Patients' and dentists' perceptions of tele-dentistry at the time of COVID-19. A questionnaire-based study

The Utilisation of Teledentistry in Australia: A Systematic Review and Meta-analysis

BACKGROUND

Teledentistry is the usage of information-based technologies to deliver healthcare services remotely. It is used to deliver care in regional, rural and remote regions and was particularly useful to deliver care during the COVID-19 pandemic.

OBJECTIVE

This systematic review and meta-analysis aimed to determine teledentistry utilisation in Australia.

METHODS

The databases PubMed, Google Scholar, EMBASE and Web of Science were searched from inception to June-2024. The phrases "Dental" AND "Telehealth" AND "Australia" and "Teledentistry" AND "Australia" were used. Two authors completed the study selection and data extraction. The Joanna Briggs Institute Critical Appraisal Tools were used to assess quality and bias.

RESULTS

Eighteen articles met the inclusion criteria. There were six diagnostic tests, six cross-sectional studies, 4 economic evaluations, one qualitative study and one expert opinion. Teledentistry was accurate for screening caries (average sensitivity=69.7%, average specificity=97.4%). There also appeared to be a non-significant negative correlation between specificity and sensitivity (r=0.432). Opinions regarding teledentistry were mixed from clinicians but positive from patients. Teledentistry may also lead to savings for patients and healthcare providers.

CONCLUSION

Teledentistry increases healthcare access especially for people in regional, rural and remote areas. It is an effective screening tool for caries. Whilst the opinions of clinicians were mixed, potential implementation barriers were identified which could improve opinions of clinicians and increase implementation.

CLINICAL IMPORTANCE

This study demonstrates teledentistry as a satisfactory tool for screening caries. This could be beneficial to those with difficulties visiting dentists in-person, particularly if they live in regional, rural or remote areas.

The effect of virtual simulation technology applied to undergraduate teaching of periodontal probing

INTRODUCTION

The rise of virtual simulation technology and dental simulators has created a new pedagogical approach for undergraduate medical education. The purpose of this study is to evaluate the effect of virtual simulation (VS) technology on improving the students' comprehensive abilities in periodontal probing teaching in pre-practicum periodontology, such as increasing the accuracy of probing, tactile perception and performance on force control.

MATERIALS AND METHODS

Twenty students were randomly selected among the fourth-year students and equally divided into VS technology teaching group (VS group) and traditional teaching group (TT group) by drawing half lots. One day later, students were required to probe the periodontal pathology model. The consistency rate between PD measurements and PD reference values, time consumption and final exam scores were recorded and statistically analysed using an unpaired Student's t test and p < .05 was considered statistical significance. Finally, questionnaires relating to teaching methods evaluation and the fidelity of the digital VS training system were distributed to students and teachers.

RESULTS

VS group had a significantly higher consistency rate (72.976 ± 6.811%) than TT group (64.107 ± 4.988%, p = .004). To specify, the difference of consistency rates between the two groups in posterior teeth was larger than anterior teeth. Similarly, a larger difference was also found in proximal surfaces compared with buccal-lingual surfaces. As the pocket depth increased, the difference between the two groups increased too. These results indicated that VS is more efficient in complicated parts of periodontal probing teaching. In addition, students in VS group spent less time and gained a higher score than TT group (p < .05). The overall satisfaction rating in VS group was significantly higher than TT group. Lastly, teachers gave significant lower scores than students concerning the fidelity of VS system.

CONCLUSION

Although there are much to improve, VS technology has obvious advantages in periodontal probing teaching in pre-practicum periodontology.

Clinical activities suspended: How the COVID-19 affected the self-confidence of Italian dental students

INTRODUCTION

COVID-19 emergency caused several effects on the dental educational system, especially affecting courses including practical activities. The study aims to evaluate the impact of the suspension of dental clinical activities on the Italian dental students' self-confidence. Furthermore, the other purpose of the research is to find an integrative didactics solution to improve the clinical training of dentistry during the COVID-19 pandemic.

