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 Table of Contents  
REVIEW ARTICLE
Year : 2017  |  Volume : 7  |  Issue : 2  |  Page : 63-67

Teledentistry: A futuristic realm of dental care


1 Department of Public Health Dentistry, JSS Dental College and Hospital, Mysuru, Karnataka, India
2 Department of Periodontology, JSS Dental College and Hospital, Mysuru, Karnataka, India

Date of Web Publication8-Jan-2018

Correspondence Address:
Dr. Salini Samyuktha Gadupudi
Department of Public Health Dentistry, JSS Dental College and Hospital, Mysuru, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijohs.ijohs_22_17

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  Abstract 


Health care is being changed dramatically by the marriage of computers and telecommunications. Implications for hospitals and physicians already have received extensive media attention, but comparatively little has been said about the impact of information technology on dentistry. Teledentistry is the use of information technology and telecommunications for dental care, consultation, education, and public awareness. This article reviews the origin, rationale, scope, basis, and requirements for teledentistry, along with the current evidence that exists in the literature and illustrates how the digital transformation will likely affect dentists and their patients.

Keywords: Applications, dentistry, teledentistry


How to cite this article:
Gadupudi SS, Nisha S, Yarramasu S. Teledentistry: A futuristic realm of dental care. Int J Oral Health Sci 2017;7:63-7

How to cite this URL:
Gadupudi SS, Nisha S, Yarramasu S. Teledentistry: A futuristic realm of dental care. Int J Oral Health Sci [serial online] 2017 [cited 2018 Dec 11];7:63-7. Available from: http://www.ijohsjournal.org/text.asp?2017/7/2/63/222395




  Introduction Top


The use of information-based technologies and communications systems to deliver health care across geographic distances is termed telemedicine.[1] The tremendous technical progress of the last 40 years has made telemedicine increasingly possible, as evidenced by the yearly 2-fold increase in the number of active telemedicine programs in the United States since the early 1990s.[2] Internet is the basis of modern systems of teledentistry, being up-to-date and fast, and able to transport large amounts of data. The entire process of networking, sharing digital information, distant consultations, workup, and analysis is dealt with by a segment of the science of telemedicine concerned with dentistry known as “teledentistry.”[3]


  History of Teledentistry Top


Teledentistry was developed as a part of the blueprint for dental informatics, a new domain combining computer and information science, engineering and technology in all areas of oral health, which was drafted at a 1989 conference funded by the Westinghouse electronics system group in Baltimore.[4] To be more specific, the birth of teledentistry as a subspecialist field of telemedicine could be linked to 1994 and a military project of the United States Army (U.S. Army's Total Dental Access Project), aiming to improve patient care, dental education, and effectuation of the communication between dentists and dental laboratories. Teledentistry demonstrated that dental professionals can consult each other even at large distances. This military project demonstrated that teledentistry was able to reduce total patient care costs, extending dental care to distant and rural areas and offering complete information required for deeper analyses.[5]


  Need for Teledentistry Top


Teledentistry can improve access to oral health care, improve the delivery of oral health care, and lower its costs. It also has the potential to eliminate the disparities in oral health care between rural and urban communities. Teledentistry may turn out to be the cheapest, as well as the fastest, way to bridge the rural-urban health divide and also can help bring specialized health care to the remotest corners of the world.[6]


  Internet as the Basis of Teledentistry Top


Internet is the basis of modern systems of teledentistry, being up-to-date and fast, and able to transport large amounts of data.

There are numerous reasons why internet-based teledentistry has taken precedence over other ways of communication: The reasons being speed, low cost, efficacy, documented consultation, minimized occupancy, simultaneous communication of multiple participants, and asynchronism, while potential shortcomings are necessity of appropriate training, pressure for an instant response, impression, message misunderstanding, privacy concerns, and possibility to overlook/neglect the message.[7]


  Types of Teledentistry Top


Teleconsultation through teledentistry can take place in either of the following ways – “real-time consultation” and “store-and-forward method.” Real-time consultation involves a videoconference in which dental professionals and their patients, at different locations, may see, hear, and communicate with one another. Store-and-forward method involves the exchange of clinical information and static images collected and stored by the dental practitioner, who forwards them for consultation and treatment planning. The third method has also been described, known as “remote monitoring method,” in which patients are monitored at a distance and can either be hospital-based or home-based. A “near real-time” consultation has also been mentioned in the literature, which involves low resolution, low frame rate product that looks like jittery television. Patients are not present during the “consultation.” Dentists can share patient information, radiographs, graphical representations of periodontal and hard tissues, therapies applied, laboratory results, tests, remarks, photographs, and other information transportable through multiple providers [Figure 1] and [Figure 2].[8],[9],[10],[11]
Figure 1: Real-time consultation

