Teledentistry

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Teledentistry is the use of information technology and telecommunications for dental care, consultation, [1] education, and public awareness (compare telehealth and telemedicine).

Contents

History

In 1994, the Department of Defense introduced the Total Dental Access Program (TDA) for the Army. [2] The goals of TDA were to increase soldier's access to care and reduce associated costs. At the time, they used what was called the plain-old-telephone-system (POTS).

In the early nineteen nineties, videoconferencing, e-mail, fax, and telephone calls were used but more recently, video conferencing and high-quality image transfer have become easily accessible. These, and the considerable improvements in digital camera technology, have provided radical new opportunities.

Nearly a third of all Americans do not visit a dentist regularly enough, according to the Gallup-Healthways Well-Being Index. [3] There are many reasons for this, most notably affordability, access and fear.

Several teledental companies operate in the United States. Direct-to-consumer orthodontics companies like SmileDirectClub also utilize teledentistry, but have drawn criticism regarding proper supervision of care. [4]

Due to the COVID-19 pandemic, dental practices were ordered to be shutdown [5] to help curb the spread of the coronavirus. As a means of providing a method by which dentists could still communicate with their patients during the shutdown, teledentistry became adopted across the world. In the US, several laws had been enacted to curb the rise of direct-to-consumer orthodontics which also invalidated the use of teledentistry by duly licensed dentists. These laws were quickly rescinded to address the pandemic and hence teledentistry is now widely used by dentists in the US. [6]

Methods

Live Video (Synchronous): Live two-way video between a patient and provider using audiovisual telecommunications technology. [7] Live video is often used to triage patients to the appropriate level of care or for specialty consultations. The American Dental Association has designated the code D9995 for this type of teledentistry.

Store-and-forward (Asynchronous): Transmission of recorded health information (for example, radiographs or digital impressions taken by an appropriately licensed provider) through a secure electronic communications system to a practitioner, who uses the information to evaluate or diagnose the patient's condition outside at a later time. [7] The American Dental Association has designated the code D9996 for this type of teledentistry.

Remote Patient Monitoring : Health data collection from an individual in one location (usually outside of a conventional clinical setting), which is transmitted to a provider in a different location for use in care and related support. [7]

mHealth : Health promotion and education via mobile devices such as cell phones or tablets. [7]

Help within the dental community

Another method is the Remote Monitoring Method in which dentists communicate with each other through the use of radiographs and other data like the patient's clinical findings, photographs, test results and case history. The patient is not present in this method of teleconsultation.

Disadvantages of this can include misinterpretation of messages, privacy issues and insufficient training of the professionals. [8]

Benefits

Teledentistry can provide easier, cheaper and less intimidating way to connect with dentistry. Teledentistry can also be used to assist general dentists with speciality work [9] and improve services to underserved populations such as in rural or less developed areas. [10]

In dental insurance policies

The dental insurance industry had adopted ADA codes such as D9995 and D9996 to acknowledge that teledentistry as a subset of telehealth exists and that these codes are recognized by the industry. However, largely the dental insurance companies had not made these codes payable to dentists in the event that they were actually billed when a teledentistry service was rendered to a patient. With the onset of the COVID-19 pandemic, the American Dental Association in November 2020, The resolution also states that dental insurers—both public and private—should cover services provided through teledentistry at the same level as if the services were delivered in a traditional in-person encounter. [11] This recommendation from the American Dental Association was strongly adopted by dental insurance carriers who in turn went a step further to include value added benefits to their dental insurance policies to allow for teledentistry. [12] [13] [14] [15]

Related Research Articles

<span class="mw-page-title-main">Dentistry</span> Branch of medicine

Dentistry, also known as dental medicine and oral medicine, is the branch of medicine focused on the teeth, gums, and mouth. It consists of the study, diagnosis, prevention, management, and treatment of diseases, disorders, and conditions of the mouth, most commonly focused on dentition as well as the oral mucosa. Dentistry may also encompass other aspects of the craniofacial complex including the temporomandibular joint. The practitioner is called a dentist.

<span class="mw-page-title-main">Dentist</span> Health care occupations caring for the mouth and teeth

A dentist, also known as a dental surgeon, is a health care professional who specializes in dentistry, the branch of medicine focused on the teeth, gums, and mouth. The dentist's supporting team aids in providing oral health services. The dental team includes dental assistants, dental hygienists, dental technicians, and sometimes dental therapists.

