Teledentistry and its use in dental education

Evaluation of a student telehealth rotation at the Columbia University College of Dental Medicine

OBJECTIVES

This study aimed to assess the impact of a telehealth rotation on the perceived benefits and challenges of telehealth use among third-year dental students at the Columbia University College of Dental Medicine (CDM).

METHODS

A newly implemented weeklong telehealth rotation at CDM engaged all 95 third-year dental students from the 2022 graduating class through assigned readings and virtual interaction with patients. The telehealth rotation involves virtual visits with patients for screening and triage. An ongoing retrospective assessment of the students' post-rotation evaluation was analyzed qualitatively to identify emerging themes and was coded to describe students' attitudes and beliefs about telehealth.

RESULTS

Students reported that the greatest benefit of telehealth is logistical convenience, while the greatest challenge to telehealth is related to the use of technology. After the telehealth rotation, students reported improvement in their clinically relevant skills and knowledge, including patient education, facilitating access to care, and communication skills.

CONCLUSIONS

The skills reported by students as the most important learning takeaway from the telehealth rotation are applicable to many aspects of care delivery, beyond the scope of telehealth. The incorporation of telehealth education into dental curricula allows students to improve essential clinically relevant skills and knowledge beyond the procedural skills emphasized during in-person patient appointments.

Beyond the Chair: Exploring the Boundaries of Teledentistry

Teledentistry, a blend of dentistry and telecommunications used to provide dental care from a distance, holds great promise in enhancing public health, especially in reaching communities with limited access. However, putting it into practice has its own set of obstacles and background variables. It is frequently difficult to obtain dental treatment, especially in rural or economically underdeveloped areas. By removing geographical constraints and offering virtual consultations and diagnostics, teledentistry provides a solution. The quick development of technology, such as portable electronics and high-speed internet, has increased accessibility and efficiency in communication, which has aided in the acceptance of teledentistry. Getting traditional dental care can be costly, particularly for people without insurance. As an affordable substitute for traditional dental care, teledentistry may lower overhead expenses related to physical dental offices. Early interventions and preventive care can greatly enhance oral health results and lessen the need for later, more invasive procedures. There are disparities in the availability of digital gadgets and internet connectivity. The laws that control telehealth services might differ greatly between nations and areas. While teledentistry can help with remote consultations and triage, it might not be able to do thorough examinations or other diagnostic treatments that need in-person attendance. Delivering dependable, top-notch telemedicine services in developing areas can pose challenges. Certain dentists might hesitate to utilize teledentistry due to concerns about the quality of care, liability issues, or potential impacts on their traditional practice models. It could be difficult to get patients to accept and use teledentistry services. This review is undertaken to assess the effectiveness of teledentistry in public health as well as legal and regulatory considerations for practicing teledentistry. Teledentistry might be the future of the oral health sector, thus fully capitalizing on this enormous opportunity to change how oral therapies are administered. Patients, dentists, and the dental community at large will need to have highly open minds. For the community's well-being and to gain its trust, ethical considerations are crucial. The outcomes of teledentistry can be attained by overcoming the obstacles and using comprehensive methods and approaches. It was noted that teledentistry is a potential strategy that combines dental care with telecommunication technology to enhance patient outcomes, reduce healthcare inequalities, and expand access to oral health services. The delivery of oral healthcare is being revolutionized by teledentistry, especially in light of contemporary issues including geographic restrictions, lack of access to dental treatment, and the ongoing global health crisis.

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.

The impact of digital healthcare and teledentistry on dentistry in the 21st Century: a survey of Hungarian dentists

BACKGROUND

The era of digitalization has arrived in the field of dentistry. Teledentistry (TD), the use of digital solutions in dentistry, is already used in practice; however, only some possibilities are considered. During the COVID-19 pandemic, remote patient monitoring and patient communication had to be solved with TD, thus causing a rapid spread of new tools. In addition to digital workflows, patient communication, AI, and online forums are also available.

METHODS

An online self-administered survey was developed for the study. The Hungarian Medical Chamber contacted potential respondents in a newsletter or e-mail. The Evasys survey system was used. The weighting procedure was executed for gender, age group, and type of settlement. A digital dental index variable was created and built with a linear regression model as a dependent variable. Explanatory variables are advantages, disadvantages, what would be necessary, experienced needs from the patients, and age.

RESULTS

A total of 171 dentists completed the survey. The best-known digital technologies are online conferences (96.5%), E-prescriptions (94.6%), and digital impressions (86.0%). Unawareness is the highest in the field of artificial intelligence in dentistry (50.5%), store-forward solutions (43.5%), and real-time solutions (41.8%). The digital dental index is 14.24 (standard deviation (SD) = 5.5), with a high power of the model.

CONCLUSION

Hungarian dentists need to be made aware of all the possibilities of TD. In addition to digital workflows, store-forward and real-time solutions can be beneficial to substitute face-to-face visits. TD can be used effectively to monitor oral cavity changes and develop dental confidence and proper oral care habits. Our survey suggests that it is necessary and inevitable to integrate TD into both graduate and postgraduate education, which may form the basis of primary health care in the next decade.

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.

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.

Tele-orthodontics education model for orthodontic residents: A preliminary study

OBJECTIVES

Tele-orthodontics is an important medium to use for diagnosis and treatment planning and to refer patients for specific treatment when deemed necessary. The effectiveness of the Tele-orthodontics Education Model serves to improve resident's knowledge, confidence, and skills in delivering tele-orthodontic patient care. The purpose of this educational single-arm pre-test-post-test interventional study was to assess and educate orthodontic residents (6 year-one, and 6 year-two) to appropriately use tele-orthodontics.

METHODS

The Tele-orthodontics Education Model utilizes three learning modules, a questionnaire before and after the training to assess participant knowledge, confidence and skills levels, three online multiple-choice questionnaires, three explanatory videos and an in-person simulation session. The Blackboard Learning Management System (virtual learning platform) facilitates access to the various modules of the program. Within each learning module, a participant's knowledge level was determined by utilizing five multiple-choice questions before and after each module. The various modules were introduced to the participants and then evaluated by reviewing the participant's responses to the multiple-choice questions.

