for charting and treatment planning in general dental practice to inform the design of a new clinical computing environment.

Methods Using a process called contextual inquiry, researchers observed 23 comprehensive examination and treatment planning sessions during 14 visits to 12 general US dental offices. For each visit, field notes were analysed and reformulated as formalised models. Subsequently, each model type was consolidated across all offices and visits. Interruptions to the workflow, called breakdowns, were identified.

Results Clinical work during dental examination and treatment planning appointments is a highly collaborative activity involving dentists, hygienists and assistants. Personnel with multiple overlapping roles complete complex multi-step tasks supported by a large and varied collection of equipment, artifacts and technology. Most of the breakdowns were related to technology which interrupted the workflow, caused rework and increased the number of steps in work processes.

Conclusion Current dental software could be significantly improved with regard to its support for communication and collaboration, workflow, information design and presentation, information content, and data entry.

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  1. PhD Students, Center for Dental Informatics, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, USA
  2. PhD Students, Center for Dental Informatics, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, USA
  3. Associate Professor and Director, Center for Dental Informatics, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, USA
  4. Assistant Professor, Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, PA, USA

Correspondence to: J. Y. Irwin1 333 Salk Hall, 3501 Terrace Street, Pittsburgh, PA 15261, USA
e-mail: rey3@pitt.edu



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