Role of Teledentistry in COVID-19 Pandemic: A Nationwide Comparative Analysis among Dental Professionals

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.

Telemedicine Awareness Among Chennai-Based Dentists: A Web-Based Questionnaire Survey

OBJECTIVES

Teledentistry has emerged as a crucial tool to address oral health needs amidst social distancing measures and lockdowns. Teledentistry during COVID-19 underscores its potential as an adaptive solution, transforming the delivery of dental care and providing a platform for maintaining oral health while prioritizing public safety. The purpose of this study is to investigate the views of Chennai dental professionals on teledentistry, which may serve as a foundation for advancements in patient care and virtual dentistry in the future, and to evaluate awareness, usefulness, and data security regarding telemedicine among Chennai dental professionals using a pretested questionnaire.

METHODS

By distributing a pretested web-based questionnaire to licensed dental professionals in Chennai, a descriptive cross-sectional study was conducted. The results were statistically analyzed and evaluated.

RESULTS

A total of 90 dentists in Chennai responded to the questionnaire, out of which 65 (72.2%) were aware of teledentistry and 32 (35.6%) practiced teledentistry. Around 25 to 29 (30%-37%) dentists were very much concerned about obtaining patients' consent, digital forgery, confidentiality, and hardware reliability in teledentistry.

CONCLUSION

This is the first kind of study ever done among dentists in Chennai, which shows enormous work is required to create awareness and knowledge among dental professionals. To inform dentists and the general public about teledentistry, targeted advertisements pertaining to the same are required.

Perceptions and utilization of tele-orthodontics: a survey of the members of the American Association of Orthodontists

OBJECTIVE

This study aimed to investigate orthodontists' utilization and perceptions of tele-orthodontics.

MATERIALS AND METHODS

A 30-item online survey was distributed to members of the American Association of Orthodontists (AAO). The questionnaire encompassed topics concerning the orthodontists' utilization, perceptions, clinical applications, limitations, and concerns regarding tele-orthodontics. Descriptive statistics were employed, and comparisons between responses from users and non-users were conducted  using Wilcoxon rank-sum tests and Fisher's exact tests.

RESULTS

152 members completed the survey, (response rate: 2.4%). More than two third of respondents (69.74%) were users of tele-orthodontics. Users were more aligned with the belief that tele-orthodontics facilitates effective communication (mean ± standard deviation (SD) 4.06 ± 0.83 vs. 3.33 ± 0.94, p < 0.001). Both groups agreed on the requirement of patient fees for tele-orthodontic visits (mean ± SD: 3.62 ± 1.11 users vs. 3.74 ± 1.02 non-users, p = 0.659), and on the capability  of the system to reduce unwarranted referrals (p = 0.20). The majority of participants acknowledged  the utility of the system in monitoring aligners' patients (89% in users vs. 61% in non-users, p < 0.001). Non-users expressed greater concerns regarding privacy risks (mean ± SD: 3.06 ± 0.97 users vs. 3.57 ± 0.86 non-users, p = 0.002). Both groups stressed the significance of obtaining informed consent before utilizing tele-orthodontics.

CONCLUSIONS

The widespread acceptance of tele-orthodontics among AAO members was apparent, as demonstrated by their recognition of its effectiveness. There was notable variation in how users and non-users perceived tele-orthodontics. The study's results offer valuable insights into both the potential benefits and drawbacks of incorporating this technology into clinical practice from the clincians' perspective.

Assessment of Knowledge and Attitude Regarding Teledentistry Among Dental Professionals: A Cross-Sectional Study

BACKGROUND

Modern technologies have led to the development of new tools, practices, and digital techniques. However, their use in public health to provide adequate oral health facilities to the community is limited. One of the facilities that can help provide better oral health with minimal cost is teledentistry. The application of this approach will reduce inequalities in accessing oral healthcare. Knowledge of the use of teledentistry is of the utmost importance to its practice. Hence, the objective of this cross-sectional study is to assess the knowledge of and attitude regarding teledentistry among dental professionals in the Sangli district of Maharashtra.

