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Teledentistry

What You Need to Know

We’re the company behind TeleDent™, a robust teledentistry platform for multi-setting use cases and professional grade dental telehealth management. Here’s an overview drawn from our blog posts and other resources on teledentistry: why teledentistry matters, who teledentistry benefits and how to think about implementing it. More questions? Dental professionals can schedule a free consultation to learn how TeleDent can help deliver more efficient excellence in care.

Select the links below to discover more about the technology of teledentistry and the many benefits and advantages for today’s oral health professionals.

What is Teledentistry?

Teledentistry is the dental form of telemedicine, the use of telecommunications and allied technologies to deliver and coordinate care. In a practical sense, teledentistry means connecting everyone involved in the dental care journey for more seamless and efficient care.

How Does Virtual Dentistry Work?

The COVID-19 Pandemic led to a substantial increase in the volume of medical appointments happening virtually. Medical facilities began consistently holding video calls with patients, especially in the dental space. It all starts with a virtual dentistry consultation. This meeting is typically divided into 3 different parts:

A woman attending a teledentistry appointment

Initial Discussion:

The consultation will begin with an initial conversation about symptoms patients have been experiencing, and any experiences they have had related to oral discomfort.


Oral Exam:

Dentists are fully capable of examining oral health virtually, where they can identify and diagnose critical dental problems. In many cases, the patient may be required to shine a flashlight in their mouth for dentists to get a better look.


Prescription:

Once patient symptoms have been evaluated, they may be prescribed treatment. Most treatments involve an in-person visit, although the dentist may be able to prescribe medication for immediate relief of symptoms.

The virtual dentist appointment is usually more efficient, and shorter than in-person visits. Though the length of the appointment can vary, online dental consultations eliminate the need for patient travel and wait times.

Advantages of Teledentistry

Virtual dentistry has many benefits over traditional, in person appointments. These advantages include:

a patient on their laptop talking with their provider
  • Reduced chair times: Since consultations are virtual, dentists are able to treat more patients in a given day.
  • Connect with patients in remote locations: Easily provide care to patients in remote areas that cannot comfortably attend in-person appointments.
  • Allows for enhanced collaboration: Providers can connect with new patient touchpoints, such as pediatricians, physicians, and skilled nursing facilities.
  • Documentation & imaging in one secure place: Patient documents are easily accessible for sharing and coordination between dentists and specialists.
  • Maintain quality control and optimize productivity: DSOs can now expand their offerings with remote mentorship and virtual site visits, allowing managers to easily check on partner practices for training and evaluations.
  • Referrals made easy: Dentists can easily connect patients to specialists by making seamless, instant referrals and follow up appointments.

Overlapping Definitions of Teledentistry

Teledentistry has sometimes in the past been used to describe only the orthodontic and aligner use cases but the use cases are much broader. The term has also been historically associated with rural applications and solving access to care disparities. While virtual dental care can fulfill those goals, it’s not limited to those use cases either.

It’s useful to think about teledentistry as a suite of communication technologies that facilitate both patient-provider and provider-provider communications, as well as facilitating the care-oriented management of clinical data and provider and organization workflows. It’s more than a video call.

Teledentistry Regulations Vary Across 50 States

Some states have specific legislation on teledentistry. Others merge teledentistry into telemedicine regulation. There’s a great variety of approaches to scope of practice, supervision, reimbursement parity, originating site requirements and even differences in what’s allowed between synchronous and asynchronous teledentistry or telehealth modalities.

Teledentistry Location Map

How Can You Use Teledentistry in Your Setting

“What states allow teledentistry?” is for the most part the wrong question to ask since teledentistry is not an on or off switch. If you are a dentist or other dental professional, a better question to ask is, “How can I work within my state parameters to use telehealth technology effectively?” Some states incorporate dental telehealth under wider telehealth legislation. State Dental Boards have widely varying policies on scope of practice and expanded functions. Reimbursement for telehealth also varies under private payers or public payers such as Medicaid.

MouthWatch has compiled quick facts on teledentistry across all 50 states (and DC). These are from a variety of state board and state regulation sources. You should look at your state board resources on teledentistry and understand applicable telehealth, telemedicine and teledentistry laws for your particular setting. We also offer a free consultation for dental professionals or dental organizations looking to understand further how teledentistry with MouthWatch TeleDent can be deployed to meet their dental care goals.

