For most of us, going to the dentist is not a pleasant experience. Actually, less than 50% of the population visit a dentist regularly. Dental treatment invariably involves close inspection, examination, diagnostic and therapeutic interventions. During the social distancing period we are facing; Teledentistry is a great way to avoid close face-to-face interaction.
Dentists are most susceptible to be infected by the coronavirus. They are also more susceptible to transmit the virus to their patients. As a consequence, most of the routine dental treatments have been put on hold. To advise the patients and screen for real emergencies, Teledentistry is a safe and reliable alternative.
Companies like the French Dental Monitoring offer new alternatives to orthodontists and patients to monitor braces or aligners treatments remotely.
Recently the company Henry-Schein conducted a very informative webinar on this new way to access dental care. We recommend that you watch it.
Just as Telemedicine, remote dental consultation did not start with the Covid-19 outbreak. In 1994, the United States Army initiated the Total dental Access (TDA) program. It was its efforts to re-engineer healthcare delivery. The program focused on three areas of dentistry:
- Patient care: In some remote rural areas, patients have to travel hundreds of miles just for a consultation that will last a couple of minutes. One of the goals of implementing teledentistry was to save costs and travel time for the patients,
- Continuing dental education: To broadcast lessons to remote clinics,
- Dentist-laboratory communication: To improve the realization of prosthetics by exchanging information between the dentist and laboratory.
How does teledentistry fit in the Covid-19 pandemics
Dr. Ghai. recently published an excellent review of the many benefits of Telehealth for oral health. He identified four areas in which teledentistry can be used not only in time of pandemics but also in routine practice.
Teleconsultation
Teleconsultations are valuable in Public Health for the consultation of physically and intellectually challenged patients and patients from aged care facilities and prisons. In a post-Covid-19 world, we suspect that patients will gradually take advantage of teledentistry teleconsultation.
In Texas, TheTeleDentists offer a consultation with a dentist for $59. Dentulu goes one step further. They allow the patients to choose their remote dentist based on their qualifications. For urgent care, the platform also helps the patients to connect with the nearest dentist within 5 minutes.
Teledentistry.com provides Telemedicine carts to General Hospital Emergency Rooms departments. Patients are checked remotely, and a consultation with a local dentist arranged. For Dentists willing to easily integrate telemedicine into their practice, Mouthwash offers Teledent, a turnkey teledentistry solution.
Telediagnosis
Telediagnosis uses technology to exchange data and information. EstomatoNet is a telediagnosis program to analyze oral lesions. In an exploratory study conducted in 2016, specialized oral medicine teleconsultants received the data. They established diagnostic and management recommendations. The number of patients referred to face‐to‐face consultation reduced from 96.9% to 35.1%.
This initiate is not an exception. More and more solutions allow providing a diagnosis remotely. In Saudi Arabia, mobile phone teledentistry was shown to offer acceptable reliability for the initial diagnosis of caries in children.
During the lockdown in Brazil, WhatsApp and Telemedicine have even been used to diagnose oral lesions successfully.
Teletriage
With a smartphone, Teletriage allows classifying the patients according to their symptoms. Virtual dentistry can also take advantage of AI-powered chatbots to advise the patients and even book a face-to-face appointment in case of an emergency.
DentalChat is one example of such an AI-powered chatbot. The company started as a dental blog as it now offers a powerful chatbot and online consultation with dentists.
Telemonitoring
Monitoring a treatment’s results often requires the patients to visit dental offices for just a couple of minutes. Remote Patient Monitoring (rpm) improves convenience both for the patient and the dentist.
A recent study by Giudice et al. concluded that telemedicine allows accurate monitoring of patients sending photos to their dentists. Especially for post-operation monitoring, remote checks decreased the pain score without impairing the recovery.
Challenges of teledentistry?
The use of telemedicine for dental consultations does not come without challenges, though. The main one relates to the need to secure electronic communications and to protect private patient information. Mobile health relies heavily on the means of communication. The deployment of the 5g network is key for digital healthcare.
At the dentist level
The dentists may be resistant to these new tools for several reasons: the need for extra-investment, poor internet access, lack of training, and so many others. The role of the American Dental Association (ADA) will be critical in the wide adoption of telehealth. The association recently updated a quick guide to educate dentists and promote the use of teledentistry. Educating young dentists is also critical, and we hope that Dental Schools will be part of the efforts to spread information and knowledge.
Changing the way dentists interact with their patients will take time. Ultimately, we are confident that Telehealth’s many added values will overcome the challenges. Most importantly, dental practitioners should be able to quantify the real benefits for their patients.
At the patient level
Telehealth is not new but saw a dramatic increase in the last couple of months. As with any new technology involving care delivery, patients should benefit from it. To improve access, the communication network needs to be reliable as well. Nobody wants to have a blurry video feed while trying to exchange dental information.
Gaining trust at the patient level will take time. The success of teledentistry will be closely linked to the success of telemedicine. The fundamental role of public and private payers should not be underestimated to educate the users.
Both patients and payers can ultimately benefit from remote access to health care. It will allow them to focus on prevention and not only on the treatments.
How to implement teledentistry in a post-Covid19 world?
The American Teledentistry Association published (ATDA) published a startup guide for dental practices to implement a remote dental health practice.
California and Arizona began covering teledentistry in 2015. Telehealth laws and regulations are constantly evolving. One critical point is to check the State Dental Practice Act to ensure that teledentistry is permitted at a state level.
It is also important to check with malpractice insurance to cover this telehealth practice. Finally, during the preparation stage, finding a HIPAA compliant solution is critical. As with most of the telemedicine solutions, ensuring the data’s security must be the priority
Many software providers offer solutions for dentists willing to implement this new way of delivering care. To be successful, Teledentistry platforms must be technically reliable, and easy to use for both patients and doctors. In a post-Covid19 world, remote dental consultations are part of the evolution of the relationship of the Society with their healthcare providers. The road ahead is exciting for telehealth, and we look forward to seeing the many avenues that will lead to a healthier future.
