1

-Teledentistry-
 2

Contents Table:

o Introduction – Page 3

o Forms of Teledentistry – Page 3

o Teledentistry Services – Page 3

o Teledentistry Delivery Mechanisms – Page 4

o Needed Tools – Page 4

o Role of Teledentistry Today – Page 5

o Benefits of Teledentistry – Page 6

o Conclusion – Page 6

o References – Page 8
 3

Introduction:

Teledentistry is a developing area of dentistry that integrates electronic health

records, telecommunications technology, digital imaging, and the Internet to link
dental providers and their patients. Due to the rapid growth of technology,
teledentistry possesses the potential to change the current practice. The term
“teledentistry” was used in 1997, when Cook defined it as “the practice of using video-
conferencing technologies to diagnose and to provide advice about the treatment over
a distance”. Also it allows a whole new way of providing specialist advice. Through the
use of telecommunication and computer technologies, it is now possible to provide
interactive access to specialist opinions that are not limited by the constraints of either
space or time. The referring dentist logs into a secure web-server and fills in the
patient's details.

Forms of Teledentistry:

Teledentistry can take two forms: Real-time consultation and Store & forward.

o Real-time consultation involves a videoconference in which dental

professionals and their patients, at different locations, may see, hear, and
communicate with one another actually using advanced telecommunication
technology and ultra-high-bandwidth network connections.

o Store & forward,

on the other hand,
involves the
exchange of clinical
information and
static images
collected and
stored in the
telecommunication
equipment. In
store and forward,
the dental
practitioner
collects all the
required clinical
information and
digital intraoral and
extra oral images and radiographs (or scanned, originally no digital images) and
forwards them for consultation and treatment planning via established
networks and/or the Internet and treatment is provided in a far timelier,
targeted, and cost-effective manner.
 4

Teledentistry Services:

o Specialist referral service involves a specialist assisting a general practitioner to

diagnose and manage a patient. This may involve a patient "seeing" a specialist
over a live, remote consult or the transmission of diagnostic images and/or
video along with patient data to a specialist for viewing later. (Almost 50
medical subspecialties successfully use telemedicine for referrals.)
o Patient consultation uses telecommunications to provide medical and
dental/oral health data, which may include audio, still or live images. Data is
exchanged between a patient and a health professional for use in rendering a
diagnosis and treatment plan. This may originate from a remote site to a
“home” dental office/clinic. Communication may use a direct transmission link
or the Internet.
o Remote patient monitoring uses devices to remotely collect and send data to a
monitoring station for interpretation. Telemedicine has used remote
monitoring for "home telehealth" applications (e.g., monitoring specific vital
signs or other indicators for homebound patients) and to support nursing visits.
o Professional education provides continuing education credits for health
professionals and delivers special health education seminars for targeted
groups in remote locations.
o Consumer medical and health information includes the use of the Internet for
consumers (patients) to obtain specialized health information and on-line
discussion groups to provide peer-to-peer support.

Teledentistry Delivery Mechanisms:

o Networked programs link hospitals and clinics with outlying clinics and
community health centers in rural or suburban areas. The links may use
dedicated high-speed lines or the Internet for telecommunication links
between sites.
o Point-to-point connections, which use private networks. These connections are
used by hospitals and clinics that deliver services directly, or contract out
specialty services to independent providers, at ambulatory care sites.
o Primary or specialty care to the home connections involves connecting
primary care providers, specialists and home health nurses with patients using
single line phone video systems for interactive clinical consultations.
o Home to monitoring center links are used for patient monitoring, home care
and related services that provide care to patients in the home. Often normal
phone lines are used to communicate directly between the patient and the
center although some systems use the Internet.
o Web-based e-health patient service sites provide direct consumer outreach
and services over the Internet. Under telemedicine, these include sites that
provide direct patient care.
 5

Needed tools:

There are many tools used in teledentistry. Tools used in Hub sites will be different
from remote sites – hub sites will only require videoconferencing equipment, whereas
remote sites will require digital dental diagnostic equipment along with
videoconferencing equipment. Moreover, mobile sites may require different
transmission equipment than fixed sites (e.g. satellite dishes and modems).

1. Videoconferencing System
2. Extraoral Digital Camera
3. Intraoral Digital Camera
4. Digital Radiographic Equipment
5. Portable Dental Radiographic System
6. Laser Caries Detection Device
7. Computer

Role of Teledentistry Today:

Role in oral medicine and diagnosis -

Distant diagnosis is an effective alternative in the diagnosis of oral lesions using
transmission of digital images by email and for dental hygienists to provide oral
healthcare to underserved populations by digitally linking up with a distant oral health
team.

