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.
Read full article here.
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.
The major updates from this conference include:
• The ADA and the Harvard-led team are working together to harmonize SNODENT and the DDS terminologies. All DDS terms will be fully included and represented in SNODENT. As such, SNODENT will be renamed SNODENT Dental Diagnostic System and will function as the full reference terminology for the dental profession. The DDS has been renamed SNO-DDS – to reflect the harmonization with SNODENT – and will function as the interface terminology for the dental profession.
• Smaller subsets of SNO-DDS are also being created to cater to the specific needs of general dentists (SNO-DDSGD), oral surgeons (SNO-DDSOS) and other sub groups. Below is a visual depiction of how the major terminologies now interact.
• SNODENT, SNO-DDS and its subsets are scheduled to go through the ANSI standards process in order to become a national standard by the end of 2016.
• To access the Speakers’ PowerPoint presentations from the March conference “Toward a Diagnosis Driven Profession,” please click here. The video presentations of the panels will be available through the AADR website (link).
• To view a partial list of all the SNO-DDS terms, please see our Browse page.
• Although the SNO-DDS is obtainable free-of-charge, as with other major terminologies (i.e. ICD, SNOMED-CT), they can also be obtained in a ready-to-upload format from PMIC (a third-party vendor) for a small transaction fee. Click here to obtain this version.
• If you would like to receive regular updates about the SNO-DDS terminology and its subsets, please sign up here via our Google forms link.
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?
For clinicians, consistent use of the SNO-DDS dental diagnostic terminology will:
- Empower them to be able to document the types and frequency of conditions they encounter
- Enhance communication between them and other clinicians thereby enabling outcomes tracking and data sharing across sites
- Allow quick access to review patient conditions and identify unclear areas
- Enhance consistent documentation and communication between the dentist and his/her patient
For epidemiologists and researchers, use of the SNO-DDS dental diagnostic terminology will:
- Allow the ability to evaluate disease patterns/determinants/outcomes of oral health
- Afford the opportunity to assess in-depth variations in oral health care, oral health care quality, costs of care and treatment effectiveness/outcomes
- Study disease trends over time, make predictions and recommendations
- Design preventive or palliative interventions where necessary
For students, consistent use of the SNO-DDS dental diagnostic terminology will:
- Help hone their diagnostic skills. Studies have also shown that arriving at a diagnosis before planning a treatment significantly increases the quality of the treatment plan and ultimately patient care
- Help structure a systematic approach to rendering dental treatment to patients
- Allow for intelligent discussion of diagnosed dental conditions, study trends and gain insight into effectiveness of different treatment outcomes based on similar diagnosis
For administrative/top executive-officers, use of the SNO-DDS will:
- Be an essential quality improvement tool measures
- Be useful in making informed decisions and policy investment/strategies e.g. sponsoring preventive oral healthcare campaign, making recommendations of better clinical practice when treatment outcome failures are rising or reducing etc.
For patients, use of the SNO-DDS will:
- Facilitate self-learning of their conditions and disease
- Facilitate communication with their dentist and specialty providers
- Facilitate communication with their primary care physician regarding their dental and oral health conditions
- Augment relationship between referring providers thereby minimizing errors