Teledentistry. You have heard it used, but what does it mean? Telehealth is helping people all over the world, but dentistry has been a bit slower in adopting this type of technology. Eden Ivie, RDH, gives us some definitions and ways that teledentistry could be used. You may be surprised when and where we could use teledentistry in our profession and how simple it really is!
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This TIPisode has been transcribed for your viewing pleasure:
Eden Ivie: Hey, everyone. It’s Eden with MouthWatch, and today I’m going to talk to you about teledentistry. Now, I’m sure you have heard the term “teledentistry.” You might have read an article. You might have seen teledentistry in the news. There’s been a lot of talk and hype about teledentistry lately, so we just want to go over the basics today and let you know what teledentistry is, how it works, and how we can use it in private practice and public health.
Now, I’m going to start by talking a little bit about telehealth in general. The definition of telehealth is the use of electronic information and telecommunications technologies to support long-distance clinical care, patient and professional health-related education, public health, and health administration. So that’s a pretty broad definition, and telehealth encompasses quite a few different modalities when were looking at telemedicine, teledentistry, teledermatology, teleradiology. All of those things fall under the umbrella of telehealth.
Telehealth might seem like a new concept, but it’s actually been around for quite a while. The medical community has been implementing these telecommunications technologies for a little bit longer than dental has, and they’ve been doing it in ways that you might not be aware of.
Now, whenever I first heard of about telemedicine, the first thing I thought of was Teladoc where I could call up a doctor on my phone or have a video conference if my child had an ear infection and that doctor could diagnose my child and write me a prescription. Now, we call that “patient-facing telemedicine.” But provider-to-provider telemedicine is more common than you might realize. Now, this might be a provider in a remote or rural hospital connecting with a specialist at a more central, larger hospital that has more resources.
These type of programs allow people who live in rural communities to have access to those specialists without having to travel great distances or pay large amounts of money. They can stay in their community with their provider but still have access to that expertise. I’m sure as you’re listening to this you can see how some of these same methods might be very useful in dentistry.
The ADA has defined teledentistry as a combination of telecommunications and dentistry involving the exchange of clinical information and images over remote distances for dental consultation and treatment planning. They have also defined four modalities of teledentistry. They have real-time or synchronous teledentistry, store-and-forward or asynchronous teledentistry, remote patient monitoring, and mobile health.
Before I get into the explanations of those four modalities, quickly want to explain that teledentistry is not usually just a patient in their home with a smartphone. The way that we see teledentistry being used most frequently is with a provider on site with the patient connecting with another provider for a consultation, diagnosis, or triage, or sometimes authorization.
The provider who is on site with the patient could be any variety of different providers. It could a hygienist who’s providing preventative care. It could be an assistant who is just doing screenings and collecting clinical data. It could be a nurse practitioner or a nurse in an emergency room or any type of medical office. It could be a school nurse. It could be a dentist who wants to consult with a specialist. And then the provider on the other end, the provider who is receiving all of the clinical data, that could be, like I said, a dentist. It could be an oral surgeon, an oral pathologist, a periodontist, anyone — any type of oral health care provider.
I’m going to quickly run through those four modalities that the ADA has laid out so that you have an understanding of how these different types of teledentistry work.
The first one, real-time or synchronous teledentistry, is providers connecting in real time. So one provider is on site with the patient collecting that data, and at the same time the other provider is reviewing that data in real time. So this might be a live video conference like a Skype call where the providers are talking to each other, the remote provider is talking to the patient and doing an evaluation through a feed from the intraoral camera. It’s all happening in real time. So think FaceTime with your patient.
The next modality is asynchronous or store-and-forward. Now, this is when one provider who’s with the patient will collect all the data — they might take images, intraoral images, extraoral images, x-rays — they’re going to write all their notes, do all of their assessments, and then they’re going to share that with the remote provider who’s going to review that at their convenience. So that’s asynchronous or store-and-forward.
The third modality is remote patient monitoring. Now, this one isn’t used a lot in dentistry at this point. This is where you would be monitoring a patient’s health status or — in telemedicine, often it’s vital signs or blood glucose levels where you’re remotely monitoring a patient from a distance. You’re able to check their vitals. Like I said, this isn’t super common in dentistry right now.
And the fourth modality is mobile health. Now, this would be — an example of mobile health in dentistry would be a toothbrushing app that reminded you to brush your teeth or timed how long you brushed your teeth or made sure you were brushing the correct quadrant. Mobile health is really anything that is involving your phone or a mobile device in connection with your health.
Whew. Now that we’re through all of the boring definition stuff, let’s talk about how we can use teledentistry in our daily practice. Teledentistry gives us the ability to provide care for patients where they are, where they receive all of their services, where they live, where they work, where they go to school. It really expands our reach and makes care accessible and affordable.
In rural communities, teledentistry allows a general dentist to connect with specialists that it’s difficult for their patients to travel to. So they might be able to do a remote consultation with this specialist and decide on treatment, and then that patient only has to travel once for treatment instead of traveling multiple times for consults and then for the treatment and then for follow-up. Both the consult and the follow-up can be done remotely in their community setting with their general dentist connecting to that specialist.
Dental hygienists armed with mobile dental equipment and teledentistry technology can take preventative care almost anywhere. They can take it into schools. They can take it into long-term care facilities. They can take it into medical settings. They can take it into all of these different places making dental care truly accessible and convenient.
Hygienists using silver diamine fluoride and ITRs, glass ionomers, can provide more than just preventative service. They can arrest decay and reduce infection.
Using teledentistry for referrals as opposed to just handing a patient a card helps that patient actually follow through with that referral. If you are introducing that patient to the specialist you want them to go see, you can do a live video consultation. You can send that specialist the documents and the images and establish that relationship between your patient and the specialist before the patient ever even leaves your chair. This takes that pressure and that responsibility off of the patient because you’ve already made that connection. And, if you are handing them over directly to the specialist, then that specialist can also reach out to schedule appointments with that patient.
Now, those are just a few of the ways that teledentistry can work in your daily practice. The two most important things to remember about teledentistry is, one, we’re not doing anything that we wouldn’t be doing otherwise. We just might be in different locations while were doing it. And number two is that we are using telecommunications technologies in every aspect of our daily life from talking to our friends and family to signing documents to banking. And we are just, with teledentistry, incorporating those same technologies that we use in everyday life into dentistry.
Thanks for listening, and don’t forget to enter the raffle for the MouthWatch intraoral camera.
Michelle Strange: Thanks for listening to another TIPisode. We are excited to announce that you can win a MouthWatch intraoral camera. Click the link in our show notes and enter to win. You can also learn more about intraoral cameras and teledentistry solutions that bring patients, providers, and treatment together at mouthwatch.com. Don’t forget to hit the subscribe button in your podcast app. Follow us on Facebook or Instagram, and head over to our website, ataleoftwohygiensists.com, to sign up for our newsletter. We appreciate all ratings and reviews. Thank you for listening to your unofficial dental hygiene podcast.