Por Yunong Sun – Student of the career of dentistry

Due to the dissemination of the world pandemic Covid-19 in 2020, the majority of the traditional careers that involve social contacts have to rummage a new path to adapt to the quarantine restrictions. The idea of “teledentistry” was brought to people’s sight along with a complete set of rules being published by the Colegio de Odontología in Costa Rica, in May 2020.

It means that the dentist will offer consultation and diagnosis to the patients using videoconferences, pictures, and other relative information that can be transmitted via the internet (Estai et al., 2017). Actually, this concept has been around since 2006, it was originally designed for patients with access difficulty to a dental clinic or high-risk populations (Estai et al., 2017). I think teledentistry can be a good solution for certain dental practice under Covid-19 with acceptable validity and efficiency.

For general consultation, patient education, subsequent care, and other non-operative procedures, seeing patients through the screen can be beneficial under special conditions. A study has shown that teledentistry allows the dentist to identify patients with precancerous lesions and have them treated on time during the Covid-19 emergency, which minimized the spread of the virus (Giudice et. al., 2020). This approach was also reported as being useful and convenient for the post-surgical follow-up. After an immediate dental operation, a decreased pain score during post-operative evaluations along with a good functional recovery through remote communication with a specialist can save the patient an extra visit to the clinic, not to mention the time and cost that would also be saved (Giudice et. al., 2020). Also, routine photos from the post-operation patients allow the dentists to monitor the healing of the injured site and the hygiene of the oral environment. Therefore, considering the benefits mentioned above, it’s worthwhile to have teledentistry on-site, especially under the Covid-19 pandemic.

Some may question the accuracy of the diagnosis results since it is solely based on the remote information exchange with the patient. Although the result from the online examination cannot be error-free in comparison to the chair-side examination, the validity of the teledentistry is acceptable. A systematic review indicated that there was moderate to almost complete agreement between the teledentistry system and traditional examination (Alabdullah & Daniel, 2018). The interproximal caries were found challenging to identify from the pictures (Alabdullah & Daniel, 2018). However, it is equally difficult for chair-side visual examinations to locate interproximal caries, which normally needs radiology to evaluate. Another result limiting factor is the quality of photos that patients provide. Technical problems such as low resolution, limited view, bad lighting, and blurry focus can directly affect the diagnosis result. Nevertheless, these issues can be solved by small tips such as stabilizing the arms when taking the picture, using two spoons to keep the mouth wide open, and using the flashlight from another phone to improve lighting, etc. Maybe a short manual of how to take adequate diagnosis pictures can be attached to the dental clinic website to better assist the patient.

After all, the teledentistry system can be convenient with non-surgical procedures with a promising validity under regulations. Therefore, it should serve as an alternative solution to the exclusive pandemic situation.

 

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Bibliographic references:
• Alabdullah, J. H., & Daniel, S. J. (2018). A Systematic Review on the Validity of Teledentistry. Telemedicine and e-Health, 24(8), 639–648. doi:10.1089/tmj.2017.0132
• Estai, M., Kanagasingam, Y., Tennant, M., & Bunt, S. (2017). A systematic review of the research evidence for the benefits of teledentistry. Journal of Telemedicine and Telecare, 24(3), 147–156. doi:10.1177/1357633x16689433
• Giudice, A., Barone, S., Muraca, D., Averta, F., Diodati, F., Antonelli, A., & Fortunato, L. (2020). Can Teledentistry Improve the Monitoring of Patients during the Covid-19 Dissemination? A Descriptive Pilot Study. International Journal of Environmental Research and Public Health, 17(10), 3399. doi: 10.3390/ijerph17103399