The COVID-19 pandemic has accelerated the adoption of teledentistry, but challenges from insurance companies, lawmakers and traditionally-minded dentists have hindered its widespread adoption, according to an Oct. 21 report from Kaiser Health News.
Seven key issues surrounding teledentistry:
- Teledentistry allows dentists to conduct more appointments and see more patients, which could possibly lead to more dental care for the 35 percent of U.S. adults who haven't seen a dentist in the previous year, according to 2019 CDC estimates.
- Some dentists and lawmakers see teledentistry as a way for dentists to make more money, as it is cheaper to provide care and they can see patients from a much wider geographic range. Kirill Zaydenman, vice president of innovation for oral health care company DentaQuest, told Kaiser Health News virtual appointments save dentists time and allow them to have room for patients "who need the more expensive services."
- Some dentists and lawmakers also view teledentistry as a set of services that offer little to no in-person dental care. SmileDirectClub, a company that provides at-home teeth aligners, opposed a 2019 Texas bill aimed at increasing access to dentistry for rural citizens. The company's attorney said the bill "could interrupt the course of a patient’s treatment," as it stipulated several teledentistry restrictions, including one that would require patients receiving teledentistry care for more than 12 months to visit a dentist for an in-person exam.
- Teledentistry has the potential to greatly expand dental care access in rural communities, but its widespread implementation is often slowed by unreliable internet connections. Mack Taylor, DDS, a dentist in rural Missouri, told Kaiser Health News many of his patients have trouble connecting to the internet.
- Many insurance companies do not reimburse for teledentistry, due in part to their concerns about fraudulent billing. Paul Glassman, DDS, a dentist in California's Bay Area who began the Virtual Dental Home project to provide care for underserved preschool children, believes these worries were unfounded. "If you want to bill for something you didn’t do, you can do that just as easily in an in-person environment as you can using teledentistry," he told Kaiser Health News.
- Teledentistry isn't reversible under Medicare, just as most dentistry isn't. Medicaid and the Children’s Health Insurance are more likely to cover teledentistry services, but 2015 data from the American Dental Association shows that only 38 percent of dentists participate in those programs. The lack of teledentistry coverage from both federal and private insurance providers has hindered teledentistry's mass adoption.
- Teledentisty can be a much-welcomed option for those who struggle with discomfort at the dentist, such as patients with sensory disorders or on the autism spectrum. Donella Pogue, a Bristol, N.Y., mother with a Medicaid-covered son on the autism spectrum, told Kaiser Health News he "is really afraid of dentistry, so when he goes to see someone, he is really tense and really jumpy." She said teledentistry worked well for him, as he felt much more comfortable conducting the visit from home.
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