More Americans now express interest in consulting healthcare professionals when and where it is convenient for them. In fact, Parks Associates reports that 60% of United States households with broadband access “are interested in remote care that would take place online or by telephone.”
With this shift toward telehealth, there has emerged a new proprietary model of virtual dental care known as teledentistry. Video consults connect the patient’s laptop, tablet, or smart phone to a virtual dentist who diagnoses the patient’s problem and gets them started feeling better quickly, which may include an e-script for an antibiotic and/or non-narcotic pain medication. When follow-on care is needed, next-day appointments are booked with an appropriate dentist, conveniently located near the patient.
Ideally, a teledentist solution for urgent oral and dental problems should be available via video consultation 24/7/365. This approach addresses dental issues early on, before they become highly problematic, and improves patient outcomes. Real time technology connects patients with the expertise they need and when it’s needed most.
Impact on Patients
Teledentistry offers key advantages for patients:
- Assessment: Patients can send a photo or video for their dentist to evaluate. Further assessment can also be made using existing dental records taken by a dentist in person and examined remotely.
- Quick relief for pain: If a patient experiences pain or requires antibiotics for an abscess in the middle of the night or on the weekend, rather than going to the emergency department (ED) or enduring the pain they can get a prescription from a teledentist.
- Monitoring: Teledentistry represents a cost-effective way for patients to have their dental treatments monitored, which is especially important in evaluating the progress of tooth movement.
- Safe and effective: In the United States, teledentistry treatments are now included in insurance coverage and in Current Dental Terminology (CDT), sealing it as a growing and permanent trend. In fact, a six-year California study shows that “virtual dental homes” are safe and effective, and a New York study highlighted the benefits of using innovative methods to deliver oral care for the underserved, particularly in rural areas.
Teledentistry in the Emergency Department
Many hospitals and urgent care centers have begun to install cloud-based teledentist services. This helps EDs and urgent care facilities gain access to a specialist who can treat oral care problems at a fraction of the cost incurred in the emergency room.
Traditionally, ED dental visits represent a significant, costly public health problem. Toothache was the top complaint bringing patients to the ED, followed by back pain, headache, mental health issues, and sore throats. Dental disorders were also included among the top three ICD-9 discharge diagnoses, together with alcohol abuse and depressive disorders, and accounted for 3.9% of clinical classifications software grouped discharge diagnoses.
Unfortunately for patients, many, if not most, EDs in the United States are not equipped to treat dental conditions or disorders. While a limited number of medical facilities and hospitals have dentists on staff in EDs, this is the exception rather than the rule.
Most patients seeking dental care in EDs receive only pain medications or antibiotics and are referred back to dental providers in the community. But due to affordability concerns and lack of insurance coverage, patients often return to the ED for the same problem, which, in many cases, becomes more advanced.
The ADA estimates that if the $520 million reimbursed by Medicaid each year for ED dental visits were instead diverted to private dental practices, care could be provided for up to 1 million additional people annually. This service also benefits employers, plan sponsors, and insurers by avoiding unnecessary, expensive ED visits and closing the gap in care coverage for groups with high-deductible health plans or those with no dental insurance.
Impact on Dental Professionals
In addition to patient care, video conferencing technology provides a unique way to overcome the barriers of geography to deliver long-distance clinical training and continuing education for dentists, dental hygienists, midlevel providers, and advanced dental therapists at remote clinics.
It also increases interprofessional communication, which will improve dentistry’s integration into the larger healthcare delivery system. Referrals, pre-authorizations, and other insurance requirements can be realized quickly online with the use of real-time clinical images. This makes dental care more efficient, resulting in cost savings for dental offices, patients, and third-party payers.
Telehealth can also facilitate greater use of dentists and non-dentist providers in nontraditional settings to help improve early diagnosis, triage, treatment, and referral of patients. Live streaming videoconferencing, intraoral camera integration, and store-and-forward exams enable dentists to capture and share all relevant patient information and clinical data.
New approaches and practice models also open opportunities for dentist practices to reach new patients, grow revenue, and achieve equity of care through innovation and more efficient care delivery.
Teledentistry gets patients the immediate help they need, saving time and money while delivering pain relief, speedy access to a dentist, and information about the importance of oral health.
Mr. Wald is CEO of the TeleDentists. His career includes stints with major advertising agencies (Ogilvy & Mather, Grey), consulting firms (Luminant), and Fortune 500 marketers (NBC, GTE/Verizon, Medtronic). He also was a cofounder and executive vice president of Teladoc Health, which he helped build into a leading telemedicine services provider. He holds an MBA in marketing from Northwestern University. He can be reached at garyw@theteledentists.com.
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