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Teledentistry Overview
Providers have used teledentistry to deliver care to the most vulnerable and underserved patients, both rural and urban for more than a decade. This initial concept was illustrated with great success in California by the University of Pacific Dental School’s Virtual Dental Home model. In many states, teledentistry was not allowed or is not a reimbursable service, which limited the utilization among providers to implement this model of care. 

During the COVID-19 outbreak, many states changed scope of practice guidelines to allow the reimbursement and utilization of teledentistry, seeing it as an effective way to assess and triage patients while limiting in-office visits except for those in need of urgent or emergency care. This combined with many of the early teledentistry platforms such as Mouthwatch’s Teledent and Simlifye’s Connect platforms made teledentistry for connecting dentists with patients very easy.

Teledentistry offers patients access to a dental provider through a secure platform in the comfort of their own home, removing barriers to care such as long wait times, transportation, and taking time off work. Beyond direct to patient teledentistry you can find many more possible ways to reach your patients.This introduction will give you some context into ways dentists across the country are utilizing teledentistry as a tool to grow their practices.

• Benefits of Teledentistry - 
  • Teledentistry is a delivery model that can create access clinical providers 
  • Teledentistry creates flexibility ……..
  • Infrastructure requirements vary by location, but certain basic technology is essential to provide high-quality services and are not as expensive as most fixed costs associated with outreach programs.
  • Teledentistry can be utilized in several different ways, which creates ways more streamlined and efficient clinical practices.
  • Teledentistry offers the opportunity to provide patient-centered services coordinated through a whole team approach 
  • Teledentistry is a cost-effective modality for both patients and providers.
  • Teledentistry is an effective modality for providing continuing education and training for members of the oral health team.

 

• There’s a lot of literature regarding teledentistry practice. Much of the research delves into the origin, rationale, scope, basis, and requirements for teledentistry.  Also, they review current evidence that exists in the literature to support teledentistry and review the ethical and legal issues related to the practice of teledentistry and the future of this alternative and innovative method of delivering dental care.
  
  
  • Teledentistry Awareness
  • Teledentistry Outcomes
  • Patient Perceptions
  • Diagnosis and Accuracy
  • Technology Study
    
    
• Basic Terminology- http://www.ada.org/~/media/ADA/Publications/Files/CDT_D9995D9996-GuideTo_v1_2017Jul17.pdf
  • Teledentistry offers patients access to a dental provider through a secure platform in the comfort of their own home remote or non-clinical environments, removing barriers to care such as long wait times, transportation, and taking time off work. Teledentistry, according to the ADA’s comprehensive statement of teledentistry , refers to the use of telehealth systmen and methodologies in dentistry. Teledentistry can include patient care and education delivery using, but not limited to the following modalities:
    • Live Video (Synchronous) live, two way interaction between a person (patient, caregiver or provider) and a provider using audiovisual telecommunications technology.
    • Store and Forward (Asynchronous) transmission of recorded health information (for example, radiographs, photographs, video, digital impressions and photomicrographs of patients) through a secure electronic communications system to a practitioner, who uses the information to evaluate a patient’s condition or render a service outside of a real-time or live interaction. 
    • Remote Patient Monitoring (RPM): Personal health and medical data collection from an individual in one location via electronic communication technologies, which is transmitted to a provider (sometimes via a data  processing service) in a different location for use in care and related support of care.
    • Mobile Health (MHEALTH): Health care and public health practice and education supported by mobile communication devices such as cell phones, tablet computer  and personal digital assistant. 

It’s important to document the method used for obtaining data, and the specifics of the appointment to include, pain assessment, patient expectations, and contraindications in medical history. Detail and specificity are extremely important; these will help the doctor with the treatment planning process. Four key things are needed: https://www.cchpca.org/sites/default/files/2018-10/CCHP_50_State_Report_Fall_2018.pdf

• Time and Date: Most teledentistry regulations require that a teledentistry visit is completed within a certain period of time. This helps identify time and date of the originating assessment in conjunctions with the examination.
• Data Collection Method: It’s important to list what was used to collect data during an assessment. These items will vary from radiography (how many, what type, etc.), photographs (intra-oral, extra-oral), and dental instruments.
• Location of Originating and Distant Sites: Per regulations, the location and time that a patient receives service via a telecommunications system must be documented as the originating site. The distance site where the exam actually occurs must also be documented.
• Name of Case Facilitator/Presenter: A facilitator/presenter has the responsibility to facilitate or present teledentistry cases to the exam provider. This may vary based on who collects the data. In traditional teledentistry, it is usually a dental hygienist. In limited evaluations with the patient directly, the presenter would be the patient.