Find information on Teledentistry in Your State

Find out what level of teledentistry regulations exist in your state, how dental hygienists, dental assistants and expanded function dental professionals (ex. dental therapists) can use teledentistry in your state, if there is public coverage available for telehealth and if payment parity laws are in place.

Key Teledentistry Facts & Statistics

The statistics below are based on a survey taken of over 520 individuals:

77% of individuals indicated that they have a primary dentist or dental practice

62% indicated they have had a virtual dentistry appointment before

77% of patients expressed interest in eliminating travel time for dental consultations and follow ups

72% of patients indicated they were very satisfied or highly satisfied with their teledentistry appointment

63% of patients indicated that a dentist who offers virtual consultations would have an influence on their decision when choosing a dentist

Use Cases of Teledentistry

Teledentistry or dental telehealth technologies have applications in the following key settings:

This means that you could deploy teledentistry from schools to nursing homes, private dental practices to pediatric offices and more. See our guide to teledentistry use cases. During times like the Covid-crisis, teledentistry is a form of crisis response when offices are closed or have reduced access and dental teams may be working remotely.

Teledentistry Patient FAQs

What specifically do patients want from a dental telehealth or teledentistry solution? Once they’ve reached out to you, what are patients expecting? What must a teledentistry vendor deliver in order for oral health professionals to meet patients’ needs?

“Can I message you with concerns and perhaps an image? Can I do it from my phone?”

This asynchronous mode of teledentistry is preferred by some patients, and certainly can be more efficient for some dental professionals. If the patient has sent diagnostically useful images and a good description of their complaint, you may have the evaluation already completed by the time of the video consult or can skip that step entirely.

“Can I schedule an online virtual consultation?”

Patients across the board are not only getting used to the idea of telehealth but expecting it as an option. Now more than ever. That may mean in their mind a live video consultation where they can see and talk with a professional face to face.

“How are you keeping my office visit as safe as possible?”

Dental practices are taking significant steps to make their offices some of the safest places in the world for a patient to be. Providing teledentistry communicates to patients that you are adopting technology to mitigate risks while improving patient experience. Retaining in-office visits for those really required and offering better pre-screening of patients, keeps everyone safer, including the dental team. Teledentistry builds patient confidence.

“Will I have treatment plans I can look at and understand at home and share with a partner to discuss?”

Patients won’t know yet to be asking this! You can surpass their expectations and establish yourself as the dentist they refer to friends and family by giving them visual treatment plans they can look at on any device wherever they are. This is one of the key ways to make use of a patient portal for improving the healthcare journey and your practice’s digital presence.

How do I schedule an appointment?

It should be really clear how they can act to schedule a teledentistry appointment or reach out to you with an asynchronous interaction (see above). They need to be able to answer easily, “What do I do to start?” If you’ve answered the question on your website and other communication channels about offering teledentistry, next they need to know how to start, and what to do next. This can be as simple as providing a form they fill out on your website, or you can book appointments over the phone if they are calling. Provide a link wherever you can to the specific starting point. Rather than a general link to your website, link to the form or make it really clear what they need to do next. That includes messaging such as “call us at our office number and we can schedule you right away.”

The first question patients will ask “Do you offer teledentistry?”

If existing or new patients have difficulty discovering you offer teledentistry services that make you and your team accessible now, they can’t take the next step. Make it clear in all your patient communication channels: your website, your outgoing phone message, via email campaigns, Facebook page, etc, and feature your virtual dentistry offerings at every opportunity – it could be the difference in acquiring new patients, and opening up new markets entirely.

A person using the teledentistry portal

Patient Portals & Teledentistry

Not every product described as a teledentistry solution provides a patient portal. (See questions to ask platform vendors below). A patient portal is your online clinical space. Just like you wouldn’t do clinical dentistry on a crowded street, you don’t want to be using public-facing text messaging for clinical conversations. A patient portal is also a type of virtual dental home: patients know that they have a place online to go that is your digital clinical presence. The online teledentistry space where they can access their PHI securely or visual treatment plans you are sharing or to initiate a conversation or share an image.