Role in oral and maxillofacial surgery -

Clinical diagnostic assessment of impacted or semi-impacted third molars assisted by
the telemedicine approach was equal to the real-time assessment of clinical diagnosis. 
Telecommunication is an efficient and cost-effective mechanism to provide pre-
 6

operative evaluation in situations in which patient transport is difficult or costly. Smart

phones provide fast and clear access to electronically mailed digital images and allows
the oral/maxillofacial surgeon free mobility, not restricted by the constraints of a
desktop personal computer. This in turn allows for improved efficiency of the specialty
consultation and improved triaging, ultimately providing improved care to the patient.

Role in prosthodontics –
The use of videoconferencing for diagnosis and treatment planning for patients
requiring prosthetic or oral rehabilitation has the potential to increase the total
number of dental specialist services in sparsely populated areas.

Role in periodontics -
The web-based teledentistry consultation system showed that referrals to oral surgery,
prosthodontics and periodontics had the highest number of consults.

Role in endodontics –
Remote dentists can identify root canal openings based on images of endodontically
accessed teeth. The diagnosis of periapical lesions of the front teeth reduces the costs
associated with distant visits and making urgent help available.

Role in orthodontics -
Orthodontic treatments provided by general dentists and supervised remotely by
orthodontic specialists through teledentistry are a viable approach to reducing the
severity of malocclusions in disadvantaged children when referral to an orthodontist is
not feasible. The online teledentistry service showed that it helped to reduce the high
level of inappropriate orthodontic referrals to consultants and provided general dental
practitioners with quick access to advice that would enable them to tackle a wider
range of cases themselves. Telecommunications applied to dentistry is particularly
useful in the orthodontic field, as minor emergencies (rubber ligature displacement,
discomfort due to the appliance, irritation of cheeks) can be solved easily at home,
reassuring patient and parents on one hand, and limiting visits to the dental office to
cases of real need.  

Role in pediatric and preventative dentistry -

Teledentistry offers a potentially efficient means of screening high-risk preschool
children for signs of early childhood caries.  The intraoral camera is a valid and
potentially cost-effective alternative to a visual
oral examination for caries especially in
preschool children attending childcare centers.

Benefits of Teledentistry:

Teledentistry offers innovative prospects in the

delivery of dental care and has the potential to
enhance the current practice of dentistry.
 7

However, teledentistry has been underused as a means of diagnosis and referral in

dentistry. Through the exchange of clinical information over distances, teledentistry
can facilitate the delivery of dental care in areas underserved by dental practitioners,
and therefore overcome social and geographic barriers. A greater number of patients
can be assessed and treated. Teledentistry has the potential to achieve the three
fundamental benefits of telehealth and telemedicine.

o Improved access – For over 40 years, telemedicine has brought healthcare

services to patients in distant locations improving access and allowing
physicians and health facilities expand their reach.

o Cost efficiencies – Adopting telehealth and telemedicine technologies have

shown to reduce the cost of healthcare and increase efficiency through better
management of chronic diseases, shared health professional staffing, reduced
travel times, and fewer or shorter hospital stays.

o Patient demand – The greatest impact of telemedicine is on the patient, their

family and their community. More than 15 years of studies have documented
patients’ satisfaction and support for telemedical services that offer access to
providers and reduce the need to travel long distances.

Teledentistry has the ability to improve access to care, improve the delivery of health
care, and lower its costs. Teledentistry can be a much needed resource for dental
consulting, referral for specialized care, dental mentoring, dentist-laboratory
communications, and continuing education.

Conclusion:

Teledentistry is not a separate dental specialty. Teledentistry does not create new oral
health care services. It simply provides an alternative method to deliver existing
services. Currently, teledental technologies have not yet become an integral part of
mainstream oral health care. The reasons are many including: reimbursement;
regulatory and legal sanction; privacy and security; compatibility and interoperability
of technology across systems; sustainability; and acceptance of teledentistry by
patients and providers alike. Yet despite these barriers, the technology currently exists
to provide teledental specialty consultation and referral services, distance learning
educational services, and limited teledental clinical preventative services. The
prosperity of teledentistry will be normal in the future because of what is provided for
doctor and patient comfort and better ways to treat.

References:
 8

1.http://ijcci.info/component/content/article/173-teledentistry-a-new-trend-in-oral-
health-?showall=1

2. http://www.teledentistry.co.uk/

3.http://www.jispcd.org/article.asp?issn=2231-
0762;year=2011;volume=1;issue=2;spage=37;epage=44;aulast=Jampani

4. https://www.academia.edu/5502068/TeleDentistry

5. file:///Users/rajkottyal/Downloads/DQ_WhitePaper_Telehealth_081816%20(1).pdf

6. http://www.nature.com/bdj/journal/v209/n8/full/sj.bdj.2010.928.html

7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3894070/

8.http://cdn.intechopen.com/pdfs/14328/InTech-
elemedicine_in_dentistry_teledentistry_.pdf

9. http://www.unmc.edu/dentistry/outreach/teledentistry/faqs.html

10.http://www.jcdr.net/article_fulltext.asp?issn=0973-
709x&year=2011&month=November&volume=5&issue=7&page=1486&id=1709