RESULTS

Twelve orthodontic residents completed the model in one session. Everyone fully completed the questionnaire. Post-test results showed higher mean scores for all questions addresses knowledge, the mean confidence, and skills score for post-test showed no change when compared to pre-test.

CONCLUSIONS

This education model was effective in improving basic knowledge in tele-orthodontics among first, and second-year orthodontic residents. We hypothesize that the residents are more informed and prepared for future tele-orthodontic practices.

The use of teledentistry in clinical oral and maxillofacial pathology practice: an institutional experience

Background

Although there has been a slight increase in dental professionals since 2011, 98 of North Carolina's 100 counties are designated as Dental Health Professional Shortage Areas by the Heath Resources and Service Administration. This shortage significantly increases disparities and access to primary and specialized oral health care. Also, dental professionals in these remote locations may feel the access and referrals to oral and maxillofacial pathologists cumbersome. In 2020, the COVID-19 pandemic prompted an inevitable surge in the use of digital technology due to the social distancing norms and lockdowns, which forced dental education institutions and practitioners to adjust to new ways of meeting, teaching, and providing dental care. In the present manuscript, we report our institutional experience delivering specialized dental care in rural areas.

Materials and methods

We conducted a retrospective case series of diagnosis, management, and outcomes of patients who underwent synchronous or asynchronous virtual and remote examination of oral lesions at ECU School of Dental Medicine and one satellite clinic over seven years. For those cases that concluded on surgical sampling, the clinical impressions, differential diagnoses, and the final diagnosis were compared to assess the accuracy of the clinical exam through teledentistry.

Results

The total study population consisted of 71 patients. Most of the remote consultations were done asynchronously. Also, most virtual clinical consultations were initiated due to clinical suspicion of malignancy and infectious/reactive conditions, accounting for 42% and 25.3% of all encounters.

Conclusions

The presented data suggest how teledentistry can support clinical practice in rural areas to achieve optimal care for the patient in rural or remote communities. Also, it significantly decreases the travel required, the number of appointments, and increases the speed of diagnosis. Teledentistry is an excellent tool available to all clinicians and can dramatically aid in diagnosing oral mucosa lesions.

The use of teleorthodontics during the COVID-19 pandemic and beyond - perspectives of patients and providers

BACKGROUND

The COVID-19 pandemic significantly impacted dental services, resulting in reduced staff availability, limited appointments, and some dental clinics even being forced to close their doors. Despite these challenges, the need for dental consultants remained present, particularly in emergency situations. One area of orthodontics that had seen a surge in demand during the pandemic is Teleorthodontics. With the help of Teleorthodontics, orthodontic consultations, assessments, and even treatment monitoring could be conducted remotely, making it a safe and convenient option for patients during those challenging times.

AIM

This survey aimed to evaluate the acceptance of patients and their orthodontists on the use of different modes of communication through Teleorthodontics during the COVID-19 pandemic and their willingness to continue using this in the future.

METHODS

An online survey instrument in Qualtrics was distributed to orthodontic patients at the University of Illinois, Chicago. The survey was available on a rolling basis for up to 6 months. A total number of 364 partients voluntarily participated in the survey. The Faculty and Residents were also asked to participate in a survey through recruitment via their UIC email addresses.

RESULTS

According to our survey, both patients and providers showed acceptance of Teleorthodontics and have used it in different forms during orthodontic treatment. The application is easy-to-use, convenient, and not at all time-consuming. Overall satisfaction with using this application was recorded at 92%, with 66% of patients stating that it saved them time by eliminating the need to travel to the orthodontic clinic. 30% of providers found that the interaction with patients using Teleorthodontics was a positive experience and would recommend it in future.

CONCLUSION

Teleorthodontics has shown great potential, particularly in follow-up cases, and holds promise as a valuable tool for online remote dental consultations in the future.

Establishment of Neural Series Transmission Keys (NSTKs) and Security in the Field of COVID-19 Telepediatric Oral Health

In this exceptional COVID-19 crisis, telemedicine had arisen as a substitute technique for medicines. Even more unequivocally, pediatric children were at high risk to outside homes. The spread of COVID-19 has suddenly ascended. Because of lockdown conventions and isolation protocols, kids were confined to live inside their homes. Non-emergency youngsters ought to be managed remotely through the telepediatric health. An establishment of Neural Series Transmission Keys (NSTKs) has been created and security had been planned on the intraoral data. Oral cavity is a kind of dental disease occurring in children. It is for the most cases caused due to drawn out bacterial invasions. Bacterial attacks are more because of sticky chocolates, desserts, sugar, and so forth. Homeopathy medicines are the best prescribed to fix such dental diseases in this current unprecedented COVID-19. Since, it needs no dental medical procedure for the non-invasive kids, which is the reason that the homeopathy medicines are most appropriate in this COVID-19 lockdown stages. The doctor can gather symptoms of the kids from their parents through online interfaces. Some of the normal homeopathy drugs are: Kreasotum, Mercurius, Mezereum, etc. Moreover, in this pandemic situation online telepediatric homeopathy medicines were better alternatives to investigate from home disengages. Additionally it bears no voyaging consumptions and costs. Secure online transmission of clinical pediatric information has been the most challenging issue in COVID-19 telepediatric oral wellbeing. Data mystery factor is protected with tendency in this proposed cryptographic technique. Neural Series Transmission Keys (NSTKs) were established based on neural network based hamming codes. It has been diffused inside the intraoral pediatric data. The proposed key was so particularly amazing that it gives assorted blend after each bit of evolving. Beginning seeds were kept at the dentists and the patients, in order to go against external attacks inside the public channel, especially during this hyper digitized COVID-19 times. Standard graphs were drawn with accuracy using the proposed cryptographic method. The absolute cryptographic time in this strategy was 2.88 ms which was significantly important. By applying Chi Square test, we have noted χ 2 = 17.012, under 5% level of significance.

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.

