Teledentistry and its use in dental education

Tele-periodontics - Oral health care at a grass root level

A new concept of tele-periodontics, which merges the innovative technology of telecommunications and the field of periodontics, is proposed. This new field of tele-periodontics will have an infinite potential where access to a specialist will be provided at a grass root level, enhancing effective delivery of therapy and information to the rural and under privileged areas. It would allow the specialist and the patient to interact either by video conferencing (real time) or through supportive information (store and forward) over geographic distances. Different probabilities of tele-periodontics such as tele consultation, tele training, tele education and tele support are also discussed in this paper.

Teledentistry: a systematic review of the literature

We conducted a systematic review of teledentistry applications. We searched the MEDLINE/PubMed, Embase and Cochrane Library databases for relevant articles published from 1992 to 2012. The reference lists of all retrieved articles were hand-searched. Studies were included after assessing the eligibility of the full-text article. A total of 878 studies were identified, of which 59 fulfilled the inclusion criteria of the review. The articles covered several dental specialties, mostly oral surgery, oral medicine and oral pathology. The most common type of teledentistry application was education (n = 21), followed by diagnosis (n = 16), consultation (n = 3) and treatment (n = 2). Teledentistry studies were reported in a total of 15 countries. The largest number of studies were conducted in the US (n = 22) and there were no studies from developing countries. Most of the reports referred to pilot projects and short-term outcomes, and most of the studies were descriptive. The review indicates that although teledentistry is an area of expansion, there are still some barriers to its increased use.

Factors influencing the adoption and implementation of teledentistry in the UK, with a focus on orthodontics

OBJECTIVES

Utilizing Rogers' diffusion of innovation theory, this study aims to develop a better understanding of the challenges faced in teledental projects, and outline the factors that impact upon the adoption and implementation of teledental projects, with a focus on orthodontics, thus attempting to provide an explanation for the low uptake in the UK, as well as to suggest factors to encourage success.

METHODS

A literature search was carried out to obtain information concerning teledentistry (and telemedicine) from both primary and secondary research sources. Using the relevant information obtained, Rogers' diffusion of innovation theory was used as a framework, which was subsequently applied to the key stakeholder groups of a healthcare organization.

RESULTS

The model describes five characteristics of an innovation: relative advantage, compatibility, complexity, trialability and observability. These attributes are discussed in the context of key stakeholder groups within a healthcare organization: clinicians, patients, hospital managers, and healthcare decision-makers and funders. Each stakeholder group is motivated by different values and experiences, which in turn influence their decision to adopt a new technology.

CONCLUSIONS

Implementing teledental applications necessitates full comprehension and consideration of the healthcare environment and also a commitment to completely integrate teledentistry within that environment. This is a process that demands strategic alignment with clinical and organizational goals, clinical engagement and strong political support. The challenges within each stakeholder group must be specifically targeted.

Applications of teledentistry: A literature review and update

Teledentistry is a combination of telecommunications and dentistry involving the exchange of clinical information and images over remote distances for dental consultation and treatment planning. Teledentistry has the ability to improve access to oral healthcare, improve the delivery of oral healthcare, and lower its costs. It also has the potential to eliminate the disparities in oral health care between rural and urban communities. This article reviews the origin, rationale, scope, basis, and requirements for teledentistry, along with the current evidence that exists in the literature. This article also reviews the ethical and legal issues related to the practice of teledentistry and the future of this alternative and innovative method of delivering dental care.

Use of videoconferencing for consultation in dental prosthetics and oral rehabilitation

We conducted a 13-month study to investigate whether videoconferencing could be used for diagnosis and for making treatment plans for patients requiring prosthetic or oral rehabilitation treatment. The consultations took place between a specialist dental treatment unit in a central hospital and general dental practitioners in seven regional health centres. Videoconferencing was conducted using standard commercial units via an IP network, at bandwiths of 762 kbit/s – 2 Mbit/s. In total, 24 patients and 25 professionals (18 dentists, 2 dental hygienists and 5 nurses) took part. There were no technical problems. In 24 out of 27 teleconsultations, a diagnosis or treatment plan could be made. All participating dentists were satisfied with the consultation process and indicated that the technology used was of sufficient quality for clinical purposes. A patient satisfaction questionnaire indicated that patients were also satisfied. Videoconsultation in dentistry has the potential to increase the total number of dental specialist services in sparsely populated areas, such as those in Finland.

