Leveraging Teledentistry to Close Gaps in Oral Health

Barriers to care require innovative solutions

Teledentistry refers to a variety of technologies and tactics used to virtually deliver oral health and education services and helps to connect providers to other providers or connects providers directly with patients to enhance care and education delivery.

Teledentistry services can expand oral health access, lower costs, and improve health outcomes and patient satisfaction—making it a critical service to transform the oral health industry. 
   
Most people aren’t getting the preventive oral health care and treatment they need to live healthy lives. According to the DentaQuest research report, Reversible Decay: Oral Health is a Public Health Problem We Can Solve, patients identify three top reasons they struggle to access oral health care: cost, lack of dental insurance, and access issues. The report also shows a widespread desire for collaborative solutions.

Access issues include:
  • Inability to take time off of work
  • Lack of transportation
  • Few dentists/oral care providers in the area
  • Lack of child care that enables you can see a dentist/oral care provider
  • Hard to find a dentist that speaks your lanuage
  • Hard to find a dentist that understands your culture
That list of access issues points to an overarching problem that teledentistry is already solving for many communities nationwide: traditional dental care delivery simply doesn't work for many Americans.
 
     
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How Telehealth Fits into Care Delivery

Teledentistry is not a specific service. Rather, it can be considered a subset of telehealth, which refers to a variety of technologies and tactics that enhance health care and education delivery. These technologies and tactics can be broadly categorized in four types:
 
1. Live Video (synchronous) Sometimes referred to as “real time” or “videoconferencing,” synchronous interactions are useful when a real time conversation is needed between a health care provider and a patient, or between health care providers. In general, live video is used for synchronous interactions, but real time interactions can also take place using some of the other modalities described below.
 
2. Store-And-Forward (asynchronous) This category refers to interactions that do not take place in “real time.” A common use of asynchronous interactions is when a health care provider reviews health information or records that have previously been gathered by another professional or allied professional at an earlier time and at a different place than where the records are reviewed. The term “store-and-forward,” although commonly used today, is an older term that originated when records were captured in one location and then sent (forwarded) to another location. Now records can be captured directly to the cloud (internet-based servers) and accessed by individuals in multiple locations, eliminating the step of “forwarding” the records. Store-and-forward telehealth is in use in many aspects of health care such as teledermatology, teleopthamology, and teledentistry.
 
3. Remote Patient Monitoring Remote patient monitoring refers to using electronic means to gather information about a patient’s health, which is reviewed by a health care provider in a location separate from where the patient resides. This can be done synchronously or asynchronously. Examples include the Holter monitor, which measures EKG readings over a 24-hour period, and emerging systems to measure the pH of patient’s saliva over a period of time for review by the patient’s dentist.
 
4. Mobile Health (mHealth) Mobile health includes information sharing, education, and patient monitoring systems supported by mobile communication devices such as smart phones, tablets, smart voice assistants and computers. These mobile devices can support interactions that overlap with the categories described above.

Nationwide, using one or many of these technologies, dedicated telehealth-connected teams are leading efforts to bring oral health care services to hard-to-reach patients – meeting them where they live, work and go to school.
 

Care Settings 

There are a variety of places where oral health care can be delivered today beyond a traditional practice setting. Each care setting is differently suited to teledentistry-enabled care.
 
  KEY  
  Teal Circle   Opportunity within emerging teledentistry landscape    
  Purple Circle   Opportunity within unexplored teledentistry landscape  
 
Care Settings Care Types
  Preventive Cosmetic Urgent Restorative Surgical
Dental Office Traditional Setting Icon
Traditional		 Teal Circle Teal Circle Teal Circle Teal Circle Teal Circle
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Retail		 Purple Circle Teal Circle Purple Circle – –
Kiosk icon
Pop-up/Kiosk		 Purple Circle Purple Circle Purple Circle – –
RV/Mobile Icon
Mobile		 Teal Circle Teal Circle Teal Circle Teal Circle –
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Portable		 Teal Circle Purple Circle Purple Circle Teal Circle –
Home icon
Home		 Purple Circle Teal Circle Purple Circle – –
Cellphone icon
Person		 Purple Circle Purple Circle Purple Circle – –

 

The Future 
The composition of dental practices is shifting. Public funding for dental care is increasing, the integration of oral health and physical health is becoming more common practice, and scientific advancements in prevention and behavior support are changing the way patients and their dentists think about oral health.  
 
This shift has given rise to a fundamental rethinking of how care can be delivered and received. In his paper, Expanding Oral Health: Teledentistry, Dr. Paul Glassman – with support from the DentaQuest Partnership for Oral Health Advancement – illustrates this by examining technology, attitudes, policy enviornments and other factors leading to greater adoption of emerging technologies. “Teledentistry is part of a broader digital health transformation that is leading to better outcomes, at a lower cost and with greater patient and provider satisfaction...” he writes, adding, “Enacting supportive policies and using telehealth-connected teams (and the other strategies described in this report) will allow public and private programs to reach more people and ‘buy more health per dollar’ of public spending.”
 
Watch the recorded companion webinar Teledentistry: Closing Gaps in Oral Health for more on how teledentistry can expand the reach of today’s oral health care system, improve outcomes and lower costs.
 
Recommended Resources  
White Paper: Expanding Oral Health: Teledentistry 
Webinar: Teledentistry Closing Gaps in Oral Health -July 2019 


 
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