MATERIALS AND METHODS

A questionnaire was administered to evaluate the impact of the suspension of clinical activities on dental students' self-confidence. A 67-questions survey tested the students' self-confidence in several dental disciplines (Conservative Dentistry, Endodontics, Oral Surgery and Dental Emergency). The study reached a sample of 193 dental students and the answers from 9 different Italian dental schools were analysed.

RESULTS

The degree of students' self-confidence for all the dental disciplines investigated was found statistically different between the periods before and after the interruption of clinical activities. The students proposed, as a potential solution to improve their practice during the COVID-19 pandemic, to combinate the use of a video tutorials and dental simulators.

CONCLUSION

The interruption of the training in clinical practice significantly affected the educational career and the self-confidence of students. An alternative teaching method involving the use of video tutorials as support in teaching clinical procedures deserves to be considered.

An Ethical Analysis Regarding the COVID-19 Pandemic Impact on Oral Healthcare in Patients with Mental Disorders

During the COVID-19 pandemic, restrictive measures were imposed that significantly impacted the healthcare system in general, and the dental healthcare system in particular. The literature cites a possible association between mental and oral health, as psychiatric patients have decreased awareness of their oral health and, therefore, poor dental status. Moreover, several studies have found a positive association between SARS-CoV-2 infection and oral health conditions, as well as between SARS-CoV-2 infection and mental health status. This context generated multiple ethical dilemmas in the case of persons with mental health disorders who require dental treatment because they are more vulnerable in this respect. This article aims to analyze the ethical issues in dental care for patients with mental disorders concerning the COVID-19 restrictive measures. The ethical aspects involved here are the basic principles of bioethics and the related elements of accessibility, equity, consent, and confidentiality.

Is teledentistry effective to monitor the evolution of orthodontic treatment? A systematic review and meta-analysis

INTRODUCTION

With the advent of COVID-19, teledentistry and remote monitoring have become an imminent reality that allows orthodontists to monitor orthodontic treatment through virtual checkups, which complement in-office appointments.

OBJECTIVE

To evaluate the effectiveness of using teledentistry in monitoring the evolution of orthodontic treatment.

MATERIAL AND METHODS

Searches were performed in on-line databases. PECO strategy focused on comparing orthodontic patients exposed and not exposed to teledentistry. Searches and data extraction followed PRISMA guidelines. The assessment of the risk of bias and the certainty of the evidence was performed using the ROBINS-I and GRADE tools, respectively. A meta-analysis was also performed.

RESULTS

Out of 1,178 records found, 4 met the criteria and were included in the qualitative analysis. The risk of bias for follow-up assesment in aligner treatment was low to moderate; while for interceptive treatment, it was high. Studies are favorable to the use of teledentistry. The meta-analysis was performed with aligners studies only, due to heterogeneity. The certainty of the evidence was considered very low.

CONCLUSION

With very low certainty of evidence, teledentistry using Dental Monitoring® software is effective as an aid in monitoring the evolution of interceptive orthodontic treatment (high risk of bias) and, especially, treatment performed with aligners (low to moderate risk of bias). The meta-analysis evidenced a reduction in the number of face-to-face appointments (mean difference = -2.75[-3.95, -1.55]; I2=41%; p<0.00001) and the time for starting refinement (mean difference = -1.21[-2.35, -0.08]; I2=49%; p=0.04). Additional randomized studies evaluating corrective orthodontic treatment with brackets and wires are welcome.

Parent perceptions regarding virtual pediatric dental clinics during COVID-19 pandemic: a cross-sectional study

Objective

To assess the attitudes and responses of parents of pediatric patients towards virtual dental clinics during COVID-19.

Material and Method

A total of 102 parents of pediatric patients who were scheduled for virtual (video or telephonic) clinic appointments for new patient consultations and follow-up clinics were included in the study. Parents and patients could attend the virtual clinic from a personal computer, tablet, or smartphone. An electronic self-administered questionnaire was sent to the parents through email after consultation (video or telephonic) which consisted of demographic data and a ten-item, five-point Likert-scale assessing: (i) parent satisfaction; (ii) ease of use; (iii) the effectiveness including increasing access to clinical services; (iv) reliability of the teledentistry system and (v) usefulness for patients. Statistical analyses used were t-test, one-way ANOVA test, Shapiro-Wilk and histogram.

