TELEDENTISTRY – History and Present, What is The Revolution Process

TELEDENTISTRY – History and Present, What is The Revolution Process

History

In this era of modern medicine, dentistry has been constantly changing with the advent of information and technology. Teledentistry is a part of Telemedicine. Based on teledentistry history in 1997 “Teledentistry” was defined as the practice of using video conferencing technologies to diagnose and provide advice about Statistical analysis: The data collected was statistically analysed using SPSS software.1

Tele in Greek means distance and mederi in latin means to heal. Teledentistry has many branches like Telestomatology, Teleradiology, Telepathology, Tele oral surgery and Teleorthodontics.  Teledentistry, a budding field in dentistry, uses information based technologies and communication systems to deliver health care services to the people. The basic provision of dental care information is carried out through the proper channels of digital communication. It can be a prominent source for inter professional communications and eventually can be used for better educational source among dental students. It also helps in imparting basic knowledge to patients about dental health care thereby improving the health care facilities to the patients.2-3

Teledentistry is a fast advancing branch which is an effective combination of technology with dentistry. It involves fast and effective transfer of information pertaining to patients through electronic gadgets over remote distances. This enables an effective exchange of information and knowledge between patient and doctor and among various specialists for a better treatment planning and outcome. Most teledentistry programs to date have focused upon distance management and administration of remote facilities, learning and continuing education, consultation and referral services rather than supervision of auxiliaries or direct patient care.4-5

Present

Now teledentistry already use for information technology and telecommunications for dental care, consultation, education and public awareness in the same manner as telehealth and telemedicine. Teledentistry can also be used to assist general dentists with speciality work and improve services to underserved populations such as in rural or less developed areas.6-8

Teledentistry is a useful tool for both the patient and doctor it can be applied in various specialities of dentistry. It cuts down the time taken for multiple opinions by various specialists and thus works out more economic for the patient and the doctor. Prevention and early detection of any carious lesion or a soft tissue lesion is possible through teledentistry.9 Many function teledentistry in each dental departments, like:

  • Oral medicine and Radiology it helps in diagnosing and framing a treatment plan of difficult cases by easy access to various specialists through transfer of radiologic images of lesions.
  • Maxillofacial Surgery teledentistry may be helpful for appropriate treatment of complicated cases by analysis of advanced dental imaging techniques (like CBCT) which are often not available in one centre.
  • Orthodontics it helps a great deal to take multiple opinions on routine cephalometric analysis for a better treatment outcome. Also, teledentistry can be used for better patient compliance and satisfaction by sharing pre and post treatment images.
  • Endodontics it can be applicable for accurate diagnosis of periapical lesion and presence of any supplementary root canal.
  • Prosthodontics teledentistry along with various computer aided diagnostic tools (like CAD, CAM) can be a useful tool in designing inlays, onlays and in crown preparation also [9].
  • General Practioners often require multiple specialists’ opinion especially when dealing with complicated and recalcitrant cases. With the advent of teledentistry, these issues can be solved by making it easy for the general practitioners to contact and communicate about any faulty differential diagnosis with the specialists located in different areas thereby improving patient comfort and prognosis. The same also applies to specialists when they need opinion of other specialists in different fields of dentistry.9

To inculcate the knowledge and practice of teledentistry in the future generation dentists it is important to assess the awareness of the present dental students. Hence, the present study was conducted among dental professionals (including staff and students) to know the knowledge and awareness levels regarding teledentistry.1

The recommendations of the Federal Council of Dentistry and the National Health Surveillance Agency, dental care has been limited to emergencies and urgencies in COVID-19 pandemi. Due to the aerosols produced during many oral procedures, this measure is justified because of the higher risk of exposure of theses professionals to the virus and prevention of cross-infection between patients. Unfortunately, this endorsement has created a distance between patients and dentists.

So on dentistry, the following common three modes of operation hold great value for oral diagnosis since this pandemi. Teleorientation allows professionals to perform screening, guide, and refer patients in isolation to face-to-face assistance, if needed. Telemonitoring permits professionals to visually monitor patients suspected or positive for SARS-CoV-2 who present oral lesions through photographic control. Finally, teleconsultation enables the exchange of information between professionals, assisting in the diagnosis and therapy to be instituted to the patient with greater agility and precision.10

The systems available for executing teledentistry are still restricted, but represent an easy, viable, and accessible tool, useful for both health professionals and patients This communication could occur through instant messaging applications (WhatsApp, Telegram, Instagram, SMS, Messenger) and video calling applications (Google Meet, Skype, Facetime, WhatsApp, Zoom). A study published by Petruzzi et al.11  Confirmed the use of WhatsApp as a support in oral diagnosis, in which 82% of the teleconsulted cases agreed with the clinicopathological diagnosis, suggesting that it is a good option for teledentistry.

There are so many good process of teledentistry, while in history of teledentistry since use in 1997 especialy using for SPSS in research, which is not directly use on patient care. Than nowadays teledentistry can be one of basic method in dental care giver by dentist directly to patient. And also teledentistry nowadays use as electronic patient medical record system, it is now possible to make/get continuous and never lasting record. Data storage does not require much space and there are less chances of damage or loosing data. Beside that, there is tele-education use by dentist and the expert for elaborate dentist’s skill by online seminar to avoid crowd, tele-education like : webinar, web-based self-intruction educational system, interactive videoconferencing, dental chat rooms. Teledentistry will be a continuous progress that will develop in the future along with the continued development of technology in the next generation.

