How Does Teledentistry Work?
Making time for regular dental checkups can be challenging, especially if you live in a more remote area. But thanks to technology, dental care is becoming more accessible to people across the country, even in rural areas. Technological advancements in healthcare are changing dentistry just as they are other types of medical care. Telehealth allows patients to consult with their medical providers via a form of digital communication rather than face to face. Teledentistry is a subset of telehealth that virtually facilitates dental care.
What is Teledentistry?
Teledentistry is a model of dental care that “provides the means for a patient to receive services when the patient is in one physical location and the dentist or other oral health or general health care practitioner overseeing the delivery of those services is in another location,” according to the American Dental Association (ADA). It is not a service but a method for delivery of oral health care services.
Telecommunication technologies can convey the dental health information and enable the delivery of oral health services outside of a physical dental office through a phone or video conference. Teledentistry can take other forms, and it includes the practice of a dentist securely sending care instructions to another specialist or dental hygienist at a mobile dental care clinic. Using virtual communication systems, a dentist can oversee the oral health care of rural patients, nursing home patients, and others who don’t have direct access to a local dentist.
“Recently, the American Dental Association set guidelines for dentists aiming to practice remotely,” said Steven DeLisle, DDS, a dentist at Children's Dentistry of Las Vegas. “The ADA says that dental benefit plans should cover remote services the same as in a traditional dental office.”
According to the ADA, there are several forms of teledentistry:
- Real-time video: This type of teledentistry is a live video recorded consultation between you and your dentist using the video camera feature on your phone, laptop, or other device connected to the internet.
- Remote monitoring: A health provider collects your personal dental health information in one location and then transmits it electronically to another provider for future treatment. This service might be used in a nursing home facility or in an educational dental setting.
- Mobile health: Mobile devices such as smartphones, tablets, computers, and personal digital assistants can support public dental health education and practice. This category of teledentistry includes apps that monitor patient teeth brushing as well as other at-home dental care.
- Recorded dental health information: This form of teledentistry is the documentation of your dental health records, including x-ray images, videos, photos, and digital impressions, that are sent via a secure electronic system to another health provider. The practitioner can then use this information to evaluate your condition or provide a service at a later time.
How Providers Are Using Teledentistry
“Maine is very spread out, and with the high cost of running a dental office, many smaller towns cannot sustain their own dentist,” Dr. Lawlor said. “Therefore, teledentistry is slowly becoming more and more of a viable and interesting option for reaching rural populations. Nobody has created a sustainable method of reaching these people via a mobile dental treatment vehicle or rural clinics.”
Using the Toothpic app, patients can find a dentist to get advice on a dental condition. The app guides the patients through a step-by-step process to collect their information and photos and sends them to a dentist for review.
“A dentist is contacted and is able to accept or decline to ‘examine’ the patient,” said Dr. Lawlor. “There is a small fee that is usually covered by the patient's insurance. Overall, the app works well but is very limited as to what it can cover.”
Dr. DeLisle described another way teledentistry can work for dental providers.
“Teledentistry works by using dental hygienists to see the patient in person and relay feedback to the dentists over an internet connection,” Dr. DeLisle said. “The dentist can chat with the hygienist and patient about dental conditions, and the dentists can even supervise some treatments performed by the hygienist.”
The Downsides of Teledentistry
Of course, teledentistry has significant limitations. It can be difficult for a dentist to determine the source of toothache pain without a physical examination.
“Even in my office with a patient in front of me and X-rays, I can still have challenging cases that are difficult to diagnose,” said Dr. Lawlor. “A photo is helpful, but tactile feedback and an X-ray are my greatest diagnostic tools. Some patients have an unfair expectation of what can be accomplished via teledentistry, and it is important to let them know that not everything can be diagnosed via telephone.”
According to Dr. Lawlor, another downside is that in most cases, no sufficient treatment can be accomplished with a teledentistry appointment.
The Benefits of Teledentistry
“The future benefit I see of teledentistry is that we will be able to triage patients with an app, then plan treatment with a mobile dental treatment clinic,” said Dr. Lawlor. “Or even get an idea of the severity and place them on antibiotics if deemed appropriate.”
Teledentistry has many limitations, but Dr. Lawlor says this type of service “can likely bridge the gap for many patients who are too anxious to step foot into a dentist’s office.”
“In fact, the ability to serve as a conduit to foster better dental health may even be its greatest advantage,” said Dr. Lawlor. “Making care accessible, even if only limited care, will lower barriers and encourage more people to take the first step.”
About the Expert Contributors
Steven DeLisle, DDS, is a board certified Dentist Anesthesiologist. After graduating from dental school at the University of Washington, Dr. Delisle enrolled in Anesthesia residency at Loma Linda University, where he treated over 2,000 special needs and pediatric patients under general anesthesia.
Benjamin Lawlor, DDS, graduated from Dalhousie University and is a fellow with the International College of Oral Implantologists. He offers family and cosmetic dental services from sedation, crowns and veneers, to implants, extractions and even Invisalign.
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