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Figure 2: Store-and-forward method

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Requirements to practice teledentistry

For most dental applications, store-and-forward technology provides excellent results without excessive costs for equipment or connectivity. A typical store-and-forward teledentistry system consists of a computer with substantial hard drive memory, adequate random access memory, and a speedy processor; an intraoral video camera and a digital camera for the capture of pictures; a modem and an Internet connection. A fax machine, scanner, and printer may also be required in some cases. To enable live videoconferencing, one might employ a widely available standalone IP/ISDN videoconferencing solution or install a PCI codec board into the system. If a live group session is desired, a multipoint control unit that bridges three or more parties is required. The codec must be able to accommodate audio and visual functions.[12]

Training

Instructors of teledentistry education courses need to have both teaching experience and computer knowledge. The educational team must continuously update the course. Educational courses should be guided by instructors who are experienced in leading online communication, able to promote discussion, and familiar with the use of computer technology. Finally, most of the teledentistry-based education programs are in English. Since the internet is a worldwide tool, future goals should include consideration of more multilingual programs.[13]

Evidence-based review on applications of teledentistry in various specializations

The results of various articles are summarized in [Table 1].
Table 1: Evidence based review on applications of teledentistry in various specializations

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[14],[15],[16],[17],[18],[19],[20],[21],[22],[23],[24]


  Discussion and Conclusion Top


Teledentistry is “not” a new specialty. It is, in reality, an alternative method to deliver the existing dental services. The utility of teledentistry in distant, remote areas cannot be emphasized enough. Its application is of utmost importance and great value in rural and urban areas where there is unavailability of specialist consultation.[11] India, with its diverse landmass, huge rural population, and existing health-care delivery mechanism clubbed with advances in telecommunications technology, could be an ideal setting for teledentistry. A cost-effective dental care can be provided through teledentistry by appointing general dental surgeon and dental hygienists can be appointed at the subcenters. Similarly, graduate dentists with knowledge in teledentistry can be appointed at the primary health centers and community health centers for discussing the diagnosis and treatment plan of the difficult cases with the specialists. The dental colleges with a predetermined catchment area could be ideal places to serve as hub sites for teledentistry consultation as they encompass all the specialists serving under a common roof. A team of specialists could communicate for a few hours on a daily basis with the dentists/hygienists/patients at the remote clinics.[10] The results achieved so far are very encouraging, setting the road signs for future investigations. However, a few things have to be addressed before teledentistry can rise to its peak. Studies involving greater number of participants will be required in future to validate the various aspects of teledentistry applications.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflflicts of interest.



 
  References Top

1.
Zimlichman E. Telemedicine: Why the delay? Isr Med Assoc J 2005;7:525-6.  Back to cited text no. 1
[PUBMED]    
2.
Dahlin MP, Watcher G, Engle WM, Henderson J. 2001 Report on US Telemedicine Activity: Association of Telehealth Service Providers. 2001.  Back to cited text no. 2
    
3.
Mihailovic B, Miladinovic M, Vujicic B. Telemedicine in dentistry (Teledentistry). In: Graschew G, Roelofs TA, editors. Advances in Telemedicine: Applications in Various Medical Disciplines and Geographical Areas. Rijeka (Croatia): InTech; 2011. p. 215-30.  Back to cited text no. 3
    
4.
Folke LE. Teledentistry. An overview. Tex Dent J 2001;118:10-8.  Back to cited text no. 4
[PUBMED]    
5.
Duka M, Mihailović B, Miladinović M, Janković A, Vujicić B. Evaluation of telemedicine systems for impacted third molars diagnosis. Vojnosanit Pregl 2009;66:985-91.  Back to cited text no. 5
    