Applicable of teledentistry and digital platforms during the COVID-19 pandemic among dentists in Fiji: A qualitative study

Objectives

This research aims to explore the perception of dental officers (DOs) and dental managers (DMs) on the use of teledentistry and digital platforms during the COVID-19 pandemic in Fiji.

Methods

This qualitative study was conducted among 30 DOs and 17 DMs. The study was conducted in private dental clinics, government dental clinics and the School of Dentistry and Oral Health clinic (SDOH), in the Central Division, Fiji that were selected randomly. The participants were selected using the purposive sampling method using the inclusion and exclusion criteria. Data was collected through in-depth interviews via zoom using a self-developed semi-structure open-ended interview questionnaire. Manual thematic analysis of the data was conducted.

Results

Five themes emerged from data analysis: utilization of teledentistry and media during the pandemic, usefulness of teledentistry, confidence with teledentistry and digital platforms-associated risks, digital platforms for record keeping, and teledentistry promotion and training. Teledentistry was mostly utilized by private practitioners and the oral surgery department. Practitioners were not in favour of teledentistry as they thought it was putting them at risk.

Conclusion

Majority of DOs and DMs were not utilizing teledentistry except for a few private dental practitioners and the oral surgery department. Future research can be conducted in other divisions and include other healthcare professionals.

The development of digital dentistry in the UK: An overview

The COVID-19 pandemic has highlighted the benefits which digital technology offers to all aspects of dental practice and education. This paper provides an overview of how digital technology has enhanced clinical and administrative procedures within dental practice, including computer-aided design/computer-aided manufacture (CAD/CAM), digital radiography, 3D printing, patient records, electronic patient referrals and electronic communications from dental practices. It then considers the development of teledentistry (mHealth) and its benefits in enabling distant consultations with patients, who for one reason or another are unable to visit dental practices easily. It then goes on to consider how and why digital dental distance learning materials were provided to general dental practitioners in England by the Department of Health (DoH) (England) and how they evolved. Finally, this paper considers the use of digital technology in dental education by dental schools.

Accuracy of Teledentistry for Diagnosis and Treatment Planning of Pediatric Patients during COVID-19 Pandemic

Teledentistry is a new technology in the dentistry field, which has great benefits during pandemic such as the coronavirus disease 2019 (COVID-19). The overall purpose of the study was to assess the diagnostic sensitivity and specificity of virtual (mobile phone teledentistry) compared with clinical examinations during COVID-19. The basic design of the study was based on the comparison treatment plans by the students and the gold standard (clinical treatment plan of an expert pedodontist with 10 years of clinical experience). This double-blind clinical trial was conducted on 20 children (aged 6 to 12 years) with a chief complaint of dental caries with or without pain. An appropriate radiograph and five standard intraoral photographs (frontal view occlusion, maxillary occlusal view, mandibular occlusal view, right lateral view, and left lateral view) were prescribed for each patient according to the guidelines of the American Association of Pediatric Dentistry. Then, the treatment plan for the carious teeth was recorded for each patient. Each patient underwent a clinical examination at first and was followed randomly by a virtual examination by two dental students. Then, the clinical and virtual treatment plans were compared with each other, and also with the gold standard. The sensitivity and specificity values were calculated for each group. The accuracy of the diagnosis was measured by applying Cohen's kappa. Interexaminer reliability was measured using the intraclass correlation coefficient (ICC) and Cronbach's alpha. The mean kappa coefficient for the interexaminer agreement (for 24 teeth) was 0.62 in clinical and 0.69 in virtual examinations. The results showed no significant difference in the treatment plans of students and the gold standard (P > 0.05). The diagnostic sensitivity and specificity were 73.22% and 95.8% for clinical and 76.44% and 92.9% for virtual treatment plans showing no significant differences between virtual (mobile phone teledentistry) and clinical examinations (P > 0.05). The intraexaminer reliability of the examiners was found to be 0.92 by calculating the ICC. Then, teledentistry can be considered as a supplement to clinical examinations of pediatric dentistry, finally resulting in better patient management. However, more studies are necessary for teledentistry.

Effectiveness of Telemedicine and Teledentistry after the COVID-19 Pandemic

Telemedicine has become increasingly important worldwide over the last two decades. As a new field, it became known especially during the COVID-19 pandemic; this review presents fields of activity with special attention to opportunities and risks. Numerous areas of application offer the possibility for broad use in the medical and dental care landscape in diagnostics, therapy, rehabilitation, and decision advice across a spatial distance. Technical and semantic standards are required, and profiles and guidelines are increasingly defined and organized. Medical/dental consultations have been established in various regions around the world as a response to pandemic challenges and have made video and online emergency consultations possible. Telemedicine applications are already regularly used in medical/dental emergencies, regardless of the pandemic situation, both for transport by train and by plane, from which patients benefit. However, legal hurdles are often still unresolved, but infrastructure challenges both for provider, user hard- and software also complicate deployment. Problems are particularly prevalent in the absence of necessary internet coverage or among socially disadvantaged and vulnerable groups who cannot afford expensive equipment or do not know how to use the technology. Broad access must be enabled, and hardware and software interfaces and updates must be regularly checked and updated. Telemedicine might also improve access to and delivery of oral and general health care support both for rural and urban areas with low costs. Even though dentistry and many medical specialties are still performed clinically by means of practical/manual examination, there are areas of diagnostics where telemedicine applications can provide good support. Therefore, as conclusions, access, and delivery of telemedicine applications in dentistry and medicine should be expanded and improved to provide access to all population groups.

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.

Diagnostic accuracy of a telediagnosis service of oral mucosal diseases: A multicentric survey

OBJECTIVE

The aim of this multicentric study was to assess the diagnostic accuracy of a telediagnosis service for oral mucosal disorders.

STUDY DESIGN

This study included 100 patients seen at the oral medicine outpatient clinic of 3 Brazilian Dental Schools (University of Campinas, Federal University of Pernambuco, and Federal University of Santa Catrina) from March 2019 to October 2019. In addition to the face-to-face assistance provided by graduate students and the final diagnosis validated by the professors of these institutions, a remote evaluation was requested for these patients through the EstomatoNet/TelessaúdeRS platform.

