A resource reallocation model for school dental screening: taking advantage of teledentistry in low-risk areas

Nursing Practice and Telehealth in School Health Services: A Scoping Review

BACKGROUND

The COVID-19 pandemic has propelled the adoption of telehealth in school settings, emphasising the pivotal role of nurses. This review explores the last decade's evidence on telehealth interventions in school nursing practice; Methods: Following Joanna Briggs Institute guidelines, we conducted a systematic search in PubMed, CINHAL, and Web of Science in March 2023. Out of 518 articles across 21 journals, 32 satisfied the review criteria. The selection process rigorously adhered to PRISMA-ScR guidelines for scoping reviews; Results: The results were categorised into three main areas: (a) the purpose of telehealth and intervention strategies, (b) the role of nursing in school-based telehealth practice, and (c) perceived benefits and limitations of school-based telehealth studies. Telehealth interventions encompass health promotion, mental health management, and early diagnosis. School nurses play a multifaceted role, including management, education, and remote monitoring. While telehealth offers advantages like improved health and cost savings, challenges include digital literacy, device access, and costs; Conclusion: This review underscores the crucial role of telehealth in schools for enhancing healthcare delivery in educational settings. However, more empirical evidence is required to specify nurses' contributions to school-based telehealth interventions. Promoting their leadership through stakeholder collaboration is essential. Further research should address challenges and opportunities in school nursing practice, enriching healthcare in educational settings.

Attitudes and opinions of telehealth in the dental school environment: A survey study

PURPOSE

The objective of this study was to assess provider attitudes and opinions regarding telehealth in the dental school environment.

METHOD

A survey was developed and validated and was sent to 849 predoctoral students, postdoctoral students (residents), and faculty at a single dental school. It consisted of 13 questions regarding the participants' professional backgrounds, opinions, and attitudes toward telehealth. The survey opened on November 16, 2021, and remained open for 6 weeks.

RESULTS

Of 849 survey recipients, 163 (19%) responded. Among 161 usable surveys, 90 (56%) were predoctoral students, 42 (26%) were postdoctoral students, and 29 (18%) were faculty. Fifty-four percent reported having completed at least one telehealth visit. Among this subset, 80% strongly agreed or agreed that telehealth is a good adjunct in providing care; 74% strongly agreed or agreed that telehealth has improved communication with patients.

CONCLUSION

Most dental providers reported positive opinions and attitudes regarding telehealth's ability to improve communication and serve as an adjunct to providing care.

PRACTICAL IMPLICATIONS

In the right circumstances, telehealth offers an alternative to traditional oral healthcare delivery methods. Based on the perceptions of dental providers, the use of telehealth may also be beneficial in combination with traditional approaches in the dental school environment.

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.

Assessing Videoconferencing as a Method of Remote Consultation in Pediatric Dentistry

Background

The oral health condition in rural areas remains compromised due to insufficient healthcare providers. Implementation of teledentistry through videoconferencing in these areas can improve this situation when trained personnel are able to carry out real-time consultations of the patients with a pediatric dentist.

Aim

To observe the feasibility of using teledentistry for an oral examination, consultation, and education, and also to assess the participant's satisfaction regarding the use of teledentistry for a routine dental checkup.

Materials and methods

An observational study was carried out with 150 children aged 6-10 years. About 30 primary health centers (PHC)/Anganwadi (AW) workers were trained to perform the oral examination with the intraoral camera (IOC). Four self-constructed and nonstructured questionnaires were prepared to understand the knowledge, awareness, and attitude of the participants toward pediatric dentistry and their acceptance of teledentistry.

Results

A total of 83.3% of children were not scared and felt that the use of IOC was better. About 84% of the PHC/AW workers found teledentistry very convenient, easy to learn, and adapt. And around 92% thought that teledentistry is time-consuming.

Conclusion

Teledentistry is a possible way to provide pediatric oral health consultation in rural areas. It can save time, stress, and money for people in need of dental treatment.

How to cite this article

Agarwal N, Jabin Z, Waikhom N. Assessing Videoconferencing as a Method of Remote Consultation in Pediatric Dentistry. Int J Clin Pediatr Dent 2022;15(5):564-568.