MATERIALS AND METHODS

A 24-unit structured online validated questionnaire with six questions regarding participants' sociodemographic information and 18 questions related to their knowledge and attitude toward teledentistry and informed consent forms were circulated via email among 100 dentists, and the responses obtained were analyzed.

RESULTS

Out of 100 responses, 61 showed basic knowledge and a typical attitude toward teledentistry. Urban practitioners were more familiar with teledentistry than rural ones.

CONCLUSION

This survey concludes that the branch of teledentistry still needs to be studied and publicized at a greater level to accelerate its widespread implementation in dentistry and especially to increase the outreach and time efficiency of dentistry.

Validity and reliability of a teledentistry survey among dental practitioners in Saudi Arabia

Background

The perception of teledentistry use among dental practitioners in various contexts was assessed using the Teledentistry Survey (the TDS-24). However, this survey's psychometric analyses have not yet been analysed. This present study aims to examine the validity and reliability of the TDS-24 in a sample of dental practitioners in Saudi Arabia.

Methods

A self-administered questionnaire, including sociodemographic characteristics and the TDS, was distributed as a cross-sectional survey to 800 current dental practitioners in Saudi Arabia recruited via convenience and snowball sampling. The construct validity and reliability of the TDS were assessed using exploratory factor analysis (EFA) and Cronbach's alpha.

Results

The EFA of the survey yielded 20 items supporting a four-factor structure as follows: factor I (10 items), factor II (four items), factor III (three items) and factor IV (three items). The overall Cronbach's alpha was 0.85, while it was 0.86 for the first factor, 0.70 for the second factor, 0.52 for the third factor and 0.57 for the fourth factor.

Conclusions

The TDS-20, after excluding four items, revealed four factors with adequate psychometric properties, making it a valid and reliable tool in assessing teledentistry perceptions among dental practitioners in this study sample.

Storytelling as Innovative Method to Improve the Recognition of Teledentistry among Adults: A Randomized Controlled Trial

Objective

Storytelling is an educational approach that encourages learners to create imaginative conceptions and think creatively. The aim of this study was to assess the effects of storytelling on improving awareness about teledentistry among adults in Saudi Arabia.

Materials and Methods

A single-blinded parallel group randomized controlled study with 88 adult participants from Saudi Arabia. Participants were randomized into an intervention group (IG) or a control group (CG). The IG received teledentistry information using a storytelling method, while the CG received a flyer containing the same information. The participants were questioned three times: P1 before the intervention, P2 immediately after the intervention, and P3 1 month later.

Results

A total of 83 participants completed all study steps. No significant knowledge score differences between IG and CG at P1, P2, or P3 nor in mean differences across time points. However, significant increase from P1 to P2 (p < 0.001) and P1 to P3 (p < 0.001) via paired t-test; no change from P2 to P3 in IG (p = 0.99) or CG (p = 0.816). Storytelling was significantly more innovative and emotionally touching than conventional flyer. The study was registered with the number ISRCTN68587630.

Conclusion

Storytelling was found to be a more innovative and emotionally impactful approach for promoting health compared to traditional flyers. Future studies should extend follow-up periods and explore diverse stories for external validation of this method.

Barriers and Enablers to Implementing Teledentistry From the Perspective of Dental Health Care Professionals: Protocol for a Systematic Quantitative, Qualitative, and Mixed Studies Review

BACKGROUND

There is growing literature on the potential of digital technologies for improving access to, ensuring continuity and quality of health care, and to strengthen health systems. Some studies have reported the cost-effectiveness of teledentistry, its reliability for remote dental screening, diagnosis, consultation, and treatment planning. Nonetheless, current evidence suggests that teledentistry implementation faces many challenges and is not yet adopted by dental health care providers (DHCPs). Developing strategies to improve teledentistry adoption requires an understanding of the factors that promote or hinder its successful implementation.

OBJECTIVE

This systematic review aims to identify and synthetize barriers and enablers to implementing teledentistry as perceived by DHCPs in their clinical practices, using the Theoretical Domains Framework (TDF) and the Capacity, Opportunity, and Motivation Behavior (COM-B) model.

