Telemedicine is emerging field being used / can be used in academic medical centers, community hospitals, managed-care companies, rural hospitals, and can also be used internationally to link providers in developing countries to hospitals in developed countries. Advances in digital communication, telecommunication, and the Internet introduce an unprecedented opportunity to remote access to medical care. It is also used to improve quality of management of dental patients at remote place for their partial or complete management at distances of thousands of kilometers away from healthcare centers or qualified dentists. 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”.
Teledentistry is a newly emerging area of dentistry involving the exchange of clinical information regarding dental health records and images via telecommunications technology from remote distances; by creating Internet link between dental health care providers in remote communities with specialists in larger communities; eliminating the disparities in oral health care between rural and urban communities for dental consultation and treatment planning. Teledentistry has the ability to improve access to oral healthcare, improve the delivery of oral healthcare, and lower its costs and access dental care for underserved patients. Dental assistant can be appointed at the sub-centers, who can provide cost-effective dental care as he/ she is supported through teledentistry by specialists. Dental assistant will discuss about the diagnosis and treatment plan of the difficult cases with the specialists. Telemedicine is part of a wider process or chain of care. It can improve this chain and thus enhance the quality and efficiency of health care.
Telemedicines work on three methods:
"Real-time" consultation uses a direct online video telecommunication between dentist, dental assistant and patient in a remote community and a specialist who provides support or supervision. All of them can see, hear and communicate with one another.
In the "store and forward" method, electronic dental health records and videos of the stored data can be retrieved and reviewed by the specialist who renders an opinion. It involves the exchange of clinical information and static images collected and stored by the dental assistant, who forwards them for consultation and treatment planning. In this the patients are monitored at a distance and can either be hospital-based or home-based.
A “Near-Real-Time” consultation involves low resolution, low frame rate product that looks like jittery television. It requires low technical equipments so that users at both the ends can communicate face to face.
We at Express Diagnostics use “Real-time consultation”.
A major challenge in teledentistry is the collaboration between the hub site and remote site. Specialist dentists with knowledge in teledentistry can be ready at the reporting site for discussing about the diagnosis and treatment plan of the cases with Dental assistant at remote location.
The results achieved so far are very encouraging, setting the road signs for future investigations. However, a number of things have to be addressed before teledentistry can rise to its peak. Further studies involving greater number of participants will be required to validate the various aspects of teledental applications.