6.
Bagchi S. Telemedicine in rural India. PLoS Med 2006;3:e82.  Back to cited text no. 6
[PUBMED]    
7.
Jadad AR, Haynes RB, Hunt D, Browman GP. The internet and evidence-based decision-making: A needed synergy for efficient knowledge management in health care. CMAJ 2000;162:362-5.  Back to cited text no. 7
[PUBMED]    
8.
Jain A, Bhaskar DJ, Gupta D, Agali C, Gupta V, Karim B. Teledentistry: Upcoming Trend in Dentistry. J Adv Med Dent Sci 2013;1:112-5.  Back to cited text no. 8
    
9.
Sanjeev M, Garg SK. Teledentistry a new trend in oral health. Int J Clin Cases Invest 2011;2:49-53.  Back to cited text no. 9
    
10.
Reddy KV. Using teledentistry for providing the specialist access to rural Indians. Indian J Dent Res 2011;22:189.  Back to cited text no. 10
[PUBMED]  [Full text]  
11.
Jampani ND, Nutalapati R, Dontula BS, Boyapati R. Applications of teledentistry: A literature review and update. J Int Soc Prev Community Dent 2011;1:37-44.  Back to cited text no. 11
    
12.
Sukhabogi JR, Hameed IA, Chandrashekar BR. Teledentistry: An essential need of the era. Univ Res J Dent 2014;4:71-7.  Back to cited text no. 12
  [Full text]  
13.
Rana N Dhruvakumar D. Teledentistry: A must in the era of patient driven dentistry. J oral res rev 2015;7:77-9.  Back to cited text no. 13
  [Full text]  
14.
Estai M, Kanagasingam Y, Xiao D, Vignarajan J, Bunt S, Kruger E, et al. End-user acceptance of a cloud-based teledentistry system and android phone app for remote screening for oral diseases. J Telemed Telecare 2017;23:44-52.  Back to cited text no. 14
    
15.
Almeida Castro MI, Canavese OD, de Morais FF, Calixto FF, Torres-Pereira Cassius C. Performance of distant diagnosis of dental caries by teledentistry in juvenile offenders. Telemed e-Health 2014;20:584-9.  Back to cited text no. 15
    
16.
Torres-Pereira CC, Castro Morosini IA, Possebon RS, Giovanini AF, Bortoluzzi MC, Leão JC, et al. Teledentistry: Distant Diagnosis of Oral Disease Using E-Mails. Telemed J E Health 2013;19:117-21.  Back to cited text no. 16
    
17.
Purohit BM, Singh A, Dwivedi A. Utilization of teledentistry as a tool to screen for dental caries among 12-year-old school children in a rural region of India. J Public Health Dent 2017;77:174-80.  Back to cited text no. 17
    
18.
Kopycka-Kedzierawski DT, Billings RJ. Comparative effectiveness study to assess two examination modalities used to detect dental caries in preschool urban children. Telemed J E Health 2013;19:834-40.  Back to cited text no. 18
    
19.
Rocca MA, Kudryk VL, Pajak JC, Morris T. The evolution of a teledentistry system within the department of defense. Proc AMIA Symp 1999;921-4.  Back to cited text no. 19
    
20.
Berndt J, Leone P, King G. Using teledentistry to provide interceptive orthodontic services to disadvantaged children. Am J Orthod Dentofacial Orthop 2008;134:700-6.  Back to cited text no. 20
    
21.
Favero L, Pavan L, Arreghini A. Communication through telemedicine: Home teleassistance in orthodontics. Eur J Paediatr Dent 2009;10:163-7.  Back to cited text no. 21
    
22.
Brüllmann D, Schmidtmann I, Warzecha K, d'Hoedt B. Recognition of root canal orifices at a distance – A preliminary study of teledentistry. J Telemed Telecare 2011;17:154-7.  Back to cited text no. 22
    
23.
Ignatius E, Perälä S, Mäkelä K. Use of videoconferencing for consultation in dental prosthetics and oral rehabilitation. J Telemed Telecare 2010;16:467-70.  Back to cited text no. 23
    
24.
Miladinović M, Mladenović D, Mihailović B, Djndjić GT, Mladenović S, Hadzibeti M, et al. Evaluation of telemedicine in the management of dentogenous infections. Vojnosanit Pregl 2013;70:569-75.  Back to cited text no. 24
    


    Figures

  [Figure 1], [Figure 2]
 
 
    Tables

  [Table 1]



 

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   Abstract
  Introduction
   History of Teled...
   Need for Teleden...
   Internet as the ...
   Types of Teleden...
   Discussion and C...
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