RESULTS

The sensitivity and specificity of telediagnosis were compared with those of the face-to-face approach and found to be 100% and 97.4%, respectively. The concordance between the examiners was 95%, and case management was relatively simple in approximately 60% of cases.

CONCLUSIONS

Based on the results, telediagnosis for oral diseases can be considered a reliable method, representing a promising alternative for the clinical support of health professionals, particularly in remote locations.

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?

Accuracy of Dental Photography: Professional vs. Smartphone's Camera

There is a scant literature on the accuracy of dental photographs captured by Digital Single-Lens Reflex (DSLR) and smartphone cameras. The aim was to compare linear measurements of plaster models photographed with DSLR and smartphone's camera with digital models. Thirty maxillary casts were prepared. Vertical and horizontal reference lines were marked on each tooth, with exception to molars. Then, models were scanned with the TRIOS 3 Basic intraoral dental scanner (control). Six photographs were captured for each model: one using DSLR camera (Canon EOS 700D) and five with smartphone (iPhone X) (distance range 16-32 cm). Teeth heights and widths were measured on scans and photographs. The following conclusions could be drawn: (1) the measurements of teeth by means of DSLR and smartphone cameras (at distances of at least 24 cm) and scan did not differ. (2) The measurements of anterior teeth by means of DSLR and smartphone cameras (at all distances tested) and scan exhibited no difference. For documentational purposes, the distortion is negligeable, and both camera devices can be applied. Dentists can rely on DSLR and smartphone cameras (at distances of at least 24 cm) for smile designs providing comparable and reliable linear measurements.

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 Teledentistry, Impact, Current Trends, and Application in Dentistry: A Global Study

Objective

The present study was aimed at assessing the impact of teledentistry, its application, and trends in uplifting dental practice and clinical care around the world. Material and Methods. The present observational study comprised of an electronic survey distributed among dental professionals around the globe. The validated survey form consisted of a total 26 questions with 5-point Likert scale response. The questionnaire used was divided into four domains: usefulness of teledentistry for patients, its usefulness in dental practice, its capacity to improve the existing practice, and the concerns attached to its use. The statistical analysis was performed using SPSS-25. ANOVA test was used to assess the effect of independent variables on dependent variables. A p value of ≤0.05 was taken as statistically significant.

Results

A total of 506 dental professionals participated in the study with the response rate of 89.39%. More than half of the participants (50-75%) endorsed that teledentistry is a useful tool for improving clinical practice as well as patient care. Two-thirds of the participants (69.96%) considered that teledentistry would reduce cost for the dental practices. On the other hand, about 50-70% of dental professionals expressed their concerns regarding the security of the data and consent of patients. The most preferred communication tool for teledentistry was reported to be videoconference followed by phone. The majority of participants recommended the use of teledentistry in the specialty of oral medicine, operative dentistry, and periodontics. There was a significant difference between the age, experience of dentists, and their qualifications with domains of teledentistry.

Conclusions

The overall impact of dental professionals towards teledentistry was positive with adequate willingness to incorporate this modality in their clinical practice. However, the perceived concerns pertaining to teledentistry are significant impediments towards its integration within the oral health system. An in-depth study of its business model and cost-benefit needs of time, especially in the context of developing countries, in order to avail the optimum benefits of teledentistry.

Telemedicine for healthcare: Capabilities, features, barriers, and applications

Regular hospital visits can be expensive, particularly in rural areas, due to travel costs. In the era of the Covid-19 Pandemic, where physical interaction becomes risky, people prefer telemedicine. Fortunately, medical visits can be reduced when telemedicine services are used through video conferencing or other virtual technologies. Thus, telemedicine saves both the patient's and the health care provider time and the cost of the treatment. Furthermore, due to its fast and advantageous characteristics, it can streamline the workflow of hospitals and clinics. This disruptive technology would make it easier to monitor discharged patients and manage their recovery. As a result, it is sufficient to state that telemedicine can create a win-win situation. This paper aims to explore the significant capabilities, features with treatment workflow, and barriers to the adoption of telemedicine in Healthcare. The paper identifies seventeen significant applications of telemedicine in Healthcare. Telemedicine is described as a medical practitioner to diagnose and treat patients in a remote area. Using health apps for scheduled follow-up visits makes doctors and patients more effective and improves the probability of follow-up, reducing missing appointments and optimising patient outcomes. Patients should have an accurate medical history and show the doctor any prominent rashes, bruises, or other signs that need attention through the excellent quality audio-video system. Further, practitioners need file management and a payment gateway system. Telemedicine technologies allow patients and doctors both to review the treatment process. However, this technology supplements physical consultation and is in no way a substitute for a physical consultation. Today this technology is a safe choice for patients who cannot go to the doctor or sit at home, especially during a pandemic.

Telemedicine Among Oral Medicine Practitioners During COVID-19 Pandemic and Its Future Impact on the Specialty

Background

The coronavirus disease 2019 (COVID-19) pandemic necessitated widespread changes in delivery of dental care. Telemedicine utilization increased overnight during this pandemic because of its ability to enhance access to oral healthcare, easily link to remote area, time management, low cost, etc. We aimed to identify the utilization of telemedicine among oral medicine practitioners in Saudi Arabia during COVID-19 pandemic and identify future impacts, potential challenges and barriers hindering the implementation of telemedicine.

Methods

The present cross-sectional electronically self-administered supplement-based survey Supplement Based Survey study was conducted among different professional levels of oral medicine involving consultants, specialists, and residents. The supplement includes demographic data, the current use of telemedicine, participant's perspective on future implications, and potential barriers and limitations of telemedicine. Internal consistency was measured using Cronbach's alpha (α) to assess how closely related a set of items in our study.

Results

Of the total (N = 75) oral healthcare professionals, 52% were male, 70.7% were Saudi, 45.3% were consultant, 42.7% had 1-5 years of experience, 82.7% were practicing in urban areas, 93.3% stated COVID-19 affected their clinics, consultation was the major reason for the use of telemedicine before (50.7%) and during (72%) COVID-19 outbreak, 57.3% were communicating with their patients, 97.33% had not experienced any cyber risk, and 45% patients were satisfied with the telemedicine service; our data showed a high level of homogeneity (α = 0.82). The poor knowledge and training on telemedicine technologies may substantially (p < 0.05) impact the future implications of telemedicine in oral medicine practice.