Preparing a Space for Virtual Dentistry Appointments

There are some simple steps you can take to setup a space either at a remote location or at your office to make an online video consultation a better experience. To help prepare a space for a video teledentistry consultation, consider the following bullet points:

A patient discussing options through the teledentistry app
  • Don’t have a door behind you. A patient might wonder, “Who’s going to walk through that door?”

  • Don’t have windows behind you, even if there’s no light shining through them. Your patient might think, “Well, who’s going to walk by that window? Is the window open?” You want to make sure that they feel comfortable, that their privacy is going to be maintained.

  • Try to keep it very simple visually behind you.

  • Make sure there’s no light behind you that would backlight you in their video view.

  • Test the view from your camera. Make sure that before you meet with a patient, you know what the view is going to look like.

  • Look directly into the camera. If you’re constantly looking up like that or looking over, you know, the patient may feel that they don’t have you with them. We don’t want to lose our patients’ trust.

  • Have space around you in the camera view so the patient feels the setting is as realistic as possible. We wouldn’t have a conversation with the patient with our face right in their face. Even on a mobile phone, set your camera away from you. We don’t want to make the patient feel that their space is being invaded.

Two Key Modes of Teledentistry

Live | Synchronous

Live stream of data or video conferencing connects providers: provider with the patient and a remote provider, a dentist, specialist or in some cases other care provider.

Store and Forward | Asynchronous

The on-site provider captures patient and exam data that can be batched, assigned, and triaged. Further, it works in the other direction: a dentist can send a treatment plan / recommendations to the remote provider and patient.

a teledentistry profession note taking

Using D9995 & D9996 CDT Teledentistry Codes

Frequently when using teledentistry, there is more than one provider involved but it’s important to know which provider will submit the code. The dentist that performs the oral evaluation, makes a diagnosis and creates a treatment plan will be the provider that reports the teledentistry CDT code. Teledentistry itself is not a specific service but rather a method of delivering care. When discussing the CDT codes for teledentistry, it’s important to know these codes are used in conjunction with another code, typically an exam.

As an example, a hygienist may offer mobile preventative care while having a collaborative dentist who performs an oral evaluation remotely, while the hygienist performs a prophylaxis and fluoride treatment onsite. In this example the dentist would submit CDT codes D0120 and D9996 for their exam and to report that teledentistry was used in this exam. The hygienist would report CDT codes D1110 and D1206 to report the prophylaxis and fluoride treatment performed on site.

The two full Current Dental Terminology (CDT) Code entries are:

D9995 teledentistry:

synchronous; real-time encounter. (Reported in addition to other procedures (e.g., diagnostic) delivered to the patient on the date of service.)

D9996 teledentistry:

asynchronous; information stored and forwarded to the dentist for subsequent review. (Reported in addition to other procedures (e.g., diagnostic) delivered to the patient on the date of service.)

4 Example Teledentistry Coding and Billing Scenarios

Here are 3 common scenarios in teledentistry between provider(s) and/or patients with coding guidance based on updates from the ADA:

Teledentistry Scenario 1

Patient contact with dentist who provides the consultation using audio means only D0190 (screening) or D0999

Teledentistry Scenario 2

Patient contact with dentist who provides the problem focused evaluation using audio and visual means D0140 or D0170 or D0171

Teledentistry Scenario 3

Patient contact with triage call center who then forwards to dentist who provides the problem focused evaluation using audio and visual means

  • CALL CENTER CODING: D0190 (screening) or D0999

  • DENTIST CODING: D0140 or D0170 or D0171

Teledentistry Scenario 4

Patient contact with the dentist who then forwards to specialist who provides the problem focused evaluation using audio and visual means. The referring dentist can be a GP or a specialist who is referring to another specialist.

  • GP DENTIST CODING: D0190 (screening) or D0999

  • GP OR SPECIALIST CODING: D0140 or D0170 or D0171

Now add teledentistry codes for the right modality to evaluation codes

Combine each of the above with the appropriate teledentistry CDT code:

  • Synchronous teledentistry: D9995 (live, real time)
  • Asynchronous teledentistry: D9996 (store and forward, or patient messaging).

(You need to understand applicable state board policies and state regulations on teledentistry and each modality for your setting.)

