Who is talking, and why it is fast
During an examination the dentist or hygienist, the operator, has both hands in the mouth: a mirror in one and an explorer or probe in the other. They cannot write, so they speak. The assistant or a second clinician records each finding as it is called. The operator does not wait for you. They move from tooth to tooth at the pace of the exam, and a good recorder keeps up without asking for repeats. That is the skill this site drills: hearing a short, compressed phrase and turning it into a correct chart entry without stopping to think about the parts.
The order of an exam
Most operators call a mouth in the same order the Universal system numbers it. They start at the upper right third molar, number 1, work across the upper arch to number 16, drop to the lower left third molar, number 17, and come back along the lower arch to number 32. Teeth with nothing to report are skipped. So a chart is usually called in rising numbers, and if you hear 14 you can expect the next callout to be 14 or higher. ChartCall plays every case in this order. When an operator jumps back, it is usually to add something they missed, and they will say the tooth number clearly when they do.
The three parts of a callout
Almost every callout carries three pieces of information:
- The tooth. A number from 1 to 32, or a letter from A to T for a primary tooth.
- The surfaces, for anything that sits on part of a tooth, such as a filling or a lesion.
- The material or condition: amalgam, composite, caries, a crown, a missing tooth.
ChartCall grades each of these separately and tells you which one you missed, because they go wrong for different reasons. A wrong tooth is usually a counting slip or a mirror image across the arch. A wrong surface is usually a mesial and distal mix up. A wrong material is usually a word you did not expect.
Number first or finding first
The same finding can be said several ways. All of these mean the same chart entry:
Number 3, MOD amalgam
3 MOD amalgam
MOD amalgam on number 3
Number 3, mesial occlusal distal amalgam
Most operators settle into one habit, usually the tooth first, but many switch when they are adding a detail or correcting themselves. The word "number" is often dropped once the exam is under way. The drills in this site mix the phrasings on purpose, so the order stops mattering to you.
Surfaces, and how they combine
Each tooth has five surfaces. On a premolar or molar they are mesial (M, toward the midline), occlusal (O, the chewing surface), distal (D, away from the midline), buccal (B, the cheek side) and lingual (L, the tongue side). On an incisor or canine the chewing surface is an edge, so O becomes incisal (I), and the outer surface is called facial (F) instead of buccal. If you mark O on a front tooth in ChartCall, it is read as I, and B is read as F, so you are never marked down for using the back tooth letter on a front tooth.
A filling that covers several surfaces is one restoration, charted once with all of its surfaces. MOD is one filling across mesial, occlusal and distal, not three fillings. The letters are written with the mesial first and the distal last when both are there, so you hear MO, DO, MOD, MODB and MODBL. When only one side is involved the proximal surface still leads: DO, not OD. A single surface is usually said as a word, "occlusal composite" or "buccal amalgam", and two or more are usually spelled as letters, "M O D".
Mesial and distal are the most common surface misses. Mesial always faces the midline of the arch, which is between the two central incisors. On a chart the patient's right side is drawn on your left, so for teeth 1 to 8 and 25 to 32 the mesial surface is on the right of each tooth diagram, and for teeth 9 to 24 it is on the left. If that feels backwards, picture yourself facing the patient.
Materials and conditions
Existing work is named by its material: amalgam (some operators say alloy), composite (or resin), glass ionomer, gold inlay or onlay, a temporary. Crowns are named by what they are made of, and the abbreviations are spoken as letters: a PFM crown is porcelain fused to metal, an SSC is a stainless steel crown. Whole tooth findings need no surfaces: missing, implant, root canal (RCT, or endo), sealant, pontic, pulpotomy.
Findings that need treatment or attention are usually called with the word that says so: caries or decay, recurrent decay under an existing filling, fractured, to be extracted, watch. Many charts record these in red and existing work in blue or black, so the treatment plan stands out. ChartCall draws them the same way, and gives every mark its own shape as well, so nothing depends on colour alone. The glossary lists every finding with its abbreviation and the other words you may hear for it.
Two findings on one tooth
A tooth can carry more than one finding, and each is called on its own. A root treated molar with a crown is two callouts: "number 19, root canal" and then "number 19, PFM crown". A bridge is called one unit at a time: the crowned teeth on either side, the abutments, as crowns, and the replaced tooth in the middle as a pontic. A missing tooth, though, carries nothing else, and an implant replaces the tooth it stands in for.
Primary teeth and mixed dentition
Primary teeth are lettered A to T along the same path: A is the upper right second primary molar, J the upper left, K the lower left and T the lower right. Because a letter on its own is easy to mishear, operators usually say "letter A" or "tooth A" rather than just "A". The findings that come up most with children are sealants, stainless steel crowns and pulpotomies. A pulpotomy and a stainless steel crown are usually called together on the same molar; a sealant goes on a different, sound tooth, not under a crown.