A Teledentistry Pilot Study on Patient-Initiated Care

COVID-19 has challenged the public dental workforce in their ability to continue providing routine oral health care services. To mitigate the risk of COVID-19 transmission to staff and patients, Teledentistry was implemented in many parts of the world, mainly to provide remote consultations, undertake triage, and offer preventive educational sessions. The aim of this paper is to describe Dental Health Services Victoria’s (DHSV) patient-initiated Teledentistry model of care implemented during peak COVID transmission in Victoria. The Teledentistry model supported patient-centered care involving active collaboration and shared decision making between patients, families, and clinicians in designing and managing remote care plans. DHSV’s eligible patient cohort includes disadvantaged population groups with greater oral health needs. Strong emphasis was placed on the simplicity and user friendliness of the Telehealth platform, as well as the support for patients with low technology literacy. Consumers and dental workforce were consulted and modifications to the use of language and services were undertaken before the launch. A total of 2492 patients accessed Telehealth services between May 2020 and April 2021. Approximately 39% of patients were born in a country other than Australia. A total of 489 patient-reported experience measures (PREMs) were received. Patients agreed or strongly agreed that the care they received met their needs (87%); they received answers to their questions (89%); they left their visit knowing what is next (87%); they felt they were taken care of during their visit (90%); and they felt involved in their treatment (89%). Teledentistry enabled patients to initiate access to care and consult with dental workforce remotely and safely during peak pandemic.

The evolution of the teledentistry landscape in Australia: A scoping review

INTRODUCTION

There has been a recent surge in the use of teledentistry services in Australia that has paralleled the COVID-19 pandemic. Due to the limited published literature reflecting on this transition, this article employed a systematic scoping review methodology.

OBJECTIVE

The objective was to explore the role of teledentistry in the provision of clinical dental services in Australia.

DESIGN

Two independent reviewers searched PubMed, Embase, Scopus, Web of Science and grey literature sources to identify literature eligible for inclusion. The search was restricted to Australia and service delivery. Data were categorically synthesised by modalities and reported benefits and limitations; findings were cross-referenced with the COVID-19 pandemic timeline.

FINDINGS

The systematic search identified 758 articles, of which 25 met the inclusion criteria. Results highlight a range of service providers and definitions of teledentistry. A shift in modality from asynchronous towards synchronous teledentistry pre- and post-COVID-19 pandemic is detailed.

DISCUSSION

Whilst highly useful during the COVID-19 pandemic, teledentistry provides a unique opportunity to continue to increase the accessibility of dental services, especially for patients in rural areas or those who are immunocompromised.

CONCLUSION

Clinicians and researchers must consider opportunities to merge existing research with the recent clinical uptake of teledentistry for patients that would benefit from teledental services beyond the COVID-19 pandemic.

Indonesian Dentists' Perception of the Use of Teledentistry

Introduction

Teledentistry is the use of information and communication technology to provide dental services from distant locations. The use of teledentistry is highly beneficial in the COVID-19 pandemic era.

Objective

This study aimed to explore Indonesian dentists’ perceptions of the use of teledentistry in their daily practice and the benefits for patients.

Methods

This was a descriptive cross-sectional study comprising an electronic survey of Indonesian dentists. We used a cross-cultural, adapted questionnaire that consisted of 26 items and 5-point Likert scale questions that evaluated dentist perception in the following 4 domains: usefulness of teledentistry for dental practice, usefulness of teledentistry to improve practices, usefulness of teledentistry for patients, and dentists who had concerns about the use of teledentistry.

Results

A total of 652 dentists from 34 provinces in Indonesia participated in this study. The majority of respondents agreed about the usefulness of teledentistry in dental practice, especially for saving time, compared to referral letters (87%). Most respondents recognised the utility of teledentistry for improving dental practice and its benefits for patients. Nevertheless, most of the dentists had concerns about teledentistry in terms of digital forgery concern (74.2%) and technical incompatibility (71.8%).

Conclusions

Indonesian dentists reported their positive perception of the usefulness of teledentistry for improving dental practice and benefits for patients, although some concerns were still present. Further studies on the application of teledentistry in Indonesia are still needed.