Result

Out of 102 parents, 52 attended video clinics and 50 attended the telephonic clinic. The majority of the parents were between 30-39 years of age, and about 73% had no previous experience with either virtual or telephonic consultation. Ninety-four percent of parents were satisfied with vide clinic consultation, and most of them agreed that accessing clinical services through a video clinic was easy to understand, comfortable, and time-saving. The majority of the parents (94%) agreed and strongly agreed that they will use video clinics again in the future for consultation.

Conclusion

Parents' response to the use of virtual clinics for pediatric dentistry during COVID was positive. The majority of the parents stated that they would consider using teledentistry for future consultation.

Teledentistry from research to practice: a tale of nineteen countries

Aim

The COVID-19 pandemic has accelerated teledentistry research with great interest reflected in the increasing number of publications. In many countries, teledentistry programs were established although not much is known about the extent of incorporating teledentistry into practice and healthcare systems. This study aimed to report on policies and strategies related to teledentistry practice as well as barriers and facilitators for this implementation in 19 countries.

Methods

Data were presented per country about information and communication technology (ICT) infrastructure, income level, policies for health information system (HIS), eHealth and telemedicine. Researchers were selected based on their previous publications in teledentistry and were invited to report on the situation in their respective countries including Bosnia and Herzegovina, Canada, Chile, China, Egypt, Finland, France, Hong Kong SAR, Iran, Italy, Libya, Mexico, New Zealand, Nigeria, Qatar, Saudi Arabia, South Africa, United Kingdom, Zimbabwe.

Results

Ten (52.6%) countries were high income, 11 (57.9%) had eHealth policies, 7 (36.8%) had HIS policies and 5 (26.3%) had telehealth policies. Six (31.6%) countries had policies or strategies for teledentistry and no teledentistry programs were reported in two countries. Teledentistry programs were incorporated into the healthcare systems at national (n = 5), intermediate (provincial) (n = 4) and local (n = 8) levels. These programs were established in three countries, piloted in 5 countries and informal in 9 countries.

Conclusion

Despite the growth in teledentistry research during the COVID-19 pandemic, the use of teledentistry in daily clinical practice is still limited in most countries. Few countries have instituted teledentistry programs at national level. Laws, funding schemes and training are needed to support the incorporation of teledentistry into healthcare systems to institutionalize the practice of teledentistry. Mapping teledentistry practices in other countries and extending services to under-covered populations increases the benefit of teledentistry.

Applications and effectiveness of teledentistry in orthodontic practice during the COVID-19 restrictions

BACKGROUND

The aim of this study was to identify the areas of application for teledentistry and analyze its effectiveness in orthodontic practice during the COVID-19 pandemic.

METHODS

A total of 233 patients (159 women, 74 men) receiving orthodontic treatment were included. During the COVID-19 restriction period, patients were given teledentistry appointments. During these video conferences, remote orthodontic checkups were performed by one orthodontist, who asked the patients for photos or videos. The applications carried out during the interviews were recorded, classified, and analyzed. In addition, clinical emergency patients were identified. After the teledentistry consultations, two different questionnaires were presented to the patients, depending on their attendance at teledentistry appointments, and the results were statistically evaluated.

RESULTS

In all, 21.25% of the patients were identified as having clinical emergencies, including injury because of damage from brackets and wires; 10% of them reported bracket breakage; 17.5% were encouraged to use intermaxillary elastics; and 3.75% were in pain. However, 50% of them were found to be unproblematic. A total of 91% of the participants in the survey reported that online checkups were sufficient to understand and resolve their symptoms. However, 28% wanted to communicate with orthodontists by video call or with photos instead of meeting face to face (65.5%) when unexpected problems arose during the COVID-19 pandemic.

CONCLUSIONS

Teledentistry can be an effective method for motivating patients who are undergoing orthodontic treatments that require cooperation. It is also an effective way of understanding the patients' symptoms and reducing the risk of cross-infection by identifying patients who will require face-to-face emergency treatment during pandemics.

