We have just recently found that when we have patients who have grown and no longer have primary dentition, when we change to the permanent dentition in charting, and then complete a filling, the filling doesn't show up in the charting. It shows in the ledger, and record of treatment, but not on the actual chart. Any idea how this can be fixed? Are we missing something?
I'm going to be working under a couple of assumptions to answer this question. I'll note those assumptions as I go.
The way that the charting module displays the graphics, especially in regard to switching from primary to secondary teeth, or vice-versa, is that the switching of dentition actually reset the graphics on the tooth under the assumption that it's a new tooth in that space now, so previous work, even if it the codes were entered in under the correct tooth indicator, will no show graphically.
With that, my assumption is going to be that the work on the tooth was entered prior to telling it to switch from primary to secondary.
This could have happened either bc they entered the work on the chart and then realized that this tooth needs to be secondary now, and then hit the secondary button. This would 'reset' the tooth and hide the work done before the transition not show bc it's timestamp is older.
It can also happen if work in the tx plan was marked completed before hitting the secondary button for that tooth.
it can also happen if the checkout was done for that tooth, and then someone went back in to the chart and changed the tooth to secondary.
These three scenarios would make the system see the transition to it being a secondary tooth happen after the work for that tooth was entered.
If you were to go to the progress note for that tooth you would see all entries there. but you'd see the entry for changing to secondary on top of the work. At this point, you would just need to do a correct entry on the changed to secondary entry and change it's date to be older then the date the work is showing entered as. Making sure that date is far enough back to come before all work done as a secondary tooth.
This would then make the graphics show correctly, as it's 'reset' would then fall at the date it was backdated to.
If you have any questions please let me know.
FYI - the easiest solution we've found for this is to highlight all the teeth in the chart, change them to secondary in "other office" and then backdate it to when the patient turned 14 (approximately when all primary teeth have been shed).