METHODS

This protocol follows the PRISMA-P (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Protocols) checklist. Literature will be searched in the following databases: PubMed, Cochrane Library, Web of Science, CINAHL, Embase, and PsycINFO. We will perform additional searches on Google, Google Scholar, and ProQuest Dissertations & Theses Global, screen the references of the included studies to capture additional relevant studies, and contact the authors of studies if we need more details. We will consider studies using qualitative, quantitative, and mixed methods. There will be no restrictions on the publication date and dental setting. We will include studies published in French, English, and Portuguese. Two independent reviewers will select the study, extract data, and assess methodological quality using the Mixed Methods Appraisal Tool's checklist. Data analysis will include a descriptive and a thematic content analysis. We will synthetize and categorize the barriers and enablers using the TDF and COM-B model and present a narrative synthesis of our results using tables, figures, and quotes.

RESULTS

By March 2023, the literature search has retrieved 7355 publications. We will identify the range of barriers and enablers to implementing teledentistry through DHCPs' perspectives. Considering the critical need for theory-based implementation interventions to improve the use of evidence-informed practices, we will synthesize the factors influencing the adoption of teledentistry based on the TDF domains and the 3 essential conditions predicting behavior change in accordance with the COM-B model. As needed, we will include additional determinants if not included in the TDF. We will conduct some subgroups analyses if studies are sufficient. We expect to complete the review by July 2024.

CONCLUSIONS

This review will provide some insights on the determinants of teledentistry implementation as perceived by DHCPs in dental settings. These findings will cater to patients, families, DHCPs, researchers, academic and professional decision-makers, and policy makers. The results of the systematic review could be used to develop theory-led interventions in improving teledentistry implementation.

TRIAL REGISTRATION

PROSPERO CRD42021293376; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=293376.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/44218.

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.

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.

Students’ appraisal of a preparedness model for the provision of oral health care during a pandemic

Background

The COVID-19 pandemic has impacted the provision of oral health care worldwide, prompting the discussion of preparedness. This study aimed to perform an initial appraisal of the usability, spatial representation, and clarity of a newly developed preparedness model from the perspective of senior undergraduate dental students at the University of British Columbia, Vancouver, Canada, enrolled in the 2020-21 academic year. Answers were analyzed thematically via an inductive coding process between March and June 2021.

Results

All the 111 students in years 3 (#55) and 4 (#56) appraised the preparedness model, generating more than 200 pages of text. Four main themes were identified across the essays: streamlined depiction, information-based approach, adaptability to an ever-changing situation, and room for improvement. Although the majority of students appraised the model as being useful in fostering information-seeking behaviour, few students disagreed with the model’s portrayal and made further suggestions.

Conclusions

Preparedness models can better guide oral health care providers during a health crisis such as a pandemic. The recently developed preparedness model was appraised as useful by senior undergraduate dental students, although alternative portrayals of the model were suggested. A comprehensive assessment of the newly developed model (and of its variations) is warranted to better support oral health care service delivery during a pandemic.

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.

Teledentistry Implementation During the COVID-19 Pandemic: Scoping Review

Background

COVID-19 spreads via aerosol droplets. The dental profession is at high risk of contracting the virus since their work includes treatment procedures that produce aerosols. Teledentistry offers an opportunity to mitigate the risk to dental personnel by allowing dentists to provide care without direct patient contact.

Objective

The purpose of this scoping review was to examine the implementation, challenges, strategies, and innovations related to teledentistry during the COVID-19 pandemic lockdown.

Methods

This scoping review evaluated teledentistry use during the pandemic by searching for articles in PubMed and Google Scholar using the search terms teledentistry, tele-dentistry, covid-19, coronavirus, telehealth, telemedicine, and dentistry. Inclusion criteria consisted of articles published in English from March 1, 2020, to April 1, 2022, that were relevant to dentistry and its specialties, and that included some discussion of teledentistry and COVID-19. Specifically, the review sought to explore teledentistry implementation, challenges, strategies to overcome challenges, and innovative ideas that emerged during the pandemic. It followed the 2020 Preferred Reporting Items for Systematic reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR). This approach is organized into 5 distinct steps: formulating a defined question, using the question to develop inclusion criteria to identify relevant studies, an approach to appraise the studies, summarizing the evidence using an explicit methodology, and interpreting the findings of the review.

