Dentists say virtual visits keep patients safe and help practices thrive

The uninitiated are sometimes dubious about virtual dental visits, but dentists say that not every appointment requires an up-close-and-personal look.

Teledentistry can be "an effective way to triage patients and conduct problem-focused evaluations in order to limit office visits to patients needing urgent or emergency care," said Grazia Yaeger, director of marketing and communications for the New York State Dental Association in Albany.

Such virtual visits, via technology like Zoom, can be used for medical history review, initial consultation and treatment planning, oral hygiene education, post-op follow-up appointments, as well as to help decide the urgency of an appointment and consultation for a patient, professionals say. In some cases, a patient will receive a prescription for antibiotics to treat an infection and schedule a follow-up visit.

During surges in the COVID-19 outbreak, teledentistry has also kept patients and dental staff safer.

According to an American Dental Association Health Policy Institute survey in April 2020, 25% of responding dentists said they were using virtual technology/communications for remote, problem-focused evaluations. This past February, 37% were using virtual technology in practice for a variety of purposes. Twenty-five percent of those were using it for triaging emergencies; 21% for post-op and follow-up care; 18% for consults; 12% for patient education; and 4% for orthodontic checkups.

While some dentists have used remote services occasionally for more than a decade, it was used sparingly until the pandemic. Haider Newmani, co-owner of Sweet Tooth Dental in Baldwin, said it used to come in handy "if a person wanted a second opinion about a treatment plan, or as a community service for the elderly or disabled."

With COVID, Sweet Tooth Dental turned to technology to aid in diagnosing emergencies, treatment planning, consultations for cosmetics like teeth whitening, veneers and Botox, which is sometimes used to treat jaw-clenching and tooth-grinding. "We could meet virtually and replace the initial in-person meeting, where there is discussion and not treatment," said Newmani, a board-certified dentist who manages the office. His business partner is the practicing dentist.

A virtual appointment, he said, could help determine whether a root canal was needed, or if an infection was present and antibiotics should be prescribed.

To get the best view inside the mouth during a televisit, Newmani said they may ask patients to use a magnifying mirror, or use their phone camera with flash to take pictures "and zoom in to share them with us."

Most who use teledentistry eventually come to the office, Newmani said, because photos and videos may not show everything clearly. "There is no substitute for a dentist’s touch," he said.

Second opinions

Similarly, dentist Marc Herman of Advanced Dentistry of Long Island in Woodbury expanded teledentistry for consultations, as a diagnostic tool, introductory meetings with new patients, and for second opinions, during which he can teleconference with the patient and the other dentist.

"It’s helpful, whether a patient has a broken tooth, needs a cleaning or a root canal, if I can see it first. I can begin planning immediately," said Herman.

Teledentistry is ideal for his elderly patients who have transportation or mobility issues. Meeting virtually reduces their in-office visits.

Tales from a first-timer

Mark Buttonow of Ronkonkoma recently had his first teledentistry appointment via his dentist’s private video chat service. He’s singing its praises.

"I'd just had an in-person appointment; this one was to talk about next steps, so teledentistry was a good option. I’m experiencing pain, so they offered me this as a more comfortable alternative. I had already gotten X-rays, so there was no need to return to the office when everyone is trying to keep their waiting rooms less crowded," said Buttonow.

His thoughts on teledentistry? "It was a little hard to hear at times, so we turned the volume all the way up on the computer. The appointment went very well. I didn’t need to wait in a waiting room while I was in pain, and it felt more private. I would do it again."

Software, security, insurance

Of course, not everyone has access to the internet, and not every dental issue can be handled remotely. "A dentist cannot diagnose or establish a comprehensive treatment plan without looking into the patient’s mouth," said Yaeger, of the dental association.

There are concerns for dentists. "Integrating teledentistry into a practice requires some hardware and software for setup and cybersecurity measures to ensure the protection of patient records," said Yaeger. And dentists must ensure that their technology and record-keeping are HIPAA compliant.

"And while the insurance industry did allow billing for teledental consultation during the pandemic," Yaeger said, "reimbursement for these procedures continues to be problematic."

'Makes our job easier'

But there are advantages. Herman says he doesn’t charge extra for teledentistry. "It’s a service that makes our job easier and improves the patient experience," he said. Happy patients stay and their positive word-of-mouth increases his business.

"I have gotten new patients, not only locally, but different states and even other countries," said Newmani. His business grew. During COVID they went from two to four treatment rooms. "Teledentistry played a part in our expansion."

Some dentists stopped doing teledentistry once the government lifted restrictions on in-person services. Not Newmani.

"This is modern medicine. We’re looking to expand our telehealth. We’re in talks with a medical doctor who has a private clinic, about partnering to offer medical/dental telehealth services."

Says Herman, "Teledentistry is here to stay."