Factors affecting the acceptance of teledentistry determined using the technology acceptance model: A cross-sectional study

Objective

The aim of this pilot study is to identify the main predictors and barriers that influence user intention to adopt teledentistry services among the Saudi population.

Methods

A total of 426 respondents completed a questionnaire. Our study used the technology acceptance model to predict how users will adopt teledentistry. An analysis of the factors that influence patient users' intention to utilize teledentistry was conducted using partial least square structural equation modeling.

Results

Among the factors that influenced the intention to use teledentistry services, social influence positively affected the intention (β = 0.18, t = 2.19, p-value = 0.03), whereas perceived risk negatively affected it (β = -0.21, t = 2.69, p-value =0.01).

Conclusion

The perception of risk was a major barrier to the adoption of teledentistry services, while social influence was a significant positive predictor. Using the findings of the study, policymakers and health service providers can gain a better understanding of the factors influencing the implementation of teledentistry.

The Dental Educational Environment of Online and Blended Learning during COVID-19, and the Impact on the Future of Dental Education

Blending face-to-face and online learning should create a focused environment that supports deep and meaningful teaching and learning that engages learners in a more active and collaborative educational experience. The present study aimed to evaluate students' online and blended learning educational environment self-perception at the Faculty of Dentistry, Kuwait University, during the COVID-19 pandemic.

METHODS

Undergraduate dental students who participated in blended learning with online lectures were invited to participate. The sample was a non-probability convenient sample, which included all clinical dental students invited to participate, who were enrolled in the fifth, sixth, and seventh (clinical year) years. All 69 students in these three clinical years were invited to participate. Electronic consent to participate and a self-administered questionnaire of two parts were completed. Part one of the questionnaire utilized the five subscales of the Dundee Ready Educational Environment Measure (DREEM) questionnaire; part two was developed in addition to evaluate the online teaching and learning subscales.

RESULTS

Descriptive statistics and analyses of variance were performed; Pearson correlations were made between the additional supplemental online teaching subscale and the original DREEM subscales. The mean students' perception of the teacher was high, followed by the academic self-perception and then the learning perception. Students' social self-perceptions had the lowest reported scores. Students' perceptions varied by year of education in all subscales except for the online domain. In comparing all domains (DREEM and the online component), graduating students (final year) had a more favorable perception than other students.

CONCLUSIONS

Within the limitations of the present study, online and blended learning were positively perceived, excluding the social self-perception and the perception that the online teaching time was not well used.

Impact of the COVID-19 Pandemic on the Oral Health Workforce: A Multicenter Study from the Southern Region of Brazil

The aim of this study was two-fold: (1) to describe the surveillance and biosafety measures adopted by dentists, dental hygienists, and dental assistants who worked in the Southern Region of Brazil and (2) to evaluate access to information in the context of the COVID-19 pandemic. This was a multicenter and cross-sectional design, using a self-applied and validated online questionnaire. The availability of health-care-related supplies and the adoption of biosafety measures recommended by the Technical Note of the National Health Surveillance Agency No. 04/2020 were analyzed. A total of 2560 Brazilian workers participated (75.8% dentists, 15.7% dental assistants and 8.5% dental hygienists), 52.7% from the public and 37.7% from the private sector. Approximately 70% of the individuals reported being away from work during the pandemic. The surveillance measures adopted with higher mean scores were the investigation of respiratory infection symptoms when scheduling appointments and the adoption of distancing in the waiting room. Of the biosafety measures to avoid aerosols, the procedures with lower compliance were those related to the use of intraoral radiographs and rubber dams. Moreover, the correct use of personal protective equipment at work seems to be related to self-perceived stress and anxiety. Worryingly, high access to information through non-governmental documents was observed. Permanent health education policies should reinforce safe practices and encourage workers to implement biosafety and surveillance measures in health services.

Teledentistry in pediatric dentistry: Postgraduate dental students' knowledge, practice, and attitudes

Objective

This study aimed to investigate postgraduate pediatric dental students' knowledge, practice, and attitudes toward teledentistry and identify potential applications of this technology in pediatric dentistry.

