Subscribe to RSS
Teledentistry in Oral Health Care
In the past few years, it has been seen that digital technology captured all field of life and health sciences. These advances revolutionized the field of dentistry and oral health education as well. Advancements have been observed mainly in education as e-learning platforms has been massively subscribed, then digital gadgets, telecommunication technology, digital diagnostic imaging services, artificial intelligence, and other softwares for disease analysis and dental follow-up. These modifications and innovations related to technology have improved the quality of patient care providing health care centers and qualified dentists the chance to practice effectively at long distances.  This concept of hobnobbing, communicating, and providing distant consultations, workup, and analysis digitally is the part of the science of telemedicine concerned with dentistry known as “Teledentistry (TD).” According to the literature, the concept of TD was drafted in 1989 as a component of the blueprint for dental informatics and patient data mining. It was introduced at a conference in Baltimore; the focus of the discussion was applying dental informatics in dental practice to help deliver quality oral health care. The significance of TD is stress-free examination, for example, child patient sitting with their parents and the dental care practitioner providing a cooperative consultancy with the child. Also, it is convenient for the patient as well to stay at home and reduce the multiple visits from far distance.
Prof. Cook first used the term TD in 1997, who defined it as an amalgamation of information technology and dental-related consultancy involving the exchange of clinical data of patient over remote distances for appropriate treatment planning. Introduction by these events to TD has given a new and feasible way to dental practice and improved patient care. Modern technology has created opportunities in the field of dentistry and improved TD to get complete, deep analysis, and precise patient information to give satisfactory results and redesign businesses.  This was evident in almost all the fields of dentistry utilizing TD as a mode of consultation and delivering minor dental services, such as in oral surgery it was proved to be a way of providing preoperative evaluation wherever mobility was restricted and improved referral system. Furthermore, it is also reported in Ireland that TD has worked in oral medicine and diagnosis where TD consultation system was implemented and reported effective in diagnosing oral lesions. Moreover, in orthodontics it was useful for interceptive orthodontic treatments, in prosthodontics, pedodontics, operatives, endodontics, and other fields of dentistry. TD was fruitful for video communication (consultation and examination) providing initial care and postoperative care to patients. Adding to that it has improved patient care as reported in one of the studies done by the “Group of Chin-Shan in their Health Center and National Taiwan University Hospital” in 2000. In this study, they have selected a doctor under training to visit Chin-Shan Township consisting of 17,000 people. He carried only some armamentariums with intraoral camera, a portable digital radiographic machine, and a software application to transfer all images to the hospital. This piloted study demonstrated the importance of TD in providing patient care related to dental issues to individuals living at remote places, facing pandemic, cannot travel, or have some major financial issues and also reinforced the viability of remote specialty consultations. Moreover, there are more studies, one of which conducted in the United States on a TD project where they have hired doctors “in six inner-city elementary schools and seven childcare centers” who has diagnosed dental caries in 173 children, almost 40% of the children aged 12 to 48 months had active dental caries. Following this study the dentist of Northern Ireland in 2010, also introduced and positively established TD program with the support of “Community Dental Service of the Home first Legacy Trust” in collaboration with the “Oral Medicine Department at the School of Dentistry, Belfast, UK Trust” using the feasibility of TD as an alternative approach to the management of oral medicine referrals.
With all these benefits and establishments, TD has also carried some shortcomings and reservations, as to be part of TD team, a dentist should have gone through good training by experts, should be attached to a specialist practicing TD, and then apply individually. Undertrained dentist can lead to loss of productivity through TD. So it is mandatory for a dentist to get proper training and gain sufficient experience before adding value in their practice of practicing TD. Not only that a dentist need to be careful and get skilled in dealing with lawful activities, technical, ethical, and social matters as these are embedded components in current practice era.  Second, there is always pressure for a prompt response. There can be miscommunication which can also have privacy concerns. In addition, there may be patients' concerns regarding information transfer related to their sickness. “Informed consent in TD should cover everything that exists in a standard, traditional consent form.” It is mandatory to inform patient beforehand of all the risks involved when diagnosing or treating patients via technology-dependent softwares as there can be sudden technical issues which are uncontrollable. One of the major problems for practicing TD in our part of setup are unclear images, radiographs that can hamper in correct diagnosis, and the logistics that is availability of the resources as many times there is a need of “store-and-forward TD system techniques consisting of a computer with a good hard drive memory, a speedy processor, a high quality intraoral video camera, a digital camera, and a high speed Internet connection,” additionally a fax machine, a scanner, a printer, and other technical hardware may also become a requirement in some cases.
However, by the in-depth literature search, it can be said that looking at the multiple benefits of practicing dentistry with telecommunication cannot be overlooked. The most highlighted points are that it can improve access to rural areas and bridge oral health care delivery, it is easy, saves time, make experts available, and help in relevant patient data transfer for consultation and diagnosis along with that economical for nonaffording patients.   In many literatures, it was evident that using TD was a great help in areas where dental services were not available. Other than that, “improving interprofessional communications by integrating dentistry into the more extensive health care delivery system as well as in taking second opinions, preauthorization, and other insurance requirements” with the use of real images of dental problems rather than tooth charts and written descriptions are some of the advantages too.
