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The Teledentistry, Impact, Current Trends, and Application in Dentistry: A Global Study

Authors:
  • Bahria University Medical & Dental College

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Objective: The present study aimed to assess the impact of teledentistry, its application, and trends in uplifting dental practice and clinical care around the world. Material and Methods: The present observational study comprised of an electronic survey distributed among dental professionals around the globe. The validated survey form consisted of a total of 26 questions with a 5-point Likert scale response. The questionnaire used was divided into four domains: usefulness of teledentistry for patients, its usefulness in dental practice; its capacity to improve the existing practice; and the concerns attached to its use. The statistical analysis was performed using SPSS-25. ANOVA test was used to assess the effect of independent variables on dependent variables. A p-value of ≤0.05 was taken as statistically significant. Results: A total of 506 dental professionals participated in the study with a response rate of 89.39%. More than half of participants (50-75%) endorsed that teledentistry is a useful tool for improving clinical practice as well as patient care. Two third of participants (69.96%) considered that teledentistry would reduce costs for the dental practices. On the other hand, about 50-70% of dental professionals expressed their concerns regarding the security of the data and consent of patients. The most preferred communication tool for teledentistry was reported to be videoconference followed by phone. The majority of participants recommended the use of teledentistry in the specialty of oral medicine, operative dentistry, and periodontics. There was a significant difference between the age, experience of dentists, and their qualifications with domains of teledentistry. Conclusions: The overall impact of dental professionals towards teledentistry was positive with adequate willingness to incorporate this modality in their clinical practice. However, the perceived concerns pertaining to teledentistry are significant impediments towards its integration within the oral health system. An in-depth study of its business model and cost-benefit is a need of time, especially in the context of developing countries, in order to avail the optimum benefits of teledentistry.
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Research Article
The Teledentistry, Impact, Current Trends, and Application in
Dentistry: A Global Study
Afsheen Maqsood ,
1
Muhammad Shahrukh Khan Sadiq ,
1
Daud Mirza ,
1
Naseer Ahmed ,
2,3
Abhishek Lal ,
4
Mohammad Khursheed Alam ,
5
and Mohamad Syahrizal Bin Halim
6
1
Department of Oral Pathology, Bahria University Medical and Dental College, Karachi 75530, Pakistan
2
Prosthodontics Unit, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian, Kota Bharu,
Kelantan, Malaysia
3
Department of Prosthodontics, Altamash Institute of Dental Medicine, Karachi 75500, Pakistan
4
Research Intern, Department of Prosthodontics, Altamash Institute of Dental Medicine, Karachi 75500, Pakistan
5
Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka, Al Jouf, 72345, Saudi Arabia
6
Conservative Dentistry Unit, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian,
Kota Bharu, Kelantan, Malaysia
Correspondence should be addressed to Mohammad Khursheed Alam; mkalam@ju.edu.sa
and Mohamad Syahrizal Bin Halim; drsyah@usm.my
Received 20 August 2021; Accepted 11 October 2021; Published 25 October 2021
Academic Editor: Fernanda Faot
Copyright © 2021 Afsheen Maqsood et al. This is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is
properly cited.
Objective. The present study was aimed at assessing the impact of teledentistry, its application, and trends in uplifting dental
practice and clinical care around the world. Material and Methods. The present observational study comprised of an electronic
survey distributed among dental professionals around the globe. The validated survey form consisted of a total 26 questions
with 5-point Likert scale response. The questionnaire used was divided into four domains: usefulness of teledentistry for
patients, its usefulness in dental practice, its capacity to improve the existing practice, and the concerns attached to its use. The
statistical analysis was performed using SPSS-25. ANOVA test was used to assess the eect of independent variables on
dependent variables. A pvalue of 0.05 was taken as statistically signicant. Results. A total of 506 dental professionals
participated in the study with the response rate of 89.39%. More than half of the participants (50-75%) endorsed that
teledentistry is a useful tool for improving clinical practice as well as patient care. Two-thirds of the participants (69.96%)
considered that teledentistry would reduce cost for the dental practices. On the other hand, about 50-70% of dental
professionals expressed their concerns regarding the security of the data and consent of patients. The most preferred
communication tool for teledentistry was reported to be videoconference followed by phone. The majority of participants
recommended the use of teledentistry in the specialty of oral medicine, operative dentistry, and periodontics. There was a
signicant dierence between the age, experience of dentists, and their qualications with domains of teledentistry.