Conclusion

Telemedicine could be a useful adjunct for oral medicine practice, especially for remote diagnosis, consultation, referral, training and education. Our study emphasizes an urgent need to increase the awareness and education on how to utilize and practice telemedicine technologies among medical staff to maximize the efficiency.

Pattern of dental needs and advice on Twitter during the COVID-19 pandemic in Saudi Arabia

Aim

To compare and evaluate the influence of the COVID-19 outbreak on tweets related to dental treatment needs and advice of Saudi Twitter users in 2020 by comparing them to the same time-period in 2019.

Methods

Eight independent searches based on dentistry related keywords: “teeth, mouth and gingiva” were carried out within the timeframe between the 23rd of March and the 21st of June for the years 2020 and 2019. Extracted tweets were analyzed by two calibrated examiners as tweets containing expressed dental needs and tweets for dental advice, while spam tweets were excluded. Descriptive analysis was performed to present the overview of the findings using SPSS. Bivariate analysis was performed with Pearson’s Chi Square, Fisher’s Exact test and Mann–Whitney U test. Statistical significance was set at p ≤ 0.05.

Results

A total of 595 tweets from the year 2019 and 714 tweets from the year 2020 were obtained. Overall, combined dental needs and advice tweets, retweets, likes, and replies were higher in 2020 compared to 2019. Dental needs tweets were higher in 2020 compared to 2019, while dental advice tweets were lower in 2020 compared to 2019. Statistically significant differences were found between 2020 and 2019 with regards to dental needs well as with dental advice (p < 0.05). In addition, statistically significant differences were found between 2019 and 2020 with presence of pain, urgency of the dental need and type of advisor (p < 0.05).

Conclusion

An obvious impact of the pandemic can be seen in the form of increased self-reported dental needs, pain and urgency among the public in Saudi Arabia. This study highlights the importance of social media, specifically Twitter, in expressing the public needs and utilizing it as a platform for education and advice.

Teledentistry as a Supportive Tool for Dentists in Pakistan

The current scenario of the COVID-19 pandemic has forced dentists to seek different options for delivering healthcare services other than the in-person direct examination in clinical practice. Teledentistry is one of the options for remote patient care and monitoring. Objective. The present survey was conducted to assess the knowledge and perception of the dentists in Pakistan regarding teledentistry as an emergent supportive tool. Materials and Methods. A self-administered, close-ended, and prevalidated survey questionnaire was used, comprising 21 questions, and distributed electronically via e-mail, WhatsApp, and Facebook Messenger to evaluate the knowledge and perception of dentists regarding teledentistry. The data collected was compiled in a systematic manner and analyzed in terms of frequency (yes/no). Results. Out of a total of 350 dentists, 325 responded to the questionnaire, and it was seen that 62.5% of them did not have knowledge about teledentistry prior to COVID-19. 65.8% of dentists considered the practice of teledentistry in nonpandemic situations in the future. Conclusion. In the present study, it was observed that most of the dental professionals had inadequate knowledge about teledentistry before COVID-19, but the awareness and perception regarding teledentistry were currently satisfactory among the dental professionals in Pakistan. This emerging trend gives a positive hope for the implementation of teledentistry in the healthcare setup of Pakistan in the near future, as it will prove to be beneficial for safe dental practice during times of pandemic and even after.

Role of teledentistry in paediatric dentistry

Introduction As a result of the COVID-19 pandemic, teledentistry has been used more frequently due to social distancing regulations to minimise the need for face-to-face attendances. Aims Evaluate uses of teledentistry within Newcastle Dental Hospital's Paediatric Dentistry New Patient Service. Establishes potential roles of teledentistry within paediatric dentistry and advantages and disadvantages of this service method. Methods Service evaluation of 653 new patient teledentistry appointments at Newcastle Dental Hospital across a one-month period (13 May- 12 June 2020).Discussion By implementing a telephone consultation as the first point of contact with our team, we were able to reduce the number of face-to-face appointments required by over a third. Teledentistry can be used for numerous applications within paediatric dentistry including initial triage, remote assessment, reinforcement of prevention, implementing initial management and building rapport. Conclusion Teledentistry is an emerging field and has the potential to improve patient journeys, reduce waiting lists and reduce unnecessary face-to-face attendances which is especially important both within and beyond the current COVID-19 pandemic to maximise safety and minimise inconvenience for both parent and child. However, care must be taken to ensure a clinician is confident in their diagnosis prior to discharging or delaying management of a patient.

Rapid implementation of teledentistry during the Covid-19 lockdown

Introduction

Objective

Methods

Results

Conclusions

Teledentistry and mHealth for Promotion and Prevention of Oral Health: A Systematic Review and Meta-analysis

The dental profession has experienced a dramatic acceleration in the use of communication systems and information-based technologies over recent years, originating new paradigms for the prevention and promotion of oral health. The purpose of this systematic review was to determine the effect of teledentistry-based (telematic) strategies, reported in randomized controlled trials and quasi-randomized trials, with a focus on oral health prevention and promotion-related outcomes in patients of all ages. We searched Medline via PubMed, SCOPUS, and Web of Science from inception until August 2020, regardless of the language of publication. We selected studies for inclusion and conducted data extraction, assessed risk of bias (Cochrane tool), and evaluated the certainty of the evidence (GRADE approach) in duplicate and independently. Out of 898 potentially eligible references, we selected 43 for full-text screening, of which 19 studies proved eligible: 18 randomized controlled trials and 1 quasi-randomized study. Virtual interventions were mostly asynchronous via apps (n = 9), text messages (n = 9), or computer-aided learning (n = 1). The use of teledentistry as compared with conventional strategies may result in a large reduction in the plaque index (standardized mean difference, -1.18; 95% CI, -1.54 to -0.82; I² = 92%; low certainty) and will likely result in a large reduction in the gingival index (standardized mean difference, -2.17; 95% CI, -3.15 to -1.19; I² = 97%; moderate certainty) and in the incidence of white spot lesions (risk ratio, 0.48; 95% CI, 0.35 to 0.66; I² = 0%; moderate certainty), with an increased effect over time. Evidence suggests that teledentistry, particularly mHealth (messages and apps), is a promising clinical tool for preventing and promoting oral health, especially under the accelerated virtualization of dentistry. Future studies should include a broader spectrum of the population, including adults and elders, to better inform policy and implementation of teledentistry (PROSPERO: CRD42020192685).