The World Wide Web of orthodontics- A comprehensive narrative on teledentistry pertaining to the orthodontics of the 21st century

Teledentistry has proven effective in practically all dental fields. It also allows access to inaccessible and underdeveloped locations. Better treatment outcomes were documented in patients treated by an orthodontist supervised by teledentistry than by a general dentist with minimal orthodontic experience alone. It may also help to focus referrals to specialists and weed out those who do not need them. But, on a critical note, a doctor-patient relationship is much more than a business transaction. A face-to-face initial consultation instills trust that a remote session cannot. Teledentistry includes professional networking of doctors. This contact includes digital information exchange, CPD programs, case discussions, and analysis that bring dentists from all around the world together to improve patient care. Teledentistry has not only spanned the distance between dentists worldwide, but has also served as a conduit between customer (patient) and manufacturer. This spawned Direct to Consumer (DTC) dentistry, sparking substantial debate among dentists worldwide. In DTC dentistry, inadequately trained customers conduct complex procedures on themselves with minimal guidance of a dentist. One of the major issues today is the general availability of clear aligners to patients without the requirement for an intermediary skilled orthodontist. The American Association of Orthodontists (AAO) has publicly questioned the validity of Smile Direct Club, a private firm that dominates the DTC industry. European Federation of Orthodontic Specialists Association, on the other hand, has sponsored a joint declaration with the representative orthodontic associations in Europe to highlight and alert patients about the potential risks of DTC products. Unfortunately, public shaming hasn't slowed commercialization of DTC firms. Teledentistry has been a boon for healthcare, but a nightmare for our profession, raising fundamental questions like what is the difference between a customer and a patient? Is dentistry a just another discipline of cosmetics? Is teledentistry making us less connected with our patients?

The Exponential Rise of Teledentistry and Patient-Oriented Protective Measures in Southeast Asian Dental Clinics: Concerns, Benefits, and Challenges

In the Southeast Asian region, various policies have been advocated by health regulatory bodies that entail protective measures such as face masks, gloves, maintaining distance in public areas, and more. These protective measures are aimed at helping reverse the growth rate of the coronavirus. Dentists in this region have incorporated several changes to their practices to help minimize risks of person-to-person transmission inside dental offices. This narrative review aimed to provide an in-depth overview of the current situation in the Southeast Asian region regarding the use of teledentistry during the pandemic. Teledentistry involves the transfer of patient information across remote distances for online consultation and treatment planning. A few years back, it used to be a lesser-known entity but has seen an exponential rise in its incorporation into dental practices all around the Association of Southeast Nations (ASEAN) region. Many clinics in the Southeast Asian region have started using online consultations to ensure that patients can be diagnosed or followed up during their treatment. Teledentistry is the clear answer in the coming months as it will help reduce the risk of virus transmission and help patients get access to oral healthcare and dentists to see their patients. This article reviews the current pandemic situation in the ASEAN region, the recent evidence, and the scope of teledentistry. It also provides recommendations for the future and sheds light on the different types of teledentistry and how it can be incorporated into practices by regulatory authorities in this region.

Teledentistry System in Dental Health Public Services: A Mixed-Methods Intervention Study

INTRODUCTION

Health information and communication technologies, such as Teledentistry, can help expand access to dental health public services making it more effective.

OBJECTIVE

To analyze the factors that affect the implementation of a Teledentistry system in dental health public services.

METHODS

The study follows the Implementation Research methodological framework. A mixed-method approach was applied using a triangulation design-sequential model to collect, analyze, and interpret qualitative and quantitative data about the implementation of a Teledentistry system. A compulsory teleconsultation from the general dentist was planned to access periodontics specialized care. The study was developed in a South Brazilian capital city and the platform of the Santa Catarina Telehealth Center was used. Qualitative and quantitative data were collected sequentially to achieve a better understanding of implementation research issues.

RESULTS

In seven months, 68 teleconsulting was performed by 22% of the general dentists, prior to the referrals on periodontics. Only one reported not needing to refer the patient to the periodontist as a result of the teleconsulting guidance. Teledentistry system implementation and usage were influenced by the managers' political and administrative awareness to deploy and maintain the intervention. Lack of sufficient resource investment, lack of system integration, and internet failures were relevant limiting factors. The teleconsultant guidelines contributed to general dentistry's better decision-making regarding treatment, urgency of case management, and prioritization of referrals to the periodontists CONCLUSION: Identifying the factors that influence the implementation and finding solutions to overcome them, can prevent future failures and improve usage of the system.