Questions to Ask Teledentistry Solution Vendors

“Can I message you with concerns and perhaps an image? Can I do it from my phone?”

This asynchronous mode of teledentistry is preferred by some patients, and certainly can be more efficient for some dental professionals. If the patient has sent diagnostically useful images and a good description of their complaint, you may have the evaluation already completed by the time of the video consult or can skip that step entirely.

“Can I schedule an online virtual consultation?”

Patients across the board are not only getting used to the idea of telehealth but expecting it as an option. Now more than ever. That may mean in their mind a live video consultation where they can see and talk with a professional face to face.

“How are you keeping my office visit as safe as possible?”

Dental practices are taking significant steps to make their offices some of the safest places in the world for a patient to be. Providing teledentistry communicates to patients that you are adopting technology to mitigate risks while improving patient experience. Retaining in-office visits for those really required and offering better pre-screening of patients, keeps everyone safer, including the dental team. Teledentistry builds patient confidence.

“Will I have treatment plans I can look at and understand at home and share with a partner to discuss?”

Patients won’t know yet to be asking this! You can surpass their expectations and establish yourself as the dentist they refer to friends and family by giving them visual treatment plans they can look at on any device wherever they are. This is one of the key ways to make use of a patient portal for improving the healthcare journey and your practice’s digital presence.

How do I schedule an appointment?

It should be really clear how they can act to schedule a teledentistry appointment or reach out to you with an asynchronous interaction (see above). They need to be able to answer easily, “What do I do to start?” If you’ve answered the question on your website and other communication channels about offering teledentistry, next they need to know how to start, and what to do next. This can be as simple as providing a form they fill out on your website, or you can book appointments over the phone if they are calling. Provide a link wherever you can to the specific starting point. Rather than a general link to your website, link to the form or make it really clear what they need to do next. That includes messaging such as “call us at our office number and we can schedule you right away.”

The first question patients will ask “Do you offer teledentistry?”

If existing or new patients have difficulty discovering you offer teledentistry services that make you and your team accessible now, they can’t take the next step. Make it clear in all your patient communication channels: your website, your outgoing phone message, via email campaigns, Facebook page, etc, and feature your virtual dentistry offerings at every opportunity – it could be the difference in acquiring new patients, and opening up new markets entirely.

Important Teledentistry Features for a Group or Practice to Consider

doctors
  • Is the system designed for one specific task, such as video conferencing, or does it have the ability to become part of a larger teledentistry workflow?

  • Does the system have HIPAA compliance?

  • Is the teledentistry system mobile friendly, for both patients and providers?

  • Can multiple providers participate simultaneously in a teledentistry consultation or collaboration?

  • Is the teledentistry system scalable for broader opportunities?

  • Is the teledentistry solution dental focused or is it a more general telemedicine solution?

  • Does it offer asynchronous teledentistry, the most common type for dental?

  • Can I invite multiple providers to collaborate on a case?

  • Can I share images with patients?

  • Will it work offline as well, in some important ways?

  • Does it support billing, reporting, user management, data/practice siloing for multi-practice/state implementations?

  • Does it enable web forms for patient intake?

  • Does it include a secure patient portal for clinical interactions with patients, including their secure access to PHI?

  • How can it create a documentable record of video chat and messaging and connect to a patient record?

virtual dentistry

Teledentistry Reduces PPE Needs

Teledentistry allows providers to communicate with their patients without being in the same space, eliminating the need during those appointments for PPE.

That communication can be real-time (synchronous) or via messaging (asynchronous). Synchronous teledentistry allows for limited exams (commonly billable) to be provided by a dentist while the patient is at home to reduce the number of patients who need to come into the office and require PPE.

Asynchronous teledentistry allows providers to triage patients’ needs and have them fill out paperwork before an appointment, lessening the time they spend in-office.

Dental hygienists can participate in in-office asynchronous teledentistry by storing all assessment data digitally for the dentist to view and treatment plan in a separate space. With the right teledentistry systems in place, treatment plans could then be sent digitally to a patient for acceptance and questions could be discussed by a synchronous teledentistry appointment. A flexible teledentistry platform allows dental teams (and patients) to pivot between synchronous and asynchronous modes while retaining a consolidated record or communication and facilitating clinical record keeping. It opens the door to several strategies to both reduce PPE needs and create efficient workflows.

