Two-Handed Case Creation: How Dental Assistants and Doctors Work Together on Cympha
This cookbook follows the assistant and the doctor through one case, step by step, up to the moment it reaches the lab through dental lab case management software.
Most general dental practices run on two pairs of hands. The dental assistant greets the patient, takes the photos, captures the scans, and prepares the chair. The doctor walks in already half-briefed, examines, decides, and dictates the plan. The hardest software design problem in dental practice is matching those two roles — letting each person work on the part they actually own, without re-typing each other's work.
Cympha is built around that division. The DA opens the case and prepares the inputs. The doctor walks in and finds everything loaded.
Here's the action sequence end-to-end.
Before the patient arrives
The DA has the next appointment's name in the schedule. From the Cympha dashboard:
- Click "New Clinical Case."
- Enter patient demographics — name, date of birth, contact info, optional PMS ID for cross-reference with the existing practice management system.
- Type the chief concern in the patient's own words, as recorded in the booking notes ("aching back tooth for three days").
- Open the chair.
The case row is now reserved as a draft. Anything attached from here onward — photos, scans, files — lands on this case automatically, including uploads from a phone via QR.
In the operatory — the DA's hand
The patient is seated. The DA's job for the next ten minutes is to capture everything the doctor will need to look at.
- Intraoral photos — taken with the chair-side camera, the tablet, or a phone via Cympha's "Upload by Phone" button. The DA clicks Upload by Phone, scans the QR code with the practice phone, takes 8–12 standard intraoral views, and submits. The photos appear in the case file list within seconds, with thumbnails.
- Extraoral / smile photos — same QR flow, same destination.
- Radiographs / scans — usually imported from the panoramic / CBCT machine or the intraoral scanner. If the practice runs the Cympha Agent, File Monitoring watches the export folder and its subfolders and raises a "Cympha Agent — New files" toast when something new appears; clicking it opens a popup that lists each file and offers Create a Case or Ignore. To add files to a case that already exists, the DA drops them on the case dropzone in the browser.
- Existing records — if the patient is referred or returning, the DA drags any existing files (referral letters, prior x-rays, old CBCTs) onto the case dropzone.
- Verbal history — the DA enters anything the patient mentions while sitting down — medications they remembered, recent dental work, pain triggers — into the Clinical Notes section. This is just a free-text scratchpad at this stage; the doctor will refine it.
By the time the DA steps aside, the case has:
- Patient demographics
- Chief concern
- 8–12 photos
- Any scanner / radiograph files
- Initial clinical notes
The doctor walks in and sees all of it in one glance.
In the operatory — the doctor's hand
The doctor examines the patient. While examining, they speak — either to the patient, or for the case record. There are two patterns:
Pattern A — type as they speak. The doctor sits at the chairside laptop, clicks Add consultation, picks the template that matches the chief concern (General, Endodontic, Oral Surgery, Implant, Aligner, DSD, Periodontal, Pediatric, TMD, Oral Medicine, Restorative, Sleep Apnea, Pre-prosthetic, Geriatric — 14 templates ship today), and types directly into the Clinical Notes section.
Pattern B — dictate, DA scribes. The doctor speaks, the DA types into the same fields. Same outcome, just different hands on the keyboard.
Either way, the doctor adds:
- Examination findings into Clinical Notes
- Their working diagnosis into Diagnosis Notes
- Selects the relevant photos and records into the consultation's Records section (multi-select; the DA's earlier captures are right there)
If the doctor decides mid-exam that they need an extra photo or angle, the DA can click Upload by Phone again — the new file appears in the picker without leaving the consultation page.
The AI pass — closing the documentation gap
The doctor clicks Run AI extraction.
Cympha reads:
- All the text the doctor typed (Chief Concern, Clinical Notes, Diagnosis Notes)
- The metadata of the records the doctor selected (filenames, content types — no image analysis at this stage; text + record-presence only)
And produces a structured object: tooth-numbered findings, diagnoses, treatment options, recommended treatment, missing-information flags. Everything goes into the AI Extracted Findings section, which is editable in place. The doctor reviews each field; if the AI got something wrong, the doctor fixes it.
The right sidebar's Checklist lights up automatically — every required item the template demands is either satisfied (green check) or still missing (red asterisk). The doctor scans the checklist in a second; if anything required is still missing, they know exactly what.
Generating the plan
The doctor clicks Generate plans.
Two plans get drafted:
- Internal Plan — clinical record format, full diagnosis, options, recommended treatment, lab/referral needs. This is the doctor's own copy and the source for any downstream lab case.
