Teledentistry has garnered attention over the past few years as potentially playing a key role in improving the access to dental care. Can it stand up to the hype?
"While teledentistry has gotten much hype, in practical terms it is limited due to the nature of dentistry," said Misako Hirota, DMD, a National City, Calif.-based dentist. "If you have an emergency, you can have a video conference call with the patient before prescribing to meet standard of care requirements. This may save you a trip into the office on a weekend, but that is about all you can do. You can try and diagnose, but without a radiograph, you are guessing, and most patients are not good at pinpointing a problem tooth until it gets severe."
Julia Hallisy, DDS, a San Francisco-based dentist, said she feels teledentistry has a significant role to play in dental health as a new and evolving care delivery model that needs structure, oversight and ongoing revisions. The applications are especially clear for pediatric patients, she said.
"A parent who has never experienced an aphthous ulcer is usually very alarmed to see a sore that causes significant distress develop in their child's oral cavity," she said. "Parents will contact their dentist in a panic because they think the child has an abscess or other serious infection. Teledentistry can help to alleviate anxiety and stress about oral conditions, keep patients out of emergency rooms and urgent care centers that often cannot help them in any way, and direct them to contact a dentist."
Not all dentists see it that way.
"Teledentistry is not that big of a deal," said Marc Whitmore, DDS, a Plano, Texas-based dentist. "Telemedicine is a much more viable thing because beyond physical examination, physicians mostly talk and prescribe, all of which can be done on a Zoom call. Dentistry, in contrast, is mostly a procedure-based industry, and just talking about it does not provide many solutions for patient care."
James Diamond, DDS, a Glendale, Ariz.-based dentist, said teledentistry is more of a revenue stream without clinical application and has limited diagnosis and treatment applications.
Michael Shakin, DDS, a Staten Island, N.Y.-based dentist, also told Becker's teledentistry isn't a big part of his practice and he doesn't see it evolving much over the next few years. Drs. Diamond and Shakin are not alone in their opinion of teledentistry.
"Teledentistry is good for the lazy and those who don't want to pay," said Robert Trager, DDS, a a New York City-based dentist in the Queens neighborhood of Jamaica. "The future should be to see your dentist in person and only rely on teledentistry if you are in remote areas."
John Osborn, DDS, owner of Osborn Family Dentistry in Maynardville, Tenn., and dental director and secretary of Remote Area Medical in Rockford, Tenn., said he was able to use teledentistry during the pandemic, but laws requiring patients to be physically in the state where the provider is licensed hindered efforts since many people had out-of-state phone numbers.
These roadblocks, coupled with questions of applicability, have left some dentists lukewarm about teledentistry.
"I'm not really impressed with teledentistry because I feel like dentistry needs X-ray and visual inspection of the oral cavity, which neither can be done via teledentistry," said Jason Kwon, DDS, of Jace Dental in Plainfield, N.J. "[But] I feel like teledentistry will get better with technology."
Glenn Prager, DDS, of Little Egg Harbor Township, N.J., said he thinks teledentistry is limited to more of the psycho-palliative experience. "It just makes the patient feel better by speaking to someone. In reality, any serious dental issues will need to be seen in person, X-rays and other diagnostic methods utilized, and a definitive diagnosis defined. None of this is possible via teledentistry."