The application of teledentistry for Saudi patients' care: A national survey study

BACKGROUND/PURPOSE

Teledentistry has emerged as a new communication tool in various dental disciplines around the world. The aim of this study was to investigate the applicability and reliability of teledentistry in the field of diagnostic dentistry and explore the perception of Saudi dentists of its benefits and concerns.

MATERIALS AND METHODS

An electronic survey with 40 questions was developed, validated and distributed electronically by email and social media channels to dentists from different specialty in Saudi Arabia. Collected data were analyzed for statistical significance.

RESULTS

A total of 148 dentists completed the survey. The current data demonstrated that 50% of study participants have had applied teledentistry in their clinical practice. Out of all, 90% have computers in their dental offices and 72% have been using electronic medical records in which radiographs and clinical images are uploaded. Most participants had smart phones (91%), in which they were used more commonly (74.3%) than conventional cameras (54.1%) to capture and share patients' clinical images over communication applications (74.3%) and less likely through emails (62.2%). Overall, 83% were confident that teledentistry can improve daily dental practice, specifically in the fields of oral radiology followed by endodontics and oral medicine.

CONCLUSION

Teledentistry is an emerging tool with potential to improve the delivery of diagnostic dental care for communities with limited or no access to dental specialists. As of today, teledentistry has not been truly implemented by the Saudi dental community. Development of national programs to educate the public and promote teledentistry among dental practitioners are warranted.

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

OBJECTIVES

 To assess knowledge, awareness, and practice of health care workers about the role of teledentistry in coronavirus disease 2019 (COVID-19).

MATERIALS AND METHODS

 A prevalidated structured questionnaire was used to evaluate awareness of general dentists, postgraduate dental students, dental educators, and consultants with postgraduation degrees toward teledentistry. The acceptability, reliability, and language clarity were also pretested. A total of 510 dental professionals contributed to this study.

STATISTICAL ANALYSIS

 A statistical analysis using SPSS (version 20.0) was performed. Responses were noted as yes or no. A p-value of ≤ 0.05 was considered to be significant. Frequencies described data. Chi-square test was performed for intergroup comparison to evaluate if the knowledge and attitude diverge with the increase in the level of seniority in the profession.

RESULTS

 Awareness regarding teledentistry is high among general dentists with bachelor of dental surgery qualification in comparison to final-year students and postgraduate dental students. The majority of participants agreed with improvement in health care (88.20%), access to rural areas (82.90%), and general practicing dentist agreed with statistically significant difference (0.00) on saving time by teledentistry.

CONCLUSION

 General practicing dentist was observed with high awareness of teledentistry as compared with postgraduate and undergraduate dental students.

How Has Teledentistry Been Applied in Public Dental Health Services? An Integrative Review

Background: There are inequities in the provision of oral health care, and a large proportion of the population face challenges in accessing public dental health care options. Introduction: Teledentistry (TD), a new branch of telemedicine dedicated to dentistry, is a potential approach that can be used to overcome these challenges. Therefore, the purpose of this integrative review was to collect information regarding the inclusion of the application of TD tools in the public dental health services. Methods: Five electronic databases (PubMed/Medline, Virtual Health Library, CINAHL, Scopus, and Web of Science) were searched for relevant articles if they reported on original data related to the use of TD in public dental health services. Results/Discussion: Twenty-four studies met the inclusion criteria and were, consequently, included in the review. Our key findings indicated that TD can be used for training and continuing education of professionals, for remote patient care, to exchange information among health professionals, and orientation. It increases the access to dental care and enables general practitioners to interact with specialties. The benefits include cost-effective health equity services, improve dental knowledge, and reduce consultation waiting time. However, despite the advances made with the use of this technology, there are still some obstacles to overcome, such as limited infrastructure, low levels of motivation and the lack of compliance, professional resistance, and legal and security issues. Conclusion: TD may be very a useful tool for dental public health increasing the quality of the care by improving access, professional education, and patient satisfaction.