- Patient Plan — plain-language format, same content but written for the patient: their concern, what we found, treatment options, recommendation, benefits, risks, next steps, approval.
Both open in a rich-text editor. The doctor reads, edits, attaches relevant pictures to the plan (any image on the case can be added), and saves.
Sharing with the patient
The doctor clicks Share with patient, enters the patient's email (or the caregiver's email for pediatric / geriatric / special-needs cases), and sends.
The patient's plan is frozen at that moment — a snapshot copy stays on the case so the patient sees the exact document the doctor sent, even if the doctor keeps refining the working copy. The patient gets an email link to a phone-friendly page where they:
- Read their plan
- See the attached pictures
- Approve, or ask questions back through the patient chat
The doctor sees the patient's response in real time in the consultation's Patient Review section and in the case activity log.
If the doctor edits the plan after the patient already approved, Cympha automatically clears the approval and emits an audit event — the patient is never bound to a document they didn't see.
Branching to a lab case
If the recommended treatment requires lab work — crowns, aligners, surgical guides, implant prostheses — the doctor clicks Branch this case.
A picker opens listing the case's consultations (newest first), plus a "No consultation reference" option at the top. The doctor picks the consultation that contains the treatment plan. The new lab case opens with:
- Patient demographics already filled in
- Chief complaint copied from the consultation
- Full internal plan content copied into the case description (so the lab sees the whole plan, not just a tagline)
- Files referenced by the consultation pre-selected for inheritance
The doctor (or front-desk staff) reviews the file selection, then finds the lab. There is no public directory — you connect with your lab offline first, then search for them by lab name, or by your lab manager's name or email. Pick the lab's service, submit, and the case enters the lab orchestration flow with the whole plan attached as captured intent, so the lab starts from what the doctor decided rather than from a one-line brief.
Who does what — at a glance
| Step | Owner | Cympha surface | |---|---|---| | Schedule, open case, demographics, chief concern | DA | New Clinical Case form | | Capture photos (intraoral, extraoral, smile) | DA | Upload by Phone | | Import scans and radiographs | DA | Case dropzone (drag-and-drop) / Cympha Agent File Monitoring | | Verbal history while seating | DA | Clinical Notes section | | Examination + dictation | Doctor | Consultation Clinical Notes | | Pick consultation template | Doctor | Add Consultation menu | | Select records relevant to consultation | Doctor | Records section | | Run AI extraction | Doctor | AI Extracted Findings | | Review + edit AI findings | Doctor | Editable fields per finding | | Generate plans | Doctor | Generate Plans button | | Edit + attach images to plan | Doctor | Plan editor (rich text) | | Share with patient or caregiver | Doctor | Share with Patient | | Patient reads + approves on phone | Patient / Caregiver | Patient consultation page | | Branch to lab when needed | Doctor / front desk | Branch this case |
Why this works for different practice shapes
Two-person practices (one doctor, one DA). The DA does the data-plumbing half; the doctor does the diagnosis-and-plan half. Nobody re-types what the other already entered. The patient is never asked the same question twice.
Solo doctors. Same screen, same buttons — the doctor plays both roles. The workflow doesn't change; the time per case just shifts.
Multi-doctor practices. Cympha's role catalogue is fixed — each person picks their role once, at sign-up, and there is no separate dental-assistant role to configure and no per-case permission screen to maintain. The DA works the chairside Clinical account alongside the doctor, so the case stays with the doctor who owns it no matter whose hands were on the keyboard. When a colleague needs to see a case they don't own, Share grants read-only access by email: they can view the case and its files, but can't upload.
Specialty practices. The 14 consultation templates mean the right structured fields show up automatically. An endodontist's chairside flow uses the Endodontic template's AAE pulpal-and-periapical diagnosis fields; a pediatric practice uses Frankl behavior rating; a TMD practice uses DC/TMD Axis I. Same UI shell, different clinical content.
What you stop doing
We publish no per-visit stopwatch figures, because none have been measured. What we can describe is the work that disappears.
The record is written once. No re-typing patient details into the lab case form. No emailing scans separately. No PDFs. No "where's that photo from last Tuesday." The whole visit — demographics, photos, scans, notes, findings, both plans, the patient's answer — lives on one Living Case, and the case's own append-only event log records who did what and when, so nobody has to reconstruct the story later.
That is where the quieter value sits. Peace of mind, because an approval the patient never saw cannot survive an edit, and the log will say so. Pride, because the plan the patient reads is written in their language and looks like the practice that wrote it. And on the lab side, a case that arrives with the doctor's full reasoning attached is a case that starts with fewer questions and less rework.