Methods

An online questionnaire was sent to all students through Google Forms. The questionnaire included questions about socio-demographic information, knowledge, practice, and attitudes regarding teledentistry and the use of teledentistry during coronavirus disease 2019.

Results

Before the coronavirus disease 2019 pandemic, only 8.2% of students knew teledentistry. However, this increased to 45% after the pandemic, with differences depending on the student's clinical experience. Teledentistry was reported as useful for medicine taking, follow-up consultations, and diagnosing soft tissue problems.

Conclusions

Integrating teledentistry topics into the dental curriculum can increase awareness and adoption of this technology in pediatric dentistry. Dental students need to be aware of its potential applications.

Teledentistry: A bibliometric analysis of the scientific publication's trend

Introduction

Teledentistry is a specialized area within telemedicine employs digital technology and telecommunications to remotely manage dental patients, offering care, advice, education, and treatment. The significance of teledentistry escalated during the COVID-19 pandemic.

Objective

This study presents a bibliometric analysis of teledentistry, based on a retrospective search of the Scopus database.

Materials and methods

The research utilized Bibliometrix and VOSviewer software.

Results

Publications on teledentistry have shown a recent surge, particularly since 2020, attributed to the pandemic. Out of 369 articles, just 28 (7.5%) were single-authored, while most involved collaborative efforts. These articles were dispersed across 160 journals, with the Journal Of Telemedicine And Telecare, International Journal Of Environmental Research And Public Health, and Telemedicine And E-Health each publishing over 15 articles. Remarkably, 66% of the journals featured open-access content. The University of Western Australia emerged as the most prolific institution, with 12 publications, while the United States, Chile, and Brazil led in the number of published documents.

Conclusions

The growing interest in teledentistry, mainly fueled by the pandemic, has promising implications for dental practice. Despite the existing limitations, it holds potential. This bibliometric analysis provides a comprehensive overview of the field and offers valuable quantitative insights for shaping future research and funding strategies, especially concerning protocol development and digital risk assessment.

Exploring challenges and mitigation strategies towards practicing Teledentistry

BACKGROUND

Since the beginning of the COVID-19 pandemic, many dentists have opted for Teledentistry as a mechanism for patient consultation, oral lesion evaluation, diagnosis, and monitoring. The current study explores the challenges faced and potential solutions proposed by dentists practicing Teledentistry in a developing country like Pakistan.

METHODS

A qualitative case study was carried out from January to December 2021. A purposive maximum variation sample of 10 dentists was interviewed in two focus groups. The interview guide was developed using the technology-organization-environment framework. The data was transcribed verbatim using otter.ai. The analysis involved immersion in the data and open coding. The conceptually related codes were synthesized into themes and subthemes.

FINDINGS

The study found various Personnel, Technological and Organizational challenges, and potential solutions from those practicing Teledentistry. The challenges included operational cost, minimal financial returns, lack of awareness, hardware and software support, and other challenges related to the availability of specialization, accessibility, and institutional encouragement. They suggested Institutional Based Practice, staff training, hiring, development of government regulations, and supporting infrastructures such as designated space, central registry, internet, and using/building software to provide 3D images as solutions.

CONCLUSION

Teledentists face Personnel, Technological and Organizational challenges and related potential solutions from those practicing Teledentistry in Pakistan. Government should encourage Teledentistry to reduce long-term costs, encourage preventive services and enable rural access to dental care. They should also involve all stakeholders to develop regulations for practicing Teledentistry in Pakistan.

Evaluation of Tele-Dentistry and Face-to-Face Appointments during the Provision of Dental Services in Poland