Results

A total of 32 articles was included in this scoping review and summarized by article type, methodology and population, and key points about the aims; 9 articles were narrative review articles, 10 were opinion pieces, 4 were descriptive studies, 3 were surveys, 2 were integrative literature reviews, and there was 1 each of the following: observational study, systematic review, case report, and practice brief. Teledentistry was used both synchronously and asynchronously for virtual consultations, often employing commercial applications such as WhatsApp, Skype, and Zoom. Dental professionals most commonly used teledentistry for triage, to reduce in-person visits, and for scheduling and providing consultations remotely. Identified challenges included patient and clinician acceptance of teledentistry, having adequate infrastructure, reimbursement, and security concerns. Strategies to address these concerns included clinician and patient training and utilizing Health Insurance Portability and Accountability Act-compliant applications. Benefits from teledentistry included providing care for patients during the pandemic and extending care to areas lacking access to dental care.

Conclusions

Pandemic lockdowns led to new teledentistry implementations, most commonly for triage but also for follow-up and nonprocedural care. Teledentistry reduced in-person visits and improved access to remote areas. Challenges such as technology infrastructure, provider skill level, billing issues, and privacy concerns remain.

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.

Dentist perceptions about the value of teledentistry

Background

Teledentistry has expanded access to oral health care by allowing patients and providers the option to receive care using technology and telecommunications. This study used a cross-sectional, mixed-methods design to evaluate dentists’ perceptions in the United States and understanding of the value and scope of teledentistry in their practices and to adopt virtual encounters as a care delivery methodology.

Methods

This study used a cross-sectional, mixed-methods design. The DentaQuest Partnership for Oral Health Advancement (now CareQuest Institute for Oral Health) conducted an electronic survey of providers in the DentaQuest Network that assessed the impact of COVID-19 on dental practices' patient volume, staffing, dental insurance carriers, treatment protocols, and the office's pre-and post-COVID finances. A total of 2767 dental providers completed the survey with a response rate of 13%. Qualitative interviews were then conducted with ten providers to get more in-depth information on teledentistry. Descriptive statistics summarize the survey population. Thematic analysis, which allows both deductive and inductive approaches, were used to analyze the interviews.

Results

About 23% of the dentists used teledentistry or virtual platforms. Findings illustrate that early adopter dentists were more likely to perceive the benefits of teledentistry as being more significant than its drawbacks. Late/resistant adopters to teledentistry were less aware of its benefits and were more focused on the drawbacks, such as upfront cost. Late adopters were also concerned about the level of care delivered through teledentistry.

Conclusions

This study explored dentists’ perceptions of teledentistry. Expanding access to care was recognized as one of the greater values of teledentistry.

Role of Newly Introduced Teledentistry Service in the Management of Dental Emergencies During COVID-19 Pandemic in Qatar: A Cross-Sectional Analysis

Introduction: The lockdown imposed by the COVID-19 pandemic rendered teledentistry (TD) necessary to maintain the continuity of oral health services and avoid missing emergency dental conditions, while minimizing face-to-face visits. Our objective was to evaluate the ability of a newly introduced triage-based TD service to deliver its goals, by evaluating its processes and outcomes and assessing the demand for TD. Methods: This cross-sectional report assessed the triage processes and outcomes (triage category, referral to emergency/dental facility undertaken, remote medications prescribed, and procedures performed at the point of referral); and evaluated the demand for the newly introduced TD service during 5 months of the first wave of the pandemic. Results: Of 850 calls, about 70.6% of the samples were managed remotely; 29.4% were categorized as emergency/urgent and referred to the emergency/dental facility. Compared with other complaints, orofacial dental pain was the most common reason for the calls (41.6%, p < 0.0001). About 14.71% of callers received prescription for medications remotely. The most demanded disciplines were general dentistry, orthodontics, and oral surgery, respectively (p < 0.0001). Of those referred to a dental facility, 31.84% required no clinical intervention, 28.7% received orthodontic appliance repair, and 14.3% and 11.2% had urgent dental extractions or root canal treatments. Demand on the service fluctuated through various distinct stages of the lockdown. Conclusions: There has been continuous demand for the newly introduced TD service throughout the period of the current report despite the fluctuations, with most complaints managed remotely. TD was effective and suitable for triage, service delivery, and care during the pandemic.