Demographics and management of paediatric dental-facial trauma in the 'lockdown' period: A UK perspective

Background

The United Kingdom entered ‘lockdown’ on the 23 March 2020 due to the COVID‐19 pandemic. This resulted in school closures forcing children to remain at home. Dental‐facial trauma was still likely to be common place due to falls and injuries exercising. The aim of this study was to explore the impact of the COVID‐19 pandemic on clinical practice in a paediatric population in a tertiary care hospital and a linked Dental Institute.

Method

A proforma was designed to capture the demographics, presenting complaints, type of dental‐facial injury, treatment need and the treatment received for all paediatric patients presenting face to face with dental‐facial trauma to King's College Hospital during the ‘lockdown’ period (23 March‐ 14 June 2020).

Results

Four hundred and twenty calls were triaged, converting to 102 patients seen face‐to‐face for dental‐facial trauma. The remainder were able to be triaged ‘virtually’. Injuries seen included 56 (54.9%) dentoalveolar injuries, 37 (36.2%) lacerations, five (4.9%) suspected facial fractures and four (3.9%) dog bites. Males and females were equally affected. The majority of incidents occurred in the home environment (n = 60, 58.8%), with the remainder (n = 42, 41.2%) occurring outside the home environment. The main causes of dental‐facial trauma were falls (n = 47, 46.1%) and bicycles/scooters (n = 29, 28.4%). The most common type of dentoalveolar injury was lateral luxation (n = 15, 26.7%), followed by avulsion (n = 12, 21.4%). Only one child required treatment under general anaesthesia (GA).

Conclusion

The demographic, presenting complaints and treatment needs of patients who presented during the lockdown period with dental‐facial trauma were unusual. The overwhelming majority were able to be treated without the use of GA. The attendance protocol in a tertiary care setting and the use of ‘teledentistry’ ensured only the most severe trauma cases were seen. This highlights how more complex trauma can still occur during ‘lockdown’ and requires immediate management.

Teledentistry: A Boon Amidst COVID-19 Lockdown-A Narrative Review

The recent spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its associated coronavirus disease (COVID-19) has caused widespread public health concerns. Despite huge efforts to contain the disease spread, it is still on the rise because of the community spread pattern of this infection. In order to prevent the community spread, a nationwide lockdown was implemented, due to which many restrictions were imposed on movements of citizens within the country. Since the dental professionals were at the forefront of acquiring the infection, the majority of the dental clinics were shut for routine dental procedures. Only emergency treatment was provided to the patients. However, due to restrictions in movement, it was difficult for the patients to visit the clinics for routine check-ups. This was overcome by the advancements in technology which has a major impact on medicine. Due to increased usage of smartphones and related software applications, the clinical data exchange was facilitated between patients and clinicians which has been termed as "teledentistry." Teledentistry is a combination of telecommunications and dentistry, involving the exchange of clinical information and images for dental consultation and treatment planning. This technology served as a boon for the dentists to manage dental emergencies during the lockdown period. This narrative review discusses teledentistry and its applications in general and specialty dental practice amidst the COVID-19 lockdown.

Synchronous Telephone-Based Consultations in Teledentistry: Preliminary Experience of the Telehealth Brazil Platform

BACKGROUND

The Brazilian National Health System (NHS) has incorporated telehealth to improve the quality of care in recent decades. Among the actions taken, teleconsultations have been offered to support diagnosis and decision-making for health professionals.

METHODS

This cross-sectional study aimed to summarize the preliminary experience of a telephone-first consultation for oral health issues available for dentists and physicians from primary health care (PHC).

RESULTS

The study sample was 385 teleconsultations with oral health questions requested from all Brazil sent from May 2018 to July 2019, majority by dentists 83.2% (n = 332). Oral medicine was the main reason for teleconsultation (50.9%). Resolution in PHC was considered possible in 57.1% of cases (n = 220).

CONCLUSIONS

It was concluded that a telephone-first consultation may be useful to improve the resolvability and the quality of care in the PHC on oral health issues. The teledentistry allows the resolution of oral issues in PHC, avoiding the displacement of patients to more distant specialized centers. Teledentistry could be more useful in the actual coronavirus disease (Covid-19) pandemic.

Communication, collaboration and contagion: "Virtualisation" of anatomy during COVID-19

COVID-19 has generated a global need for technologies that enable communication, collaboration, education and scientific discourse whilst maintaining physical distance. University closures due to COVID-19 and physical distancing measures disrupt academic activities that previously occurred face-to-face. Restrictions placed on universities due to COVID-19 have precluded most conventional forms of education, assessment, research and scientific discourse. Anatomists now require valid, robust and easy-to-use communication tools to facilitate remote teaching, learning and research. Recent advances in communication, video conferencing and digital technologies may facilitate continuity of teaching and research activities. Examples include highly-interactive video conferencing technology, collaborative tools, social media and networking platforms. In this narrative review, we examine the utility of these technologies in supporting effective communication and professional activities of anatomists during COVID-19 and after.

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.

Awareness of, Beliefs about, Practices of, and Barriers to Teledentistry among Dental Students and the Implications for Saudi Arabia Vision 2030 and Coronavirus Pandemic

Objectives:

Saudi Arabia launched multiple initiatives to overcome the problem of health-care access. The recent coronavirus pandemic created urgent demand to deal with the problem using nonconventional venues such as telehealth and teledentistry. This study aimed to investigate teledentistry knowledge, attitudes, and practices, and barriers to its use among dental students and teaching staff in Makkah province, Saudi Arabia.