Tele-dentistry is a rapidly growing field, especially in the era of the COVID-19 pandemic. Due to the COVID-19 pandemic, remote services are of increasing interest to both patients and dental personnel. They allow for reduced person-to-person contact and thus a reduced risk of transmission of the SARS-CoV2 virus. The COVID-19 pandemic has affected the functioning of all areas of life, including dental treatment. The aim of the study was to assess the possibility of using tele-dentistry for dental services and analyse the attitudes of patients and dentists towards this solution. The period analysed was between March 2019 and February 2021 in five healthcare entities in Cracow in Central Europe. The study’s retrospective analysis shows a positive attitude of patients towards tele-dentistry at every stage of treatment, from diagnosis through postoperative care, and a significant reluctance of dentists in the majority of dental specialties towards tele-dentistry. Consequently, a significant percentage of patients were invited to dental offices for a face-to-face appointment during the COVID-19 pandemic. The negative attitude of dental personnel towards tele-dentistry compared with the positive attitude of patients towards tele-dentistry is somewhat worrying in view of the possibility of a further pandemic. At the same time, it provides important information about the need to educate and support dental personnel in tele-dental solutions and improve solutions for the future. Taking into account the potential reduction in dental care costs for patients and countries after the implementation of tele-dentistry solutions, this is an important topic, while current studies do not comprehensively address the attitudes of patients and dental personnel towards tele-dentistry. In other parts of the world, a similar approach to tele-dentistry is used by patients and dentists.

The impact of COVID-19 on individual oral health: a scoping review

BACKGROUND

Poor oral health due to dental caries is one of the most prevalent non-communicable diseases worldwide. It has a significant impact on individuals across the lifespan and is a leading cause of preventable hospitalizations. The impacts of COVID-19 on oral health at the practice level are well documented, but gaps in understanding the impact on individual oral health remain. This review addresses this gap.

METHODS

Using a JBI scoping review process we mapped and summarized the evidence to identify the impact of COVID-19 on individual oral health. Key search terms were developed, and searches were undertaken by an experienced research librarian.

RESULTS

The 85 included studies were conducted in 23 countries from 5 regions across the world classified using the United Nations Geoscheme system. The majority (82/85) were quantitative, 2 were reviews and there was one qualitative interview study. Cross-sectional surveys were the most common data collection approach followed by an analysis of clinical data, analysis of internet trends and other online methods. Five key areas were identified including changes to the provision of emergency dental services, provision of routine oral health services, oral hygiene maintenance at home, changes in dietary preferences, alternative models of dental provision and help-seeking and attitudes towards dental care in the future.

CONCLUSIONS

This scoping review has demonstrated that the pandemic has impacted on oral health at the individual level. It is important that we are aware of these impacts and ensure that support systems are in place to overcome future periods where access to dental care might be compromised. The provision of preventive care remains a vital first step in ensuring good overall oral health as is paramount during periods where access to dental treatment might be limited.

Challenges and opportunities of online education in dentistry post-COVID-19

Identifies the main tenets of learner-centred education.

Identifies different modes of delivering educational content.

Considers the boundary between formal and informal learning.

Evaluation of Social Media Usage by Dental Practitioners of Pakistan for Professional Purposes - A Cross-Sectional Study

Background

In the past couple of years, the use of social media has been on a tremendous rise with greater attention in the field of healthcare, including dentistry. The use of social media for professional purposes is emphasized as unprofessional use can be detrimental. This study aims to evaluate the use of social media by dentists for professional purposes.

Materials and Methods

This cross-sectional study was carried out between December 2021 and March 2022. An online questionnaire was formulated using Google Forms and distributed to the dental professionals through various social media platforms such as Twitter©, Facebook©, Instagram©, Snapchat©, WhatsApp©, and Email©. The questionnaire consisted of two parts: demographic characteristics and questions about the use of social media for professional purposes. For data analysis, SPSS version 25.0 was used, where a multiple linear regression test was used to compare the responses of the participants with their demographic characteristics. A p-value of ≤0.05 was considered to be statistically significant.

Results

A total of 404 dentists participated in this study with a response rate of 89.7%. The majority of the 276 (68.3%) dentists believed to have a professional account to use social media for professional purposes. Most of the 280 (69.3%) dentists agreed social media improved knowledge and communication skills with the patients. About 248 (61.4%) dentists considered the use of social media for general purposes during clinical hours led to wastage of time. About 160 (39.6%) dentists considered connecting with patients on social media to be inappropriate.

Conclusion

The use of social media is on the rise at a tremendous rate in different fields of work, including dentistry. Social media is a great tool for dentists to help expand and grow their clinical practice. However, the professional use and ethics whilst using social media should be considered by the dentists.