The American Dental Association (ADA) is an American professional association established in 1859 which has more than 161,000 members. Based in the American Dental Association Building in the Near North Side of Chicago, the ADA is the world's largest and oldest national dental association. The organization lobbies on behalf of the American dental profession and provides dental accreditation.

Cosmetic dentistry is generally used to refer to any dental work that improves the appearance of teeth, gums and/or bite. It primarily focuses on improvement in dental aesthetics in color, position, shape, size, alignment and overall smile appearance. Many dentists refer to themselves as "cosmetic dentists" regardless of their specific education, specialty, training, and experience in this field. This has been considered unethical with a predominant objective of marketing to patients. The American Dental Association does not recognize cosmetic dentistry as a formal specialty area of dentistry. However, there are still dentists that promote themselves as cosmetic dentists.

<span class="mw-page-title-main">Dental hygienist</span> Medical professional

A dental hygienist or oral hygienist is a licensed dental professional, registered with a dental association or regulatory body within their country of practice. Prior to completing clinical and written board examinations, registered dental hygienists must have either an associate's or bachelor's degree in dental hygiene from an accredited college or university. Once registered, hygienists are primary healthcare professionals who work independently of or alongside dentists and other dental professionals to provide full oral health care. They have the training and education that focus on and specialize in the prevention and treatment of many oral diseases.

<span class="mw-page-title-main">Dental assistant</span> Medical profession

Dental assistants are members of the dental team. They support a dental operator in providing more efficient dental treatment. Dental assistants are distinguished from other groups of dental auxiliaries by differing training, roles and patient scopes.

Dental insurance is a form of health insurance designed to pay a portion of the costs associated with dental care.

<span class="mw-page-title-main">Denturist</span>

A denturist in the United States and Canada, clinical dental technologist in the United Kingdom and Ireland, dental prosthetist in Australia, or a clinical dental technician in New Zealand is a member of the oral health care team and role as primary oral health care provider who provides an oral health examination, planning treatment, takes impressions of the surrounding oral tissues, constructs and delivers removable oral prosthesis treatment directly to the patient.

The following outline is provided as an overview of and topical guide to dentistry and oral health:

A dental spa is a dental facility supervised by a licensed Oral Health Care Provider in which dental services are provided alongside spa treatments.

Restorative dentistry is the study, diagnosis and integrated management of diseases of the teeth and their supporting structures and the rehabilitation of the dentition to functional and aesthetic requirements of the individual. Restorative dentistry encompasses the dental specialties of endodontics, periodontics and prosthodontics and its foundation is based upon how these interact in cases requiring multifaceted care. This may require the close input from other dental specialties such as orthodontics, paediatric dentistry and special care dentistry, as well as surgical specialties such as oral and maxillofacial surgery.

<span class="mw-page-title-main">Pediatric dentistry</span> Branch of dentistry

Pediatric dentistry is the branch of dentistry dealing with children from birth through adolescence. The specialty of pediatric dentistry is recognized by the American Dental Association, Royal College of Dentists of Canada, and Royal Australasian College of Dental Surgeons.

<span class="mw-page-title-main">Dentistry in the United States</span>

The practice of dentistry in the United States is overseen by several agencies, including the American Dental Association, the Commission on Dental Accreditation, and the regional boards. Ultimate licensure is the responsibility of individual states. There are roughly 190,000 practicing dentists in the United States.

Computers and software have been used in dental medicine since the 1960s. Since then, computers and information technology have spread progressively in dental practice. According to one study, in 2000, 85.1% of all dentists in the United States were using computers.

<span class="mw-page-title-main">University of Michigan School of Dentistry</span> Dental school of the University of Michigan

The University of Michigan School of Dentistry is the dental school of the University of Michigan, a public research university located in Ann Arbor, Michigan. Established in 1875, the School of Dentistry engages in oral and craniofacial health care education, research, patient care and community service.

<span class="mw-page-title-main">Brighter</span>

Brighter is a Santa Monica-based internet and healthcare company that connects dentists, patients, and dental insurers. The company licenses a consumer-driven dental benefits experience to insurance carriers to help them administer dental plans more efficiently and offer patient-friendly services such as online and mobile provider directories, patient reviews, and a proprietary online appointment scheduling feature, Brighter Schedule. The company's founder and CEO is internet entrepreneur Jake Winebaum.