Using teledentistry to improve access to dental care for the underserved

Teledentistry is an exciting new area of dentistry that fuses electronic health records, telecommunications technology, digital imaging, and the Internet to link health providers in rural or remote communities. For the patient located in underserved or remote areas, teledentistry improves ready access to preventive dental care and teleconsultation with specialists. It allows the dentist in the nearby community to provide easier access to preventive care to a patient who, otherwise, probably will not seek care. It enables the specialist located many miles away to make a diagnosis and recommend treatment options and/or referral.

Use of telemedicine for pre-implant dental assessment – a comparative study

Summary

We evaluated real-time telemedicine for exchanging expert opinions in the area of pre-implant dental assessment. From 2003 to 2005, every tenth patient at the armed forces’ dental clinic in Cologne-Wahn seeking implant counselling was discussed via videoconference (intervention group, n = 85). Indications, prosthodontic options, the required number of implants and implant positions were determined. The mean time required for the videoconferences was 3.5 min (range 1.0–9.5). In the control group ( n = 772), the implant consultation was performed based on existing records, without using telemedicine. In three cases (3%), a basic change in the prosthodontic concept was required as compared to the telemedicine plan; in the control group, the concept changed in 7% of cases. The changes in the number and position of implants during therapy were also similar in the two groups. The results showed that telemedicine permitted satisfactory preoperative evaluation of the implantation operation.

Communication channels to help build an international community of education and practice

Two-way communication is required if nurses are to build knowledge networks of international communities of nursing education and practice. Are expensive new technologies feasible or preferred for effective communication and productive outcomes? In this report from a longstanding partnership between schools of nursing at Peking University and the University of Michigan, case study methodology is used to evaluate more than a decade of experience with communication modalities: in person, postal mail, express mail, e-mail, fax, telephone, hand delivery by other travelers, and Web sites. Although each education and practice community develops unique ways to build its shared knowledge, a communications plan is suggested, with use of multiple communication techniques, especially those that are low cost and the most dependable. High-cost technologies are not always feasible or preferred. For the project described, they were not necessary to the major outcome, a nursing education and practice network that resulted in the first nurse-managed community-based clinic in China.

Development of oral home telecare programme for the home-dwelling elderly: a pilot study

OBJECTIVES

The aim of the pilot study was to develop and evaluate a telecare programme for home-dwelling elderly to provide education on oral and general health care.

DESIGN

A field trial with a computer system linking a university with a structured network.

SUBJECTS

A group of home-dwelling elderly males with a mean age of 73.3 years.

METHODS

Qualitative assessment following videophone interviews with clients and their families.

RESULTS

Clients and families were able to gain a better understanding and knowledge of oral health care particularly the skills required to perform new oral care procedures.

CONCLUSIONS

Preventive oral homecare via videophone offers the potential for providing a long-term structure for maintaining oral health particularly with limited social resources.

Biomedical informatics training for dental researchers

Dental researchers collaborating closely with biomedical informaticians have achieved many advances in oral health research, such as in mapping human genetics and addressing oral health disparities. Advances will continue to increase as dental researchers and biomedical informaticians study each others' disciplines to increase the effectiveness of their collaborative research. The combined skills will greatly increase the effectiveness of dental research. This manuscript summarizes the core of biomedical informatics curriculum (biomedical informatics knowledge, data management, and software engineering) for dental research. It also summarizes the obstacles that must be overcome for all dental research students to receive the training in biomedical informatics they require. These issues are: a lack of biomedical informatics faculty, a lack of biomedical informatics courses, and a lack of accreditation standards. Last, intra- and inter-institutional collaboration solutions are described.