Is Teledentistry a Method for Optimizing Dental Practice, Even in the Post-Pandemic Period? An Integrative Review

Background: For the past two and half years, dentists all across the world, along with their patients, have faced numerous challenges. In this context, the aim of this integrative review was to assess if dentists’ and patients’ attitudes regarding teledentistry (TD) have changed since the COVID-19 outbreak, and if the use of TD will continue to rise, even in the post-pandemic period; (2) Methods: A literature search was performed between August 2021 and January 2022. The PubMed, Scopus, and Science Direct databases were searched for articles published between 2012 and 2022 using a combination of the following Mesh terms: “COVID-19”, “pandemic”, “oral telemedicine”, “teledentistry”; (3) Results: Among the 52 included papers, nine papers were published between 2011 and 2019, and 43 articles were published after 2020 (12 were published in 2020, 29 papers were published in 2021, and two in 2022). Among the articles published before 2020, seven out of nine included papers were reviews, and two were original research. Among the 43 papers published after 2020, 18 were reviews and 25 original research. (4) Conclusions: Based on the results of this integrative review, there is clear evidence that the interest in teledentistry and teleassistance in the dental field has increased rapidly, especially in the context of the COVID-19 pandemic. Therefore, while dental practitioners should be encouraged to keep themselves updated about new technologies, patients should also be constantly informed about their options for receiving special oral health care.

Virtual consultations for oral surgery patients

Background

Following Covid-19, many departments have incorporated teledentistry into practice. As new consultation methods are introduced, it’s imperative that patients have as similar an experience with virtual consultations to ensure informed decision-making. This project evaluated patients' perceptions of video consultations and determined if patients seen virtually received the same standard of information by auditing compliance with sending patient information leaflets (PILs) following video consultation.

Method

The department’s PILs were used to create an inclusion list for patients requiring a PIL. A retrospective audit assessed the notes of 100 video consultations for records of if PILs were sent and by what method. The department’s PILs were digitalised and a clinical mailbox introduced enabling clinicians to email patients a PIL hyperlink. The audit was repeated for 88 video consultations. Patient and staff feedback was gathered via online surveys.

Results

Initially, 51% of cases met the criteria requiring a PIL and 16% of patients were sent PILs. Following mailbox introduction, 53% of cases met the criteria and 94% were sent PILs, 100% via email. Patient and staff feedback was positive regarding video consultations and digital PILS. Technical difficulties were reported in 44% of cases.

Conclusions

Patients perceive virtual consultations to be a positive change and the introduction of a mailbox enhances video consultations in an efficient and cost-effective manner. Patient information can be standardised, via digital PILs, regardless of consultation type. As departments implement post-pandemic changes, utilisation of a mailbox can provide multiple improvements to care.

Awareness, Knowledge, Attitude, and Practice of Teledentistry among Dental Practitioners during COVID-19: A Systematic Review and Meta-Analysis

Background and Objectives: This systemic review aims to appraise and analyse the awareness, knowledge, attitude, and practice of teledentistry among dental practitioners during COVID-19. Materials and Methods: This review was registered in the PROSPERO database (CRD42021283404). Cross-sectional articles on dental practitioners' perceptions towards teledentistry published between March 2020 and September 2021 were searched in ten online databases (PubMed, Google Scholar, Web of Science, ScienceDirect, Cochrane, EMBASE, SIGLE, EBSCO, LILACS, and Open Grey). The Joanna Briggs Institute critical appraisal tool was employed to analyse the risk of bias (RoB) of each article, whereas the Oxford Centre for Evidence-Based Medicine recommendation tool was used to evaluate the level of evidence. Data were analysed using the DerSimonian-Laird random effect model based on a single-arm approach. Results: Six studies were included and demonstrated Level 3 evidence. A single-arm meta-analysis revealed that dental practitioners had a high level of awareness (70.4%) and attitude (72.5%) towards teledentistry during the COVID-19 pandemic, but their knowledge level (57.9%) was moderate with a poor practice level (35.8%). A substantial heterogeneity was observed with the overall I2 ranging from 90.78% to 98.21%. Furthermore, meta-regression indicated that the sample size of each study had a significant (p < 0.05) impact on the degree of data heterogeneity. Conclusions: Despite their high degree of awareness and attitude, dental practitioners demonstrated moderate knowledge and relatively poor practice of teledentistry during the COVID-19 pandemic. More well-designed studies are warranted to investigate the alternatives for enhancing dental practitioners' knowledge and practice of teledentistry interventions.

