A Systematic Review of the Research Evidence for the Benefits of Teledentistry
Teledentistry is a subset of telehealth. It is often utilized as an educational tool as well as to deliver dental care from one geographical location to another in areas with shortages of infrastructure and human resources. Teledentistry has great potential to provide care for high-risk populations and facilitate referrals. In a recent systematic review published in 2018 in the Journal of Telemedicine and Telecare the authors aimed to “inform future decisions about the benefits of integrating teledentistry into routine health services, by presenting an overview of the evidence for the effectiveness and economic impact of teledentistry.”1
Several areas of dentistry have been identified as areas that could help improve access to care such as remote consultations for preparing treatment plans, providing preventive care, supervising practitioners working in rural settings, and continuing education. Alaska has implemented a program, The Dental Health Aide Therapists that utilizes telemedicine to address inequity in access to dental care in rural areas of Alaska. This model brings to light the possible benefits of teledentistry in rural areas.
Upon reviewing articles to include in the review 217 were identified as candidates. Of these 11 were considered to meet the inclusion criteria. Nine of the eleven studies included considered clinical outcomes, while the other two focused on economic analyses. The studies were clustered into two groups, telediagnosis and teleconsultation.
Overall, there is a positive trend in the literature supporting the use of teledentistry. However, only a small number of studies reported controlled comparisons of teledentistry and conventional dentistry. In most of the studies reviewed there was a focus on the efficacy of teledentistry rather than its effectiveness. This was also true in the economic analyses, cost-minimization was being considered rather than cost-effectiveness.
The authors also note, “Despite its great potential to address the needs of rural or remote populations, our findings indicated that more than half of the reviewed studies were undertaken in urban areas rather than rural settings.” Additionally, most studies were conducted in developed countries rather than developing countries. Unfortunately, this indicates the studies reviewed were inadequate to determine the status of the technology.
The authors conclude by stating, “The present review identifies a growing body of evidence supporting efficacy of teledentistry, particularly, in some areas of dentistry. However, in many cases, the review studies provide only preliminary results and considered only the feasibility and short-term use of teledentistry. Due to limited conclusive evidence and the heterogeneity of the methods used, interventions and outcomes assessed in the reviewed studies, the generalizability of the findings is limited. Well-designed research into the assessment of teledentistry, taking into account its effectiveness, cost-effectiveness and long-term use, will. Be required before future decisions on whether to establish teledentistry services can be made.”
Do you have experience with teledentistry? Have you found it to be cost-effective? Have you found it useful as a clinical tool for diagnosis and treatment planning?
- Estai M, Kanagasingam Y, Tennant M, Bunt S. A systematic review of the research evidence for the benefits of teledentistry. J Telemed Telecare. 2018 Apr;24(3):147-156. doi: 10.1177/1357633X16689433. Epub 2017 Jan 24. PMID: 28118778.