Marketing Your Teledentistry Services

Patients and your community need to hear about the services you offer. Here are some quick bullet points that you can use as a checklist for getting the word out:

Update your practice’s outgoing phone message to mention your teledentistry services and how to schedule 

Add a clear announcement on your homepage about teledentistry services

Make sure there’s a way for people to take action: a button, a navigation item, a link, a phone number that brings them into your scheduling workflow.

Include a mention of teledentistry on your Facebook business page, including a link to where patients can request a teledentistry appointment

Post about new teledentistry options on our social channels.

Update or create your Google My Business listing to include telehealth services with links to where to book your teledentistry appointments.

Send a press release to local papers, tv outlets, business chambers, and relevant local organizations (nursing homes, community support, schools) about how you are serving the community by leading with the adoption of teledentistry.

Email your patient list with an announcement of teledentistry services and invitation to register for your patient portal.

Started running local targeted ads for people searching for dental problems that highlight your telehealth or teledentistry availability.

Become a TeleDent Subscriber

All TeleDent subscribers have access to the full range of teledentistry capabilities in TeleDent and all the benefits they can drive for practices, providers, and patients.

award winning teledentistry services

Tellies Awards: Innovation in Teledentistry

MouthWatch launched the Teledentistry Innovation Award to shine a light on innovators and pioneers across the spectrum of connected dental care who have led the way and shown by example how teledentistry technology can enhance dentistry.

See Tellies Recipient Interviews

Further past teledentistry innovation award winners have included:

Paul Labbe, DDS

Dr. Labbe is a pediatric dentist with 5 office locations. He uses teledentistry to provide care to underserved children in his community. Teledentistry enables him and his team to conduct dental screenings at local schools and then in turn, provide the parents and guardians with diagnosis and treatment plans with the option to bring their children to one of his offices for restorative treatment.

MiQuel McRae, RDH, CDHC

Miquel founded ToothBUDDS, a non-profit that employs a team of dental hygienists to provide oral care to underserved children in her area – Many of which have some form or oral disease. Miquel and her team provide education, screenings, cleanings and fluoride treatments in local school settings. Thanks to teledentistry, they can connect children with urgent dental needs to a local dentist, so they don’t fall through the cracks.

Angie Stone, RDH

Angie and her team of oral care specialists provide onsite hygiene services to elderly patients who live in nursing homes, assisted living facilities and private homes. They use teledentistry to document each patient visit with intraoral photos and videos and to communicate with family members and participating dentists to ensure that their clients receive restorative care when needed.

Brittany Kinol, DMD

With two offices in the Pittsburgh area, Miracle Dental reaches children in a range of settings that are most convenient for them and their families. By coordinating care delivery with Head Start programs, schools, and public insurance carriers, Miracle Dental’s mobile hygienists use teledentistry to deliver preventive care to students in the most convenient way possible.

Teledentistry Pioneer Paul Glassman, DDS, MA, MBA

Dr. Glassman is the first recipient in the newly created “Teledentistry Pioneer” category. He is the founder of the Virtual Dental Home Program, whereby he and his team at the University of the Pacific developed a more efficient way to connect patients to dental care through the combination of technology and innovation. This care-delivery model, combined with his efforts in education, in supporting legislative changes that support teledentistry and improve access to care have helped create a landscape where more and more programs and providers are interested in teledentistry and the opportunities it creates.

Liz Best – NYU Dental College

Liz is a grants administrator at the New York University (NYU) College of Dentistry, who obtained a Human Resources & Services Administration grant to fund the implementation of teledentistry technology into the school’s curriculum. Working with TeleDent, NYU has incorporated teledentistry technology into second year coursework.

Staci Stout, RDH, BSDH

Smart Smiles, a school-based oral health program based in Utah that focuses on prevention. Its mobile hygiene program provides care to children at school to ensure they have access to oral healthcare. A team of hygienists equipped with portable preventive care equipment and teledentistry technology see children at more than 30 schools in the Salt Lake City area.
Learn more about the Tellies Award and submit a candidate.

Explore Further: Recent Blog Posts on Teledentistry

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