It is suggested to integrate TD as a part of dental education in final year of bachelor degree which will help and support dental students before entering professional practice and to get insight and build their future in this evolving field. It is also helping in other fields of dentistry as tremendous results can be seen in practicing family dentistry in spreading awareness regarding dental diseases. Moreover, dental educationists and dental experts can plan and offer postgraduation in TD that can also add value in the current era to make dental health care effective and efficient. 
Article published online:
11 March 2022
© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
- 1 Alauddin MS, Baharuddin AS, Mohd Ghazali MI. The modern and digital transformation of oral health care: a mini review. Healthcare (Basel) 2021; 9 (02) 118
- 2 Feuerstein P. Can technology help dentists deliver better patient care?. J Am Dent Assoc 2004; 135 (Suppl): 11S-16S
- 3 Fricton J, Chen H. J F. Using teledentistry to improve access to dental care for the underserved. Dent Clin North Am 2009; 53 (03) 537-548
- 4 Jampani ND, Nutalapati R, Dontula BS, Boyapati R. Applications of teledentistry: a literature review and update. J Int Soc Prev Community Dent 2011; 1 (02) 37-44
- 5 Bradley M, Black P, Noble S, Thompson R, Lamey PJ. Application of teledentistry in oral medicine in a community dental service, N. Ireland. Br Dent J 2010; 209 (08) 399-404
- 6 Younai FS, Messadi DV. E-mail-based oral medicine consultation. J Calif Dent Assoc 2000; 28 (02) 144-151
- 7 Kopycka-Kedzierawski DT, Billings RJ. DT K-K. Teledentistry in inner-city child-care centres. J Telemed Telecare 2006; 12 (04) 176-181
- 8 Sfikas PM. Teledentistry: legal and regulatory issues explored. J Am Dent Assoc 1997; 128 (12) 1716-1718
- 9 Wilson R. Ethical issues in teledentistry: following the American Dental Association Principles of Ethics and Code of Professional Conduct. J Am Dent Assoc 2021; 152 (02) 176-177
- 10 Golder DT, Brennan KA. DT G. Practicing dentistry in the age of telemedicine. J Am Dent Assoc 2000; 131 (06) 734-744
- 11 Schleyer T, Spallek H. Dental informatics. A cornerstone of dental practice. J Am Dent Assoc 2001; 132 (05) 605-613
- 12 Lienert N, Zitzmann NU, Filippi A, Weiger R, Krastl G. N L. Teledental consultations related to trauma in a Swiss telemedical center: a retrospective survey. Dent Traumatol 2010; 26 (03) 223-227
- 13 Torres-Pereira C, Possebon RS, Simões A. et al. Email for distance diagnosis of oral diseases: a preliminary study of teledentistry. J Telemed Telecare 2008; 14 (08) 435-438
- 14 Rollert MK, Strauss RA, Abubaker AO, Hampton C. MK R. Telemedicine consultations in oral and maxillofacial surgery. J Oral Maxillofac Surg 1999; 57 (02) 136-138
- 15 Ibraheim A, Sanalla A, Eyeson J. The role of teledentistry in oral surgery during the COVID-19 pandemic. Adv Oral Maxillofac Surg 2021; 1: 100005
- 16 Brüllmann D, Schmidtmann I, Warzecha K, d'Hoedt B. D B. Recognition of root canal orifices at a distance - a preliminary study of teledentistry. J Telemed Telecare 2011; 17 (03) 154-157
- 17 Park JH, Kim JH, Rogowski L, Al Shami S, Howell SEI. JH P. Implementation of teledentistry for orthodontic practices. J World Fed Orthod 2021; 10 (01) 9-13
- 18 Bauer JC, Brown WT. JC B. The digital transformation of oral health care. Teledentistry and electronic commerce. J Am Dent Assoc 2001; 132 (02) 204-209
- 19 Ignatius E, Perälä S, Mäkelä K. E I. Use of videoconferencing for consultation in dental prosthetics and oral rehabilitation. J Telemed Telecare 2010; 16 (08) 467-470
- 20 Abbas B, Wajahat M, Saleem Z, Imran E, Sajjad M, Khurshid Z. Role of teledentistry in COVID-19 pandemic: a nationwide comparative analysis among dental professionals. Eur J Dent 2020; 14 (S 01): S116-S122
- 21 Ahmed MA, Jouhar R, Ahmed N. et al. Fear and practice modifications among dentists to combat novel coronavirus disease (COVID-19) outbreak. Int J Environ Res Public Health 2020; 17 (08) 2821
- 22 Butt RT, Janjua OS, Qureshi SM. et al. Dental healthcare amid the covid-19 pandemic. Int J Environ Res Public Health 2021; 18 (21) 11008