Materials and Methods:

A total of 314 dental students participated in this cross-sectional study. Data were collected using a validated self-reported questionnaire to measure teledentistry awareness, attitude, practices, and barriers to teledentistry. The study was approved by Umm Al-Qura University, Saudi Arabia.

Results:

Only 17.2% were aware of the term “teledentistry.” However, after it was explained, participants were able to correctly answer 25.16%–62.42% of items about teledentistry. A total of 67.83% would practice teledentistry, and 70.7% support using teledentistry on a national scale for Vision 2030. Only 25.16% used teledentistry before, but 56.05% did dental consultations via smartphone. The most common barriers were patient satisfaction requiring a dentist’s physical presence, violation of patient privacy, and low levels of population education.

Conclusion:

Dental students seem to know little about teledentistry. However, they are open to learning and using it. It is encouraged to include the topic in continuing dental education, including how to use it during health disasters such as the coronavirus pandemic.

COVID-19 outbreak, disruption of dental education, and the role of teledentistry

The novel coronavirus disease 2019 (COVID-19) has affected the whole world and has now been declared a Pandemic by the World Health Organization (WHO). Although the mortality rate of this virus is low, it is especially potent against people with underlying systemic conditions. Dentistry is a profession where the doctor, as well as the dental staff, works in close vicinity to the patient’s mouth. Dental education has two core components; didactic and clinical training (including patient care). Dental education has been interrupted in the past due to certain events (Arab Spring and SARS outbreak). Currently, the pandemic of COVID-19 has disrupted dental education globally as most of the dental schools and universities in the world have closed amidst the COVID-19 outbreak. Teledentistry is a subspecialty of telemedicine that helps in the provision of educational activities, advice, and diagnosis about treatment over a distance with the help of technology like video conferencing. The current overview summarizes the potential role of teledentistry in continuing the dental educational process in terms of delivery of didactic components, clinical training, and patient care. It can be concluded that with modern updated devices and tools, teledentistry can be an effective way to prevent disruption of dental education and it can be utilized in continuing the dental educational process in this critical time of the COVID-19 outbreak.

Management of oral medicine emergencies during COVID-19: A study to develop practise guidelines

Coronavirus disease (COVID-19) pandemic has become a significant global public health concern. Since the announcement of the Public Health Emergency of International Concern, many countries have implemented lockdown and restrictive quarantines; therefore, routine dentistry, as well as oral medicine practise, have been suspended in several countries. However, urgent oral cares and emergencies are still operated and delivered by on-call dental practitioners. The objective of this study was to investigate the management of oral medicine emergency during a viral pandemic such as COVID-19. During the lockdown period, digital technologies, such as video conferencing with Zoom, Google Meeting or WhatsApp, are useful and efficient tools that oral medicine practitioners could consider to use for patient triage, managing emergencies, reassure, and follow patients remotely. Oral medicine emergencies can be carefully evaluated and triaged via video conferencing and sometimes phone contact, to avoid life-threatening risks while realising the limitations by both patient and clinician.

Dentists’ Self-perception on Teledentistry: The Changing Landscape Driven by Technological Booming in the 21stCentury

Aim:

Teledentistry has gained popularity worldwide because it is cost-effective and increase accessibility to dental healthcare. This study assessed the self-perceptions of teledentistry among dental practitioners in Saudi Arabia and examinedany gender-related differences.

Methods:

This cross-sectional study was conducted between January and December 2017 and recruited a convenience sample of dental practitioners, whose self-perceptions of the practice-related use of teledentistry were assessed viaateledentistry survey (TDS). The TDS consisted off our sections:efficiency in patient care, cost reduction,capabilities forimproving practice, and security and confidentiality.Data analyseswere conducted throughdescriptive statistics,internalreliability tests(Cronbach’s alpha), andchi-squaredtests of the TDS.

Results:

The response rate was 620/800(78%). Most respondents were female (62%), and 58% of themworked in the public sector. The internal reliability of the TDS was 0.85 for the whole sampleand 0.85 and 0.90 for males and females, respectively. Among the entire sample, 51% agreed that teledentistry reduced potential cost, and 65% reported shortened waitlists. More females (42%, p<0.001) than males (22%) agreed that teledentistry could help monitor a patient’s condition.More females (35%) than males (13%, p<0.001) considered that teledentistry would require additional appointments for imaging. More females(29%, p=0.0001) than males (22%) expressed great concern aboutpotential violations of confidentiality.

Conclusion:

These findings suggest thatteledentistry in dental practiceis well perceived by practitioners in Saudi Arabia. Gender differences in perceptions are linked to certain aspects of teledentistry.

Pediatric Dentistry in Primary Healthcare: Creation, Development, and Evaluation of a Distance Education Course

BACKGROUND

Oral health in childhood is a major problem for global public health. In Brazil, the prevalence of childhood tooth decay varies from 12% to 46%. Dental care treatment in Brazil is almost the exclusive responsibility of primary healthcare (PHC). Therefore, it is essential these professionals are prepared to conduct restorative, endodontic, and exodontic treatments and preventive care in children.

INTRODUCTION

Children make up a large proportion of the population in territories requiring advanced dental care provided by PHC in Brazil. To care for these patients, it is necessary to have both manual dexterity and technical knowledge of pediatric dentistry. Accordingly, this study aimed to develop a distance course on pediatric dentistry.

MATERIALS AND METHODS

A pretest questionnaire consisting of 15 questions was used to assess initial dental knowledge of participants. After completion of a five-module course, participants retook the same initial dental knowledge questionnaire (post-test). Descriptive statistic and paired t test, one-way analysis of variance, and Pearson and Spearman correlation were used, and a significance level of 5% was set.

RESULTS

The majority of participants completing the five-module course were women who earned specialty degrees beyond undergraduate studies and currently worked in PHC (>5 years). Participant performance on the dental knowledge questionnaire after completion of the five-module course improved pre- to post-test.