The Impact of COVID-19 Pandemic on Patients Receiving Orthodontic Treatment

OBJECTIVE

 The coronavirus disease 2019 (COVID-19) pandemic impacted the provision of dental treatment in a timely manner including orthodontic treatment. The objective of this study was to assess challenges encountered by patients undergoing orthodontic treatment during the pandemic and their attitude toward managing these challenges.

MATERIAL AND METHODS

 A cross-sectional sample of orthodontic patients at Prince Rashid Hospital in the north of Jordan was recruited to participate in a self-administered questionnaire that included questions related to orthodontic problems encountered during the lockdown, ways to overcome these problems, and concerns about their treatment.

RESULTS

 A total of 120 patients participated, 40 males and 80 females. Most participants (n = 86) had a fixed orthodontic appliance, who reported various orthodontic problems (82%), but the most common problems reported were exposed wire endings and loosening of brackets. Likewise, the most commonly reported problem among those with removable appliances (n = 34) was a broken or loose appliance (60%). However, patients of both types of appliances ignored the problem and waited until the re-opening of dental offices. Further, most patients missed at least one appointment for different reasons and three-quarters of them (76.6%) did not communicate with their orthodontists during the lockdown. Patients expressed their disagreement with the closure of dental offices during the pandemic because of their concern of a prolonged waiting to receive another appointment.

CONCLUSION

 The COVID-19 pandemic had a significant impact on orthodontic care and the maintenance of appointments during the lockdown periods. Patients varied in ways they managed their orthodontic problems, including their commitment to communicate with the dentists or maintain their appointments. Hence, patients should be trained on how to manage the appliance problems when they need and encourage them to accept distant communication during the emergencies.

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.

Teledentistry awareness, its usefulness, and challenges among dental professionals in Pakistan and Saudi Arabia

Objectives

This study aims to describe the perception of dental professionals in Pakistan and Saudi Arabia (SA) towards the practice of teledentistry, its usefulness and challenges.

Methods

A cross-sectional study was carried out among 190 dentists from January 2021 to April 2021. The participants were included in the study using snowball sampling method. A 26-item adopted questionnaire was distributed using different social media channels. Chi-square test was used for analysis.

Results

Out of 190 participants, 46.3% were from Pakistan and 53.7% were from SA. The majority of participants in both countries agreed that teledentistry would enhance guidelines and advice (74.2%), improve peer-to-peer interaction (79.5%) and make patient's referrals more efficient (75.8%). For the usefulness, most participants agree that it is economical for the patients (61.1%), improves communication (74.7%), helps in educating the patients (86.3%), avoid unnecessary travel (76.8%), helps monitoring (71.6%), and benefits patients in remote areas (74.7%); however, more Pakistani participants perceived that time spent with the patient would increase compared to SA participants (p < 0.001) and a higher proportion of SA participants believe that it helps in communication and monitoring of patients (p < 0.001) than Pakistani participants. Regarding the challenges in the use of teledentistry, few participants think that it violates the patient's privacy (22.6%) or is difficult to use (14.7%) or have distrust towards the teledentistry equipment (24.2%).

Conclusion

The results indicated a high awareness and a positive attitude towards teledentistry, and its adaptation in their dental practice in both countries. However, limited infrastructure, set-up cost, and information technology (IT) literacy are the main challenges in integrating teledentistry which can be overcome by strategic government initiatives, policies, and programs.

Teledentistry and its applications in paediatric dentistry: A literature review

Background

During the unfortunate event of the COVID-19 pandemic, restrictions were placed on face-to-face interactions in dentistry to promote social distancing and reduce spread of virus. In order to provide dental services teledentistry was employed.

Objective

This article aims to review the literature and information available on the provision and utilization of teledentistry as a method to address oral health needs of paediatric patients.

