Dental Telemedicine (Teledentistry)

What is Teledentistry?

Teledentistry is the use of telehealth in the dental industry. Telehealth is the use of digital communication technology to coordinate and deliver health care.

Teledentistry refers to the use of virtual communication between a dentist and patient. It can be used to provide patient care or ediucation.

Teledentistry has an enormous potential to increase the reach and quality of dental care.

According to the American Dental Association (ADA):

"...examinations performed using teledentistry can be an effective way to extend the reach of dental professionals, increasing access to care by reducing the effect of distance barriers to care. Teledentistry has the capability to expand the reach of a dental home to provide needed dental care to a population within reasonable geographic distances and varied locations where the services are rendered."

— ADA Policy on Teledentistry

How Does Teledentistry Work?

Teledentistry is typically carried out in one of the following modalities:

Synchronous (Real-Time Consultation)

Synchronous means at the same time. This refers to live video or phone calls between a patient or caregiver and a provider. Video conferencing is the most common telehealth method.

This real-time interaction mimics a normal visit to the dental office. It makes it possible for patients to undergo certain examinations and follow-up appointments at home.

It is the legal responsibility of the dental practice to ensure that their technology, examinations, and records are HIPAA compliant to provide a diagnosis and treatment plan.

The dentist can then prescribe medications, recommend at-home solutions, or refer the patient for in-person care.

Asynchronous (Store-and-Forward Method)

Asynchronous communication refers to sending and storing health information via secure communication systems.*

Common documents include:

• Radiographs (X-rays)
• Photographs and Videos
• Digital impressions
• Photomicrographs

This dental information is used by a practitioner to evaluate a patient's condition. It can be sent anytime and doesn't need to be communicated during a live interaction.

*The hardware and software used must be HIPAA compliant

Remote Patient Monitoring (RPM)

Remote patient monitoring is used to provide care or support from a different location. Personal and medical data is collected and digitally transferred to a provider. The patient may be located in their home or another healthcare facility (such as a hospital).

This allows the dental health care provider to monitor a patient's progress remotely. They may include video chats as a part of their care delivery system. They can make any changes to their treatment regimen remotely.

Mobile Health (mHealth)

Mobile health refers to any health care or public health practice supported by mobile phones or tablets. With the rapid global integration of mobile phones into our daily lives, this is a primary focus of health care providers and educators.

Teledentistry Services & Use Cases

Teledentistry services are already becoming popular in certain areas. Here are some ways in which teledentistry is already being employed and ways it may become more popular in the near future:

Private Practice

Many private practice dentists and dental specialists are adopting telemedicine. Many offer video chat consultations or follow-up appointments to their patients.  

In addition, teledentistry allows oral health care providers to create networks quickly and easily. The digitalization of dental records and services has provided a communication system that can connect patients to the specialists they need more efficiently than traditional methods.

Public Health

Teledentistry is becoming integrated into public health systems as well, though more slowly. Mobile Hygeine programs have been added to some schools. Federally Qualified Health Centers (FQHCs) also have opportunities to integrate teledentistry into their practices.

Teledentistry could be used for dental hygiene education or to connect people in rural areas with dental providers where access to care is limited.

The delivery of services via teledentistry must comply with the state’s scope of practice laws, regulations or rules.”This means that the dentist must possess a license in good standing with the dental board in the state of the patient. 

In the U.S., there is not a single federal dental license, allowing dentists to practice anywhere in the country. Some states (like Texas and Maine) do not allow the practice of teledentistry because their regulatory agency rules require tactile and visual examinations for the diagnosis of dental problems. 

Medical & Dental Integration

Dental care providers can also connect with other medical professionals. Your oral health and general health are intrinsically linked. Connecting dental professionals with medical professionals creates the opportunity for better all round health care.

It can also reduce time between care and eliminate the need for patients to travel to different locations for treatment.

Direct-to-Consumer Products & Services

Certain dental services, including teeth straightening and teeth whitening allow opportunities for direct-to-consumer treatment. Until recently, these services were only provided by dental offices. Now, telehealth companies are offering these same treatments at greatly reduced prices.

Pros and Cons of Telehealth Dental Care

Teledentistry is a controversial topic among dentists, public health officials, and state regulatory agencies. Though it has limitations, the need for the dental industry to integrate teledentistry services is obvious. It remains an ever-evolving branch of dentistry.

Pros of Telehealth Dental Care

• Increased access to patient care — This is especially important to patients in rural or underserved areas, people with limited mobility or severe health complications, and travelers who experience dental problems when they are away from home.
• Opportunity for patient education — Often patients simply need to know whether what they are experiencing is an emergency. A virtual consultation can educate the patient in order to help them make the best decision for the situation.
• Prescription of antibiotics for dangerous infections — Infections that are in danger of spreading can be seen and diagnosed during a virtual consultation. This can increase a patient's chance of recovery if a virtual consultation can be provided quickly. It can also help reduce the burden on our overtaxed emergency rooms and urgent care facilities. 

Cons of Telehealth Dental Care

• Not available in every state — Dentists must adhere to the protocols set forth by their licensing state’s regulatory agencies. 
• Certain treatments need in-office visits — While crooked or stained teeth can sometimes be treated remotely, there is no remote treatment for other issues such as cavities or gum disease. In-person, physical dental treatment is necessary to fix some dental problems.
• No x-rays or in-person evaluation limits the accuracy of diagnosis — Certain dental problems require high-definition dental x-rays and a tactile examination of the tooth in question. With the limited information provided in a teledental consultation, patients could receive an incorrect diagnosis.

Teledentistry & Dental Emergencies

Video consultations can help people undergoing a dental emergency. A quick video call with a dentist could provide the patient with vital information that gives them a clear path ahead or even saves their life.

Many patients are unsure if their condition is considered an emergency. In many cases, urgent care is not necessary. Teledentistry could save these patients a costly trip to the emergency room with a video conference and follow-up dental appointment.

When a patient does experience a true dental emergency, teledentistry can get them medication or refer them to an urgent care facility immediately. 

Teledentistry & The COVID-19 Pandemic

During the COVID-19 (coronavirus) pandemic, teledentistry has played a vital role. It has helped keep patients with dental problems out of crowded hospitals and emergency rooms. It also has allowed high-risk patients to make dental appointments while staying home. 

As the world begins to shift towards more remote work, products, and services, telehealth will take on a much more prominent role. There has been a rapid change in health services caused by the need to reduce occupancy, follow social-distancing protocols and travel restrictions, and keep vulnerable populations protected.

This change has opened the door for modifications of the traditional health care models. Teledentistry will be one of the branches of health care that drive innovation and progress.