NHS Prototype Base Charting

A base chart must be completed for all patient Assessments to include:

The state of the tooth
The state of the tooth surface
Caries present
Un-erupted/missing teeth

The system will then calculate a DMF (Decayed/Missing/Filled) score from the base chart data. The NHS requires you to review and manually edit before confirming that it is complete and accurate.

The information is transmitted through to the Board and to the Department of Health. For NHS Pilot/Prototype practices base charting is particularly important because it is used in two automated processes:

EXACT automatically feeds the base chart data into the Full Risk Assessment, which a clinician runs after patient assessment.
EXACT automatically transmits base chart data to NHS Dental Services.

Please ensure that all clinical staff in the practice understand how to base chart in EXACT.

Base charting Caries

Use the following CP-codes to enable proper system calculations:

CP-CARARR Arrested Caries Present

CP-CAREAR Early Caries Present

CP-CAREST Established Caries Present

NOTE: The decayed teeth calculation on the DMF will look only at teeth with Established Caries.

Base charting un-erupted teeth

Do not use the missing tooth service as

it will cause incorrect calculation of the DMF, and
it will then need to be voided once the tooth erupts.

Use the following to enable proper system calculations:

ERUPT-EXFOL (Unerupted or exfoliated teeth)

This will turn the tooth outline on the chart grey and show as un-erupted in the Base Charting history.

When the tooth erupts, base chart it again using the same code. You may see a screen prompt asking if you want to void the original service. Answer NO if the tooth is newly erupted - this will change the tooth frame to black and mark the tooth as Erupted in the base charting history.

Base charting deciduous teeth

Use the same ERUPT-EXFOL code and procedures as for un-erupted teeth (above). The deciduous tooth will disappear entirely from the chart. If you mark it as erupted again, the tooth will appear again on the chart with the regular black outline.

To start the Full Risk Assessment and edit the DMF calculations

When you complete base charting, check (tick) CP RISK-F Full Risk Assessment to run the Full Risk Assessment Wizard:

The DMF screen shows calculated scores from your base charting and enables you to adjust them.

IMPORTANT:

It is compulsory that you review these scores, edit them where necessary and check (tick) to confirm that this is a complete and accurate record.
Be aware that the system cannot distinguish between a permanent or temporary filling with the same code. For example, if you've filled a carious tooth with a temporary filling, it may not show in the decayed section of the DMF at the subsequent review, even though the tooth still has decay present. In this case you need to manually adjust the score on the DMF screen - if you fail to do this, the record will be inaccurate.
Changing the scores on the DMF screen does not retrospectively change the base charting on the tooth chart.
The DMF will adjust automatically if a tooth with base-charted Caries is subsequently restored.

Customising a Base Charting Service

If none of the delivered codes are appropriate you can customise a service, but you need to follow some guidelines so that the software can calculate the DMF.

To customise a service item for use in NHS base charting

Go to Configure > Services...

In the Service list, locate and double-click the service that you want to customise, to open the Edit Service Item window:

First check that the service item has an appropriate Chart Graphic from the dropdown list.
The selection is important because the NHS Pilot Category field options (in the next step) are determined by this graphic.
Select the most appropriate NHS Pilot Category from the options in the dropdown list.
If none are appropriate, select Other:
Select OK to finish.