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Inside Dental Hygiene
August 2021

Teledentistry Expands Options for Patients and Providers

Michelle Strange, MSDH, RDH

Teledentistry is not new, but for a hands-on profession, it can be hard to understand its role in patient care. Until recently, when faced with a dental emergency, patients had only one option: to pay a visit to the dental clinic. While this may be feasible for patients in close proximity to dental facilities, others (such as those who live in remote areas, professionals who cannot leave the office, parents who cannot find childcare, etc) have trouble accessing dental healthcare. However, recent technologic advancements have created an opportunity for patients to receive dental care without being physically present at a clinic.

Teledentistry provides dental care using telecommunication channels, including mobile phones, web cameras, and video teleconferencing. It began in 1994 when the United States Department of Defense (DoD) launched the Total Dental Access (TDA) program for army personnel.1 The program aimed to provide better dental care for patients compared to traditional methods while also reducing cost. Since then, teledentistry has evolved into a medium for screening, consulting, educating, and rendering triage care to patients.

Teledentistry services can be rendered through synchronous and asynchronous means; in the former, the doctor and patient review information and interact in real time, whereas the latter does not involve the immediate evaluation of findings.2

Given the advantages of teledentistry, it is expected to be widely accepted by both dental practitioners and patients. Some of the arguments raised against it include the cost of deploying the required technology, limited coverage for teledentistry services by third-party payers, and lack of legal framework for the delivery of patient care. Although these can be seen as reasonable concerns, teledentistry still plays a major role in the future of patient care. State laws are changing, and third-party payers have recently started to cover some services provided via teledentistry.

Reducing the Cost of Dental Care

As healthcare costs climb with no end in sight, it is crucial for healthcare providers, patients, and companies that pay for patients' medical services to work hand-in-hand to ensure that all parties receive value for their money. Teledentistry is changing the face of dental practice with the elimination of compulsory physical visits. All patients and dentists need for consultation are teleconference-enabled devices and they can proceed.

Teledentistry eliminates the cost of traveling to a dental clinic and reduces the time interval between a referral and a visit. Plus, dentists can leverage the technology to offer their services to a wider geographical area at minimal cost.

A study analyzing the cost of patient care delivery techniques reveals that traditional and synchronous methods were costlier than the asynchronous method.3 Another study also found that teledentistry helped patients who live in remote areas to save on costs compared to traditional practices.4

Improving Overall Dental Care Delivery

Dentistry comprises numerous branches, including endodontics, prosthodontics, orthodontics, periodontics, oral pathology, and oral and maxillofacial surgery.5 In some cases, a general dentist may be unable to diagnose disease and create a suitable treatment plan, and may require the opinion and knowledge of specialists or more experienced practitioners.

Teledentistry bridges the gap by enabling dentists to request guidance and improve the oral health care delivered to patients.6 General practitioners can connect with specialists using video conferences for collaboration or share clinical data with asynchronous teledentistry, ensuring the patient receives the appropriate care and eliminating the need for an initial consultation. Experts also believe that teledentistry has helped to improve diagnosis compared to traditional processes.

For example, radiographs are an integral part of diagnosing intraosseous oral lesions. Accurate radiographic reading is imperative when dealing with oral and maxillofacial pathologies. As such, a patient's treatment plan depends on fast and precise diagnosis. General dentists might not have the experience needed to interpret all radiographs or CBCT scans and will need to consult with an oral radiologist. Teledentistry is a convenient and efficient way to connect patients with the proper care, especially when rapid diagnosis is critical, such as when they need to consult an oral radiologist. Research shows that teledentistry can improve the speed of treating pathological conditions such as temporomandibular disorders compared to traditional consultancy.7

Delivering Oral Health Education

The dental industry has witnessed numerous technologic developments and treatment protocols, thus increasing the need to keep existing and prospective patients updated. A range of oral health education initiatives launched by various health authorities have played significant roles in this process.

Most people have access to smartphones, laptops, and the Internet. With this in mind, practitioners can use smartphone applications, online portals, or web-based education modules for continual dental education of their patients.

Teledentistry could positively impact the long-term results of nonsurgical treatments and even postoperative check-ins. Since effective hygiene and consistent follow-up are crucial to improving oral habits, employing tools such as video conferencing, text messages, and mobile health applications can help dental practices achieve this goal.

Bringing Dental Care to Remote Areas

The invention of teledentistry has created an opportunity for patients living in remote areas to access better dental care. In many cases, even when people in these areas need urgent care requiring  immediate diagnosis and treatment, only a handful of dental practices are available to serve them.

A study on dental service in rural communities shows that limited means of transportation, geographical isolation, and acute provider shortage are the barriers to dental health.8 A 2017 Rural Health Information Hub survey revealed that 65.2% of adults living in metropolitan areas visited a dentist compared to 55.7% living in remote areas.9

Furthermore, studies reveal that remote populations often overlook proper dental care due to a lack of awareness and education. It is therefore important to educate the population of these regions on oral health, while concurrently providing accurate diagnosis and treatment plans.

In many areas, general practitioners are available, but specialists are limited and require  significant travel for patients. Using teledentistry, general practitioners could facilitate triage, preoperative, and postoperative visits, limiting the patient's need to drive to the specialist for the procedure. Teledentistry also allows providers to have consults with and be mentored by specialists, so patients can receive quality care while reducing travel.

Although teledentistry has been in existence since the invention of the telephone, technologic advancements are enabling dentists and patients to conduct virtual visits and even solve urgent problems through video consultations. In addition, artificial intelligence10 is being utilized. There is more to come in dentistry technology, and dental healthcare workers need to adapt, adopt, and evolve to deliver the most effective and efficient patient care. Over time, practices expect to see a wider acceptance by patients, given the numerous benefits this technology offers.

About the Author

Michelle Strange, MSDH, RDH
Level Up Prevention Infection
Client Success Manager
Charleston, South Carolina

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