Results

Teledentistry has been utilised in paediatric population for the purpose of oral health education and promotion, remote diagnosis and monitoring, and behaviour guidance. Studies involving paediatric population for aforementioned applications have shown that this practice strategy is beneficial to provide dental treatment in remote locations with little access to paediatric dental specialists, monitor patients between appointments, conduct remote diagnosis and screening programmes, promote oral health of children through dental education, and in pre-appointment behaviour guidance. This method was particularly useful during the current COVID-19 pandemic where dentists use their mobile phones, computer webcams for patient appointments while maintaining safe distance and avoid exposing themselves as well as patient to the virus.

Conclusion

Teledentistry can be a supplement to face-to-face methods of paediatric dental care, ultimately leading to better patient management. This technology can make a significant contribution in reducing the supply-demand gap of paediatric dental specialists in places where healthcare facilities are limited and ensure safety during the pandemic whilst providing dental care to paediatric patients. Further research is required for safe, effective and evidence-based use of teledentistry in the field of paediatric dentistry.

The perspective of undergraduate dental students on web-based learning in pediatric dentistry during the COVID-19 pandemic: a Korean multicenter cross-sectional survey

BACKGROUND

The COVID-19 pandemic changed the world and created a shift in the dental education program. This sudden change in the dental education program may have affected the academic standards of dental students. This study aimed to evaluate the overall satisfaction and effectiveness of online learning in pediatric dentistry of undergraduate dental students' during the COVID-19 pandemic in South Korea.

METHODS

An anonymous online survey was sent to three dental schools, and responses were collected from dental school students. Questions included the demographics, perspectives of online classes, comparison of online and offline pediatric dentistry classes and opinions on how dental schools are handling the pandemic. Students' perspectives on online classes were evaluated based on satisfaction with online education. Data were analyzed using the Kruskal-Wallis test and the Mann-Whitney U test.

RESULTS

Most students took online classes from home (80.9%) using Zoom (50.4%). The majority reported overall program satisfaction (74.1%) and agreed that universities implemented online classes well (55%). Students who were in favor of online classes responded more positively to questions on the effectiveness and safety of online learning (p < 0.05). Regardless of satisfaction with online education, the students agreed that the online education shift was the right decision in pandemic outbreak.

CONCLUSIONS

Dental students in South Korea preferred and adapted well to the web-based learning program in pediatric dentistry during COVID-19 pandemic.

Knowledge, Perception, and Experience of Dentists About Teledentistry

OBJECTIVES

This study aimed to evaluate the level of knowledge, perception, and experience of teledentistry amongst Brazilian dentists with the ongoing COVID-19 pandemic.

METHODS

Between June and July 2020, an online questionnaire was used to collect information on the demographic and professional profiles of dentists and their levels of knowledge, perception, and attitudes towards teledentistry. Descriptive statistics were reported as percentages, and Chi-squared test was used to compare responses amongst general practitioners, specialists, and those with varying levels of professional experience.

RESULTS

This study included 575 dentists, the majority of whom were from the southeast region of Brazil (73.4%) and had a specialist degree (70.4%). Approximately 42.4% of the study sample had graduated more than 10 years ago, 39.3% between 2 and 10 years ago, and 18.3% up to 2 years ago. In general, the majority of dentists exhibited only a superficial awareness of the resolution that regulates teledentistry in Brazil. A greater number of specialists were aware of the resolution (P = .007) and felt confident performing teledentistry (P = .000) compared to general practitioners, whilst those with more experience (graduated more than 10 years ago) exhibited greater knowledge (P = .012) and preparation (P = .000). More than 60% of the dentists, regardless of dental specialty and clinical experience, had no knowledge of providing prescriptions via teledentistry. The majority of general practitioners (89.5%) and specialists (81.4%) had no previous experience using teledentistry.

CONCLUSIONS

The findings of this study suggest that Brazilian dentists are inadequately prepared for the implementation of teledentistry.