COVID-19 presents an opportunity for dental teams to become ready for person-centred care

Two publications that recently appeared in the British Dental Journal mooted the position that dentistry may not be ready for person-centred care. This commentary takes up this discussion and agrees that while person-centred care is essential to dentistry, it is not without its challenges. Drawing on the multidisciplinary expertise of its authors (two sociologists, one psychologist and a dentist), the nature of these challenges is interrogated further. It also identifies opportunities for change on this position from within the literature, as well as by clinical practice. We present evidence to suggest that the current pandemic has shown that dental teams are capable of rising to a challenge and adapting to change. In this light, we propose that the pandemic presents dental teams with an opportunity to be even more person-centred.

Remote clinical consultations in restorative dentistry-A survey

OBJECTIVES

To assess the patient experience of Remote Clinical Consultations (RCCs) for head and neck cancer and cleft lip and palate patients undergoing specialist restorative dentistry treatment in the context of a secondary care service.

METHODS

An online survey was designed; all ninety three patients were invited to participate in its completion following a video or telephone remote clinical consultation with one restorative consultant in Addenbrooke's Hospital between August 2020 and April 2021. The video consultations were carried out via NHS England's Attend Anywhere platform.

RESULTS

Sixty three responses were received. Over 70% of patients valued a video or telephone remote clinical consultation rather than an in-person attendance. Patients reported a good experience and would recommend a remote clinical consultation instead of an in-person attendance if no treatment would likely be required. Those who were less likely to recommend a remote clinical consultation were those who had difficulties logging-in to the remote platform or had technical issues.

CONCLUSION

While a number of patients still would have preferred a face-to-face attendance, both telephone and video remote consultations were highly valued by patients, and the overall patient experience was that of acceptance. Benefits of remote consultations perceived by patients included having set time to discuss concerns and queries, becoming familiar with a clinician prior to any treatment, saving time, minimising travel and reducing expenses. Barriers to a positive experience included technical difficulties. This survey contributes to the evidence supporting remote clinical consultations as a practical way of delivering specialist consultations in restorative dentistry, it highlights this virtual process largely relates to the practicalities of service provision and highlights the use of remote consultations for specific appointments.

CLINICAL SIGNIFICANCE

This study demonstrates patient feedback to a strategy implemented due to adaptations in working methods required as result of the Covid-19 pandemic. Patients were found to have a positive, accepting experience of both telephone and video remote clinical consultations. the study identifies a high patient acceptability and ability to overcome some of the disadvantages of an in-person attendance including saving time, travel and associated expenses while also contributing to a reduction in CO₂ emissions and potentially improving clinical efficiency and capacity. These findings add to existing evidence and are indicative that remote consultations provide a practical way of delivering specialist communication in restorative dentistry as part of a unique patient pathway.

Practical Applicability of Teledentistry in Pediatric Patients Amidst Pandemic : A Narrative Review

The coronavirus disease-2019 (COVID-19) pandemic has imposed a situation where all healthcare facilities except emergency services remain suspended. These times generated the necessity for the implementation of a healthcare delivery system that can be accessed digitally and, thus, benefit the majority of children as well as healthcare professionals. This review aims to propose a sound model of less technique sensitive, safe and handy strategies for dental traumatic injuries, endodontic and restorative concerns, and orthodontic urgencies until complete clinical help can be sought. Five hundred thirty articles were obtained from the PubMed, Google Scholar, Embase, Lilacs, and Cochrane databases published from 2011 to 2021. Nineteen articles that described teledentistry in the COVID-19 era were included. Teledentistry can serve as a vital patient management strategy that can aid in triaging urgent and elective patient treatment needs, ultimately easing the burden of clinics and at the same time providing a safer means of consultation.