Dental Telemedicine (Teledentistry)

Michael Bayba
Written by
Michael Bayba
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Evidence Based
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6 sources cited
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What is Teledentistry?

Teledentistry refers to the virtual communication between dentists and patients. During these appointments, a patient sends in photos for the dentist to examine.

Then, the dentist provides virtual care and education on the dental issue(s). Teledentists can also refer patients to in-person dentists as needed.

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

Pros and Cons of Teledentistry

Teledentistry is a controversial topic among:

  • Dentists
  • Public health officials
  • State regulatory agencies

Teledentistry has limitations. However, there are many pros of teledentistry. It remains an ever-evolving area 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 away from home.2
  • Opportunity for patient education — Often, patients need to know whether they are experiencing an emergency. A virtual consultation can help the patient make the best decision for their condition.
  • Prescription of antibiotics for dangerous infections — Infections in danger of spreading can be examined and diagnosed during a virtual consultation. This can increase a patient's chance of recovery if a virtual consultation is provided quickly. It can also help reduce the cost of overtaxed emergency rooms and urgent care facilities. 

Cons of Telehealth Dental Care

  • Not available in every state — Dentists must follow the protocols of their licensing state. 
  • Certain treatments need in-office visits — Crooked or stained teeth can sometimes be treated remotely. However, there is no remote treatment for other issues like cavities or gum disease. In-person, physical dental treatment is necessary to fix many dental problems.
  • No x-rays or in-person evaluation limits the accuracy of diagnosis — Certain dental problems require high-definition dental x-rays and an in-person examination. With the limited information provided in a teledentistry consultation, patients could receive an incorrect diagnosis.

How Does Teledentistry Work?

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

Synchronous (Real-Time Consultation)

Synchronous means 'at the same time.'

This refers to live video or phone calls between a patient and dental provider. Video conferencing is the most common telehealth method.

This real-time interaction mimics a regular visit that takes place in a dental office. Patients can undergo examinations and follow-up appointments at home.

The dentist can then:

  • Prescribe medications
  • Recommend at-home solutions
  • Refer the patient for in-person care

It is the legal responsibility of the dental practice to ensure that the following are HIPAA compliant to provide a diagnosis and treatment plan:

  • Technology
  • Examinations
  • Records

Asynchronous (Store-and-Forward Method)

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

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Common documents include:

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

A practitioner uses this dental information to evaluate a patient's condition. It can be sent anytime. It 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 moved to a provider. The patient may be located in their home or another healthcare facility. For example, like 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 system. They can make any changes to their treatment plan remotely.

Mobile Health (mHealth)

Mobile health refers to any health care or public health practice supported by mobile phones or tablets.

With the high use of mobile phones in our daily lives, teledentistry is a primary focus of health care providers and educators.

7 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 future:

1. Private Practice

Many private practice dentists and dental specialists are using telemedicine. Many offer video chat consultations. Or they may provide follow-up appointments for 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 system that can connect patients to the specialists they need more efficiently than traditional methods.

2. Public Health

Teledentistry is becoming used in public health systems as well. However, this is at a slower rate.

Mobile Hygiene programs have been added to some schools. Federally Qualified Health Centers (FQHCs) also have opportunities to use teledentistry in their practices.

Teledentistry could be used for dental hygiene education. Or, it can be used 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 the dentist must have a license in good standing with the dental board. It must also be in the same state as the patient.

In the U.S., there is not a single federal dental license. This allows dentists to practice anywhere in the country.

Some states do not allow the practice of teledentistry. For example, Texas and Maine.

This is because their regulatory agency rules require tactile and visual examinations for the diagnosis of dental problems. 

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3. 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-around care.

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

4. Direct-to-Consumer Products & Services

Certain dental services allow opportunities for direct-to-consumer treatment. This includes teeth straightening and whitening.

Until recently, these services were only provided by dental offices. Now, telehealth companies are offering treatments at greatly reduced prices.


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5. Second Opinions 

Getting second opinions on potential dental work is effective and useful in teledentistry service.

Patients would have to set up an appointment with a different dentist to receive a second opinion in the past. These appointments are often inconvenient and pricey.

However, using a teledentistry service to get a second opinion is convenient and affordable. You can easily connect with a dentist from anywhere in the world. This makes it easy to find an expert who specializes in your specific dental procedure. 

This process saves time and provides you with feedback from a broader range of dentists. You can also ask them about any other oral health concerns you may have.

6. Concierge Services

Some teledentistry platforms offer concierge services.

Instead of setting up an online appointment, a dental professional will come to your home. This dental service is convenient for those with disabilities or injuries.

7. Non-Emergency Dental Issues

If you have a minor dental issue such as a toothache, you can connect with an online dentist at any time.

An online dentist can:

  • Provide tips to reduce discomfort
  • Prescribe medications
  • Help you find a dentist in your area

Other non-emergency dental problems include:

  • Small tooth chips
  • Sensitive teeth
  • Loose restorations (e.g., fillings, crowns, and bridges)

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. This information may even save 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 pandemic, teledentistry played a vital role.

Teledentistry helped keep patients with dental problems out of crowded hospitals and emergency rooms. It also allowed high-risk patients to make dental appointments while staying home.3

Telehealth will take on a much more critical role as the world shifts toward more remote work, products, and services.

There has been a rapid change in health services caused by the need to:

  • Reduce occupancy
  • Follow social-distancing rules and travel restrictions
  • Keep vulnerable populations protected

This change has opened the door for changes in the traditional health care models. Teledentistry will drive innovation and progress.

Resources

(1) Jampani, N D et al. “Applications of teledentistry: A literature review and update.” Journal of International Society of Preventive & Community Dentistry vol. 1,2 (2011)

(2) ADA Policy on Teledentistry, American Dental Association, 2020

(3) Ghai, Suhani. “Teledentistry during COVID-19 pandemic.” Diabetes & metabolic syndrome vol. 14,5 (2020): 933-935

(4) Deshpande, Shantanu et al. “Teledentistry: A Boon Amidst COVID-19 Lockdown-A Narrative Review.” International journal of telemedicine and applications vol. 2021 8859746. 16 Feb. 2021

(5) Giudice, Amerigo et al. “Can Teledentistry Improve the Monitoring of Patients during the Covid-19 Dissemination? A Descriptive Pilot Study.” International journal of environmental research and public health vol. 17,10 3399. 13 May. 2020

(6) Estai, Mohamed et al. “Teledentistry as a novel pathway to improve dental health in school children: a research protocol for a randomised controlled trial.” BMC oral health vol. 20,1 11. 14 Jan. 2020

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