Conclusions. The overall impact of dental professionals towards teledentistry was positive with adequate willingness to
incorporate this modality in their clinical practice. However, the perceived concerns pertaining to teledentistry are signicant
impediments towards its integration within the oral health system. An in-depth study of its business model and cost-benet
needs of time, especially in the context of developing countries, in order to avail the optimum benets of teledentistry.
Hindawi
BioMed Research International
Volume 2021, Article ID 5437237, 9 pages
https://doi.org/10.1155/2021/5437237
1. Introduction
Since the advent of telehealth technology decades ago, the
elds of medicine and dentistry have seen substantial scien-
tic advances. The use of telehealth-associated modalities
has transgured diagnosis, therapies, and surgery in the eld
of dentistry [1]. In that regard, teledentistry (TD) is a form
of telehealth utilizing a combination of telecommunications
and dentistry, which involves the exchange of clinical infor-
mation and relevant imaging over remote distances for con-
sultation and treatment planning. Teledentistry is a novel
eld with a massive potential for uplifting clinical care and
dental education with its innovative approach [2].
The rst practical application of TD has its root in a US
project launched in 1994 to assess the dental health of the
servicemen of United States army [3]. The term TD was
formally used for the rst time in the literature by Cook in
1997. The initial description pertaining to TD was conned
to videoconference and its associated role in consultation
and diagnosis from long distance [4]. With rapidly improv-
ing technology in the 21
st
century, the term TD expanded its
ambit to include the subdomains such telediagnosis telecon-
sultation, teletriage, and telemonitoring [5]. According to
the American Dental Association, TD comprises of four
basic modalities that include synchronous, asynchronous,
remote patient monitoring, and mobile health. The synchro-
nous modality utilizes virtual video call in order to facilitate
real-time interaction between the dental practitioner and
patient, while the asynchronous approach deals with diagno-
sis and examination through the transfer of data via videos,
radiographs, and intraoral imaging [6].
The COVID-19 pandemic caused due to the spread of
SARS-COV-2 virus has posed a menacing challenge to the
healthcare systems across the world. Due to its transmission
via droplets and air, the traditional face-to-face interaction
between the dental practitioners and patient entails a risk
of viral transmission [7]. In such circumstances, TD has
proven itself to be a boon; it has circumvented the traditional
face-to-face dentist-patient interaction by providing an
eective substitute for the purpose of online consultation,
exchange of investigations, and planning treatment [8].
Ample evidence has universally accepted TD as a viable
modality that provides minimal cost, reduced stress of trans-
portation, and better access to specialist practice [9].
Numerous studies have been conducted in various coun-
tries regarding the perceptions, eectiveness, and applications
of TD at national level. Estai et al. assessed the perception of
Australian dentists on the use of TD and concluded that an
overwhelming majority of dentists (80%) agreed regarding
the benecial outcomes of using TD for both dentists and
patients [10]. A Canadian study conducted by Palmer et al.
showed similar results where the majority of orthodontists
supported the use of digital and electronic technology in den-
tal practice [11]. A recent questionnaire-based study carried
out in Saudi Arabia reported that a substantial proportion of
respondents agreed with the fact that TD would improve den-
tal practice through enhancing communication with peers,
guidance, and referral of new patients despite the concerns
of data privacy and security [12].
So far, the current literature is devoid of a global survey
that is focused upon assessing the usefulness of TD in provi-
sion of dental care. A study incorporating the impact of TD
and current trends among dental practitioners at global
stage needs to time in order to evaluate the application and
eectiveness of TD in dierent countries and their respective
dental healthcare systems. Therefore, the current study was
aimed at evaluating the impact of TD, its application, and
trends in improving dental practice and patient outcomes.