FDI numbering
Outside the United States, and in some programs, teeth are numbered in the FDI two digit system. The first digit is the quadrant, 1 to 4 for permanent teeth and 5 to 8 for primary, and the second counts back from the midline. Universal 3 is FDI 16, and it is said "one six", never "sixteen". Switch the drills to FDI with the numbering toggle and both the chart and the spoken callouts follow. The full conversion table is at the foot of the glossary.
Keeping up
- Find the tooth first. The number comes first in most callouts, and a chart entry on the wrong tooth is wrong however good the rest is.
- Hold the surfaces as one chunk. "M O D" is one word to an experienced recorder, not three letters.
- Listen for the order of the exam. If the last callout was 14, the next one is almost always 14 or higher.
- Chart first, tidy later. If you miss a word, chart what you heard and ask for the one missing piece at a natural pause, not in the middle of the operator's sentence.
- Practise with captions on, then turn them off. Then raise the speed. The exam mode hides captions entirely.
Veterinary charting: callouts during a COHAT
In a veterinary clinic the charting happens during the COHAT, the comprehensive oral health assessment and treatment, with the dog or cat under general anaesthesia. The veterinarian probes each tooth, reads the radiographs and calls what they find, and a technician or assistant charts it. Many clinics call this four handed dentistry. The pace is the same as in a human clinic: the clinician does not wait, so the person charting has to turn a short phrase into a chart entry at once. Switch the drill, practice, exam or projection mode to the canine or feline chart with the switch at the top of the page.
Triadan numbers, and how they are said
Dogs and cats are charted in modified Triadan numbering. Every tooth has three digits: the quadrant, then the position counted back from the midline. Quadrant 1 is the right upper jaw, 2 the left upper, 3 the left lower and 4 the right lower, and 5 to 8 are the same four quadrants for deciduous teeth. The canine tooth is always 04 and the first molar always 09, so 104 is the right upper canine and 309 the left lower first molar. A cat has fewer premolars than a dog, but the missing positions are skipped rather than renumbered: a cat has no 105, and its lower premolars are 307 and 308.
The number is said as the quadrant and then the position. 104 is "one oh four", 309 is "three oh nine", 110 is "one ten" and 411 is "four eleven". Most clinicians say the number first and leave out the word tooth, but some name the tooth instead: "left mandibular first molar, furcation two" means 309. ChartCall mixes these, so you learn to hear both.
One oh four, fractured, pulp exposed
Three oh nine, mobility two
Complicated crown fracture on 104
Left mandibular first molar, furcation two
The order of a veterinary chart
ChartCall plays each patient in Triadan order: quadrant 1 from 101 back to the last molar, then quadrant 2, 3 and 4. Some clinics go round the mouth instead, following the arch from the right upper molars to the left, then back along the lower jaw. Either way a clinician rarely jumps about, and when they do they say the number clearly.
Grades and scales
Much of a veterinary chart is a grade on a scale rather than a material: mobility 1 to 3, furcation 1 to 3, calculus index 1 to 3, gingival index 1 to 3, and tooth resorption stages 1 to 5. The grade is said as a word, "mobility two", and written as a number. ChartCall grades the tooth and the finding separately as it does for human teeth, and when the finding is right but the value is not, it says so: "Grade: you charted mobility 1, the callout was mobility 2." Furcation is only charted on a tooth with two or more roots, so a canine tooth or an incisor never has one.
Surfaces on a dog or cat tooth
Veterinary charts name surfaces a little differently. The outer surface is labial on incisors and canines and buccal on premolars and molars. The inner surface is palatal on every upper tooth and lingual on every lower tooth. Mesial and distal work as they do for people. Only teeth with a true grinding surface have an occlusal surface, which in ChartCall means the dog's molars. Surfaces are usually said as words: "three oh nine, buccal gingival recession". On the chart, press B for labial or buccal and L or P for the inner surface; ChartCall puts it on the surface that tooth has.
Fractures, resorption and baby teeth
A fractured tooth is called by whether the pulp is exposed, because that decides the treatment. "Fractured, pulp exposed" or a complicated crown fracture needs root canal treatment or extraction; "fractured, no pulp exposure" is an uncomplicated crown fracture. Tooth resorption, very common in cats, is called with its stage from the radiograph. A baby tooth still present beside its adult replacement is called on its deciduous number: a persistent baby canine in the right upper jaw is 504, not 104, and the puppy or kitten cases in ChartCall are charted on the deciduous chart. When a tooth comes out during the procedure it is called as extracted, usually right after the finding that led to it.
What this site is and is not
ChartCall is a study aid for learning to hear and chart callouts. It is not charting software and not a clinical record, and every case in it is invented. The phrasing it uses is written to match the common patterns described above, but the operator you work with will have habits of their own, and the conventions your program teaches come first.
Last reviewed . First published .