Pedagogy and innovative care tenets in COVID-19 pandemic: An enhancive way through Dentistry 4.0

The global oral healthcare sector has now woken to implement Dentistry 4.0. The implementation of this revolution is feasible with extensive digital and advanced technologies applications and the adoption of new sets of processes in dentistry & its support areas. COVID-19 has bought new challenges to dental professionals and patients towards their customised requirements, regular dental health checkups, fast-paced and safe procedures. People are not visiting the dentist even for mild cases as they fear COVID-19 infection. We see that this set of technologies will help improve health education and treatment process and materials and minimise the infection. During the COVID-19 pandemic, there is a need to understand the possible impact of Dentistry 4.0 for education and innovative care. This paper discusses the significant benefits of Dentistry 4.0 technologies for the smart education platform and dentistry treatment. Finally, this article identifies twenty significant enhancements in dental education and effective care platforms during the COVID-19 pandemic by employing Dentistry 4.0 technologies. Thus, proper implementation of these technologies will improve the process efficiency in healthcare during the COVID-19 pandemic. Dentistry 4.0 technologies drive innovations to improve the quality of internet-connected healthcare devices. It creates automation and exchanges data to make a smart health care system. Therefore, helps better healthcare services, planning, monitoring, teaching, learning, treatment, and innovation capability. These technologies moved to smart transportation systems in the hospital during the COVID-19 Pandemic. Modern manufacturing technologies create digital transformation in manufacturing, optimises the operational processes and enhances productivity.

Dental Education in the Time of COVID-19 Pandemic: Challenges and Recommendations

Moving within the second wave of the coronavirus (COVID-19) pandemic, dental education delivery has been profoundly affected by this crisis, so has the structure, evaluation, and future of dental education. Both pre-clinical and clinical dental education have experienced challenges ranging from fully online educational content to limited dental training for senior dental students. This crisis appears to be a tipping point that produced confusion in dental teaching especially clinical sciences. Although medical institutions immediately started to adapt to the unexpected COVID-19 crisis, dental and oral health educational services are profoundly impaired due to the dental team's propinquity to the patient and the aerosols generated during routine dental therapeutic procedures. Dental students unlike other medical students are considered to be at the highest risk due to the nature of their clinical training that includes working in the oral cavity of patients using aerosol-generating equipment. Some dental schools have taken the leadership and documented their modifications during this pandemic; however, there is a serious need for further investigation and wide range screening of the situation in the dental schools during the COVID-19 crisis. The aim of this mini-review is to present these challenges and how academic dental institutions have implemented strategies to overcome them.

Knowledge and Perceptions of COVID-19 Among Health Care Professionals, Medical Students, and Dental Students in the GCC Region: A Cross-Sectional Correlational Study

Purpose

The aim of this study was to assess the levels of awareness and knowledge regarding COVID-19 among healthcare professionals and students in Kuwait and the Gulf Cooperation Council (GCC) region.

Materials and Methods

An online cross-sectional survey using a previously validated questionnaire was used to assess the awareness and knowledge levels of COVID-19 in this study, which was distributed via various online platforms to include as many participants as possible. The study targeted medical doctors, dentists, medical students, and dental students from the GCC region. Participants were at least 18 years old, voluntarily consented to complete the questionnaire, and were assured that their responses would remain anonymous. Permission was obtained using a previously validated and applied questionnaire to assess their level of awareness and knowledge regarding COVID-19. To compare the proportional responses between groups in descriptive statistics, a proportion Z-test was used to find any significant differences, with a statistical significance set at p < 0.05.

Results

A total of 1621 participants responded to our questionnaire. Almost two-thirds of the respondents were female (64.4%), and the majority were less than 25 years old (67.2%). Dentists accounted for 12.6% of the total population, and their clinical experience ranged from 0.25 to 52 years (median: 3 years, IQR: 1–10 years). Meanwhile, medical doctors accounted for 24.5% of the responses, and their clinical experience ranged from 0 to 50 years (median: 13 years, IQR: 3–23 years). Among the dental students, 42.3% were in the pre-clinical years, while 57.7% were in the clinical years of study. However, among medical students, 57.5% were in the pre-clinical years, while 42.5% were in the clinical years of study.

Conclusion

Our results demonstrated that dental students, medical doctors, and medical students exhibited higher odds of having satisfactory COVID-19 perception scores than dentists.