From ADA News: “Newly approved standard enables electronic capture of patient diagnoses”

Dec. 7, 2016
Two SNODENT subsets were submitted along with SNODENT through the ADA’s American National Standards Institute-accredited standards development process: the SNO-DDS (Dental Diagnostic System) subset and the SNO-DDS General Dentistry, a subset developed for general dentistry.
To develop the two subsets, SNODENT was harmonized with the Dental Diagnostic System, formerly known as the EZCodes, a diagnostic dental code set with a collection of approximately 1,500 dental terms. The smaller SNO-DDS General Dentistry subset provides an easily implemented code set that satisfies the majority of needs for general dentistry.
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DDS becomes SNO-DDS in harmonization with SNODENT

In March 2016, dental and informatics leaders and researchers from across the United States and beyond gathered in Los Angeles, CA to discuss the future of dental diagnostic terminologies and the challenges and opportunities presented by current and potential systems. Stakeholders from the Government, Dental Professional Organizations, Insurance, EHR and Academic Institutions came together for a full day of presentations and brainstorming.

Please see our event recap and session slides for more information, or click below to expand this post.

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What is SNO-DDS?

SNO-DDS, formerly known as The Dental Diagnostic System (DDS), and before that as the EZCodes, consists of about 1700 terms organized into 106 subcategories and 17 major headings. It is a:



A common and consistent language



Specifically created for and applicable to the field of Dentistry



Related specifically to diagnoses



Contains concepts at the appropriate granularity required by oral health providers


SNO-DDS, a standardized diagnostic dental terminology, is a collection of specific dental terms that is designed for the purposes of dental diagnosis documentation. It currently consists of about 1500 unique terms, carefully organized to make diagnosis entry an easy and standardized task.
The development of the original DDS terminology was a product of a work-group of domain experts. The task was to brainstorm on current diagnostic thinking and form the rudiments of the dental diagnostic terminology. The basic structure of the terminology initially developed incorporated the skeletal structure of Z-codes (a small diagnostic terminology in place in two US dental schools). Essentially, the first version of the DDS developed amalgamated diagnostic terms certified and approved by dental specialists (Endodontics, Periodontist), Z – codes and from International Classification of Diseases (ICD) terms. This was subjected to another round of reviews by domain experts and the Consortium of Oral Health-Related Informatics (COHRI). With COHRI’s approval, the first version of DDS was completed.
Up until recently, Dentistry did not possess a standardized tool for documenting diagnoses of oral health-related conditions. This is not to suggest that dentists don’t make a diagnosis. As is the standard clinical practice in medicine, diagnosis should be clearly recorded after thorough clinical examination and investigation and before treatment planning and actual treatment. Dentistry as a sub-specialty of medical practice should not deviate from the standards of clinical precepts.
Standardized dental diagnostic terminologies bring to light good clinical judgment of providers, allow for systematic ordering of care, and serve as a good source of data for clinical/public health research and care outcomes measurement through quality related queries etc. With the majority of dental schools in the USA using the same electronic health record system (AxiUm, Exan, Vancouver, Ca.), Dentistry is strategically poised to utilize the full potential of EHR. The benefits of this include ensuring all dentists-in-training (dental students and specialty trainees) imbibe the culture of efficient and effective use of a standardized dental diagnostic terminology; and the combination of clinical data across clinics and sites.
In working closely with the ADA, the DDS was harmonized with SNODENT, to form the SNO-DDS (interface) terminology. At the end of this harmonization process, all applicable DDS terms will be fully included and represented in SNODENT. This process also implies the retirement of some DDS terms and inclusion of several SNODENT terms into SNODDS that were not originally in the DDS terminology. SNODENT will remain the full reference terminology for the dental profession. The DDS (now renamed SNODDS) will be the interface terminology for the dental profession. A smaller subset of the SNODDS is also being generated to cater to the specific needs of general dentists (SNODDS-GD). All of these have been put through the ANSI standards process in order to become a new national standard, endorsed and maintained by the ADA and DDS teams. SNODENT will be also be renamed to “SNODENT Dental Diagnostic System” to reflect this harmonization.
SNO-DDS allows the dentists to have a practical terminology chair-site that is fully integrated with the large reference terminology SNODENT, which is part of the medical reference terminology SNOMED. The figure below shows the relationship of the SNO-DDS with SNOMED and SNODENT. The small refset developed for just general dentistry, SNO-DDSGD, contains only diagnostic terms related to general dentistry, and might be useful for small practices that employ a few general dentists.


Why use a dental diagnostic terminology?


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+ Benefits for Patients