Dentistry provided by the National Health Service in the United Kingdom is supposed to ensure that dental treatment is available to the whole population. Most dentistry is provided by private practitioners, most of whom also provide, on a commercial basis, services which the NHS does not provide, largely cosmetic. Most adult patients have to pay some NHS charges, although these are often significantly cheaper than the cost of private dentistry. The majority of people choose NHS dental care rather than private care: as of 2005, the national average proportion of people forced to use private care was 23%. NHS dentistry is not always available and is not managed in the way that other NHS services are managed.

Dustin Burleson is an American orthodontist and consultant.

Occupational hazards in dentistry are occupational hazards that are specifically associated with a dental care environment. Members of the dental team, including dentists, hygienists, dental nurses and radiographers, must ensure local protocols are followed to minimize risk.

<span class="mw-page-title-main">Dental aerosol</span> Hazardous biological compound

A dental aerosol is an aerosol that is produced from dental instrument, dental handpieces, three-way syringes, and other high-speed instruments. These aerosols may remain suspended in the clinical environment. Dental aerosols can pose risks to the clinician, staff, and other patients. The heavier particles contained within the aerosols are likely to remain suspended in the air for relatively short period and settle quickly onto surfaces, however, the lighter particles may remain suspended for longer periods and may travel some distance from the source. These smaller particles are capable of becoming deposited in the lungs when inhaled and provide a route of diseases transmission. Different dental instruments produce varying quantities of aerosol, and therefore are likely to pose differing risks of dispersing microbes from the mouth. Air turbine dental handpieces generally produce more aerosol, with electric micromotor handpieces producing less, although this depends on the configuration of water coolant used by the handpiece.

References

  1. ↑ Clark, GT (2000). "Teledentistry: What is it now, and what will it be tomorrow?". Journal of the California Dental Association. 28 (2): 121–7. doi:10.1080/19424396.2000.12223058. PMID   11323836. S2CID   46508527.
  2. ↑ Rocca, M. A.; Kudryk, V. L.; Pajak, J. C.; Morris, T (1999). "The evolution of a teledentistry system within the Department of Defense". Proceedings. AMIA Symposium: 921–4. ISSN   1531-605X. PMC   2232632 . PMID   10566495.
  3. ↑ "Oral Health Isn't Much Of Americans' Concern, Poll Finds: One-Third Didn't See The Dentist Last Year". Medical Daily. 2014-04-29. Retrieved 2017-11-27.
  4. ↑ "In-home teeth straightening can save thousands. But brace yourself for the risks". Los Angeles Times. 2020. Retrieved 2020-05-27.
  5. ↑ Kalenderian, Elsbeth; Spallek, Heiko; Franklin, Amy; Olsen, Gregory; Walji, Muhammad F. (24 February 2022). "COVID-19 and Dentistry: Challenges and Opportunities for Providing Safe Care".{{cite journal}}: Cite journal requires |journal= (help)
  6. ↑ "Governor Abbott Signs Texas Teledentistry Bill into Law". Dentistry Today. 2021-06-18. Retrieved 2021-12-29.
  7. 1 2 3 4 "ADA Policy of Teledentistry". American Dental Association. 2015. Retrieved 2020-05-25.
  8. ↑ Santi, Dr Priti (2019-07-06). "Why is teledentistry wonderful for you?". DentalDost. Retrieved 2020-12-11.
  9. ↑ "Teledentistry Shows Potential to Assist Rural Communities". NIH. December 24, 2008.
  10. ↑ Chen, Jung-Wei; Hob-Dell, Martin H.; Dunn, Kim; Johnson, Kathy A.; Zhang, Jiajie (2003). "Teledentistry and its use in dental education". Journal of the American Dental Association. 134 (3): 342–6. doi:10.14219/jada.archive.2003.0164. PMID   12699048.
  11. ↑ "ADA updates teledentistry policy".
  12. ↑ "News releases".
  13. ↑ "New Teledentistry Coverage Benefit Delta Dental of Iowa Members - Delta Dental of Iowa".
  14. ↑ Delta Dental of Arizona (January 19, 2022). "Delta Dental of Arizona Launches Delta Dental Virtual Visits Delivered by TeleDentistry.com". www.deltadentalaz.com. Retrieved 2023-04-14.
  15. ↑ "Delta Dental of Illinois adds 24/7 virtual visits". 10 March 2022.
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