Resources :

  1. Boringi M., Waghray S., et al. Knowledge and Awareness of Teledentistry among Dental Professionals – A Cross Sectional Study. Journal of Clinical and Diagnostic Research. 2015 Aug, Vol-9(8): ZC41-ZC44  43
  2. Arora S, Dwivedi S, Vashisth P, Mittal M, Nayak S. Teledentistry: A review. Annals of Dental Specialty. 2014;2(1)11-3
  3. Fricton J, Chen H. Using Teledentistry to Improve Access to Dental Care for the books/advances-in-telemedicine-applications-in-various-medical-disciplinesUnderserved. Dent Clin North Am. 2009;53(3):537-48.
  4. .Jampani ND, Nutalapati R, Dontula B, Boyapati R. Applications of teledentistry: a review and update. J Int Soc Prevent Communit Dent. 2011;1:37-44
  5. Nagarajappa R, Aapaliya P, Sharda AJ, Asawa K, Tak M, et al. Teledentistry Knowledge and Attitudes among Dentists in Udaipur, India. Oral Health Dent: 2011;5(7): 1486-88.
  6. Sanjeev M, Shushant GK. Teledentistry a new trend in oral health. 2009;13-14:1-8. 2011;2(6):49-53.,
  7. Reddy KV. Using teledentistry for providing the specialist access to rural Indians. utilization and costs. J Dent Hyg. 2013;87(6):345-52. 
  8. Brullmann D, Schmidtmann I, Warzecha K, Dhoet BJ. Telemed: Recognition of root canal orifices at a distance – a preliminary study of teledentistry. Telecare. 2013;19(4):179-83.
  9. Branko Mihailovic, Milan Miladinovic, Biljana Vujicic. Advances in Telemedicine: Applications in Various Medical Disciplines and Geographical Regions, Prof.  partiCularS of ContriButorS: Georgi Graschew (Ed.). InTech, China. 2011. Chapter 11, Telemedicine in of Dental Specialty. 2014;2(1)11-3. Dentistry (Teledentistry); pp.215-30. Available from: http://www.intechopen.com/
  10. Telles-Araujo G. T., Caminha R. D. G., et al. Teledentistry Support in COVID-19 Oral Care. Clinics. 2020;75:e2030
  11. Petruzzi M, De Benedittis M. WhatsApp: a telemedicine platform for facilitating remote oral medicine consultation and improving clinical examinations. Oral Surg Oral Med Oral Pathol Oral Radiol. 2016;121(3): 248-54. https://doi.org/10.1016/j.oooo.2015.11.005
The Best Time To Visit A Dentist In The Middle Of Covid-19 Pandemic

The Best Time To Visit A Dentist In The Middle Of Covid-19 Pandemic

This pandemic has been giving a lot of obstacles and pressures to everyone including Dentists. The guidance and setting in Dental office also have been set up to minimize the cross infection or transmission of this Covid-19. CDC also has published few guidances for dental setting while pandemic.1 Since March until May 2020, most of dental clinics chose to close their pratice place for a while in Indonesia, even The American Dental Association (ADA) had recommended US dentists to close their pratices to all but the emergency dental work.2 The practice of dentistry involves the use of rotary dental and surgical instruments, such as handpieces or ultrasonic scalers and air-water syringes. These instruments create a visible spray that can contain particle droplets of water, saliva, blood, microorganisms, and other debris. Surgical masks protect mucous membranes of the mouth and nose from droplet spatter, but they do not provide complete protection against inhalation of airborne infectious agents. There are currently no data available to assess the risk of Covid-19 transmission during dental practice.1

Then the patients have been asking if they can’t do the dental treatment at all, or a question when this pandemic will end. The only real answer is “we don’t know, no one knows” since it is the first time for everyone and it is still being studied. Closing dental practices during the pandemic can reduce the number of affected individuals, but will increase the suffering of the individuals in need of urgent dental care. It will also incense the burden on hospitals in emergency departments.3

The ADA published a helpful patient guide listing which dental problems require emergency care and which can wait a few weeks.The following are conditions that you need to see a dentist for right away despite the danger of COVID-19, according to the ADA:

  • Bleeding that doesn’t stop
  • Painful swelling in or around your mouth
  • Pain in a tooth, teeth or jaw bone
  • Gum infection with pain or swelling
  • After-surgery treatment (dressing change, stitch removal)
  • Broken or knocked out tooth2

It is important to note that during this pandemic, the range of emergency dental treatment on offer may be limited to dental extractions only rather than fillings or other restorative care and scalling (cleaning) which have higher significance for people with bleeding disorders due to managing the risks of bleeding. It is important before attending an emergency appointment that you have communicated your bleeding disorder to the emergency dentist who you may not have met before.4 Unfortunately, there may be instances where patients behave unreasonably, perhaps out of frustration or anxiety.5 It happened several times in our clinic too, but we chose to give a better explanation so it can be acceptable by our precious patients. Clear communication with patients will also help, so update your website and practice answerphone messages to make it clear how patients can access dental services during the coronavirus pandemic.5

Resources:

  1. https://www.cdc.gov/coronavirus/2019-ncov/hcp/dental-settings.html
  2. https://www.medicinenet.com/should_i_go_dentist_covid-19_coronavirus_pandemic/ask.htm
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7141449/
  4. https://www.ehc.eu/coronavirus-updates/dental-care-and-covid-19-pandemic/
  5. https://www.nature.com/articles/s41407-020-0288-y