CONCLUSIONS

These data suggest that completion of a distance course on pediatric dentistry can be an effective tool for improving knowledge of pediatric dentistry in PHC professionals.

Use of a Teledentistry-based Program for Screening of Early Childhood Caries in a School Setting

Aim The aim of this study was to assess the reliability and feasibility of using teledentistry for the screening and diagnosis of dental caries in children between the age groups of three to six years. Design This study included a total of 318 school-going children whose caries scores were calculated by visual method and using digital photographs generated by an intraoral camera by two examiners: examiner 1 and examiner 2 (E1 and E2). Intra-examiner and inter-examiner variability were determined. Reliability was compared across the three groups. Results Intra-examiner and inter-examiner variability when compared revealed no significant difference. A Cronbach's alpha of 0.983 was generated, which shows high reliability. Conclusions Effective screening for early childhood caries (ECC) in young children was possible with digital images generated in a school setting, thus paving the way for the application of teledentistry as effective means for the diagnosis of dental caries.

Role of information and communication technology in promoting oral health at residential aged care facilities

Information and communication technology (ICT) can provide knowledge and clinical support to those working in residential aged care facilities (RACFs). This paper aims to: (1) review literature on ICT targeted at residents, staff and external providers in RACFs including general practitioners, dental and allied health professionals on improving residents’ oral health; (2) identify barriers and enablers to using ICT in promoting oral health at RACFs; and (3) investigate evidence of effectiveness of these approaches in promoting oral health. Findings from this narrative literature review indicate that ICT is not widely used in RACFs, with barriers to usage identified as limited training for staff, difficulties accessing the Internet, limited computer literacy particularly in older staff, cost and competing work demands. Residents also faced barriers including impaired cognitive and psychosocial functioning, limited computer literacy and Internet use. Findings suggest that more education and training in ICT to upskill staff and residents is needed to effectively promote oral health through this medium.

Teledentistry in dental specialist education in Finland

Specialist dental services are available unevenly in Finland. A project to implement information and communication technologies in dental specialist education started in 2002 and was concluded in 2005. University lectures were transmitted to various training locations using IP-based videoconferencing (384 kbit/s–1 Mbit/s). Lectures and seminars were carried out on average twice a week. 17 of the 26 postgraduate students answered a questionnaire in which they rated the quality of picture and sound on a 4–point scale. The overall rating of videoconferencing as a tool in specialist training was excellent in 15%, good in 62%, neutral in 15% and poor in 8%. In the absence of teledentistry, the trainees needed to travel to the University of Turku approximately 80 times each year. Over a three year training period (one year in university, two years in other cities), the overall potential cost saving per student was estimated to be at least €43,600.

Teledentistry: A Tool to Promote Continuing Education Actions on Oral Medicine for Primary Healthcare Professionals

BACKGROUND

Difficulties in diagnosis of oral mucosal lesions are a significant cause of delayed oral cancer diagnosis, and this difficulty may be due to gaps in knowledge. This study evaluated the diagnostic skills of primary healthcare professionals regarding oral cancer and presented them with an e-learning course.

MATERIALS AND METHODS

Forty-seven primary healthcare professionals (32 dentists and 15 nondentists) enrolled in a 24-h course on oral medicine delivered through an e-learning platform. A test, based on 33 clinical images of oral lesions, was used to evaluate the diagnostic skills of participants. The participants were requested to classify each lesion as benign, potentially malignant, or malignant as well as to inform their clinical impression. Three specialists also took the test as the gold standard.

RESULTS

Twenty-seven participants completed the test. Nondentists and dentists showed a comparable sensitivity of 68.8 ± 11.1 and 63.7 ± 15.8, respectively. Specialists performed somewhat better; however, the difference was not statistically significant (81.0% ± 4.1%, p = 0.16). Dentists and specialists (70.0% ± 16.6% and 95.5% ± 3.1%, respectively) showed higher specificity than nondentists (39.3 ± 20.6, p < 0.01). Nondentists had a higher number of unanswered questions (p < 0.01) for classification and clinical impression (50.0% ±45.1% and 72.0% ± 25.0%, respectively) than dentists (5.7% ±11.9% and 19.8% ± 20%, respectively). Both dentists and nondentists had low attendance in the course (44.57% ± 37.38% and 26.53% ± 26.53%, respectively, p = 0.26). To the best of our knowledge, this is the first study to assess the diagnostic skills of public health workers belonging to different professional categories.

CONCLUSION

Both dentists and nondentists have a fairly good capacity for discriminating the nature of oral lesions. Early squamous cell carcinoma is the most challenging situation and remains an issue to be addressed.

Views of Australian dental practitioners towards rural recruitment and retention: a descriptive study

Background

Despite an increase in the supply of dental practitioners in Australia in recent years, there remains an unequal distribution of dental practitioners with more dental practitioners working in city areas. This is in part due to difficulties in attracting and retaining dental practitioners to rural practice. The aim of this study was to investigate the attitudes of Australian dental practitioners towards what may attract them to rural areas and why they may remain in them.

Method

A descriptive study, utilising telephone, semi-structured interviews with dental practitioners across Australia. Dental practitioners were recruited through their professional associations. Data were analysed using content and thematic analysis.

Results

Fifty participants; 34 dentists, eight oral health therapists, and eight dental prosthetists working in rural and urban areas of Australia. Four main themes were identified: Business Case: concerns related to income and employment security, Differences in Clinical Practices: differences in clinical treatments and professional work, Community: fitting in and belonging in the area in which you live and work, and Individual Factors: local area provision for lifestyle choices and circumstances. The most influential of these themes were business case and individual factors. Smaller rural areas, due to low populations and being unable to provide individuals with their lifestyle needs were considered unappealing for dental practitioners to live. Previous experience of rural areas was highly influential.

Conclusions

The main factors influencing rural recruitment and retention were income sustainability and employment security, and individual factors. Dental practitioners felt that it was harder to earn a sustainable income and provide quality lifestyles for their family in rural areas. Previous experience of rural areas was influential towards long-term rural retention. These factors should be considered in order to develop effective strategies to address the unequal distribution of dental practitioners.