2. Materials and Methods
2.1. Study Setting and Ethical Consideration. The present
study was approved by the ethical review committee of
Altamash Institute of Dental Medicine, Karachi. The study
was carried out at numerous countries.
2.2. Sample Size and Study Design. The sample size was cal-
culated through OpenEpi software. Consider the usefulness
of teledentistry for patients, with a mean score value
of9:64 ± 4:26[12] and with a 95% condence interval and
the power of test 80%. The total estimated sample size
was 506 participants. The study design was descriptive
observational that comprised of convenient sample of 506
dental professionals.
2.3. Questionnaire Design and Distribution. An electronic
and validated questionnaire was disseminated among the
selected dental professionals between June and July of 2021
through e-mail and other social media applications (What-
sApp®, Facebook®, Instagram®, skype®, Imo messenger®,
snapchat®, and LinkedIn®). The permission from dentists
to participate in the study was sought out before the ques-
tionnaire dissemination. The dentists working in dental hos-
pitals, clinics, and institutes were approached through phone
calls and emails for this purpose. The questionnaire used in
this study was adopted after a prior permission, from a sim-
ilar study conducted in the Kingdom of Saudi Arabia by Al
Khalifa and AlSheikh [12]. The questionnaire consisted of
two parts related to participants general information and
dierent domains of teledentistry. The rst part of the ques-
tionnaire covered professional, demographic information,
and communication method preferences. The second part
of the questionnaire was based on ve-point Likert-type
responses. This part was comprised of a total of 26 ques-
tions, which were further divided under four domains that
encompassed: data security concerns by the dental profes-
sionals, teledentistry and practice improvement, the useful-
ness of teledentistry for dental practice, and its usefulness
for dental patients.
There was a brief description of the questionnaires pur-
pose with a denition of teledentistry and its benets and
possible uses in daily practice. The consent agreement was
incorporated within the questionnaire. The regular
reminders (after an interval of week) were sent to the nonre-
spondents via e-mail and other social media networks, after
initial distribution of the questionnaire. In response, 566
forms were received back from the participants, out of which
2 BioMed Research International
60 incomplete forms were excluded from the study. A total
of 506 forms were included in the study.
2.4. Statistical Analysis. The SPSS-25 was used for statistical
analysis. Descriptive statistics were performed for frequency,
percentage, mean, and standard deviation of demographic
variables; qualication of participants; experience; place of
practice; and use of teledentistry in dierent specialties.
ANOVA test was applied to see the eect of independent
variables (age, gender, qualication, and years of experience)
on dependent variables (domains of teledentistry). A pvalue
of 0.05 was taken as statistically signicant.
3. Results
This observational study consisted of 506 participants. The
response rate of participation was 89.39%. There was 266
(52.56%) female and 240 (47.43%) males in this study. The
age range of participants was from 20 to 64 years. There
were 340 (67.2%) participants from 20- to 34-year age
bracket, 133 (26.3%) belonged to 35 to 44 years, 13 (2.6%)
were from 45- to 54-year age group, and 20 (4.0%) were
from 55- to 64-year age bracket. Qualication-wise, the
majority of the 259 (51.2%) participants were general dental
practitioner, and 172 (34.0%) participants were consultant/-
specialist. Regarding the experience, majority of the 306
(60.5%) participants had 15-year experience, 104 (20.6%)
participants had 610 yearsexperience, and 55 (10.9%)
participants had 1115 years of experience.
In this study, the majority of the responses were
recorded from South Asia 183 (36.16%), 65 (12.84%) from
continental Europe, 87 (17.19%) from Western Asia, 34
(6.71%) from East Asia, and 29 (5.73%) from the United
States of America as shown in Figure 1.
Furthermore, most of the dentists 247 (48.81%) worked
in a private setup, while 122 (24.11%) worked in a public
sector and the remaining 137 (27.07%) were working in aca-
demic institutes. In this study, majority of the respondents
191 (37.7%) worked 3549 hours per week, whereas 170
(33.6%) worked 119 hours per week, and 118 (23.3%)
worked 2034 hours. Regarding the daily use of the internet
in clinical practice, the majority 249 (49.2%) selected 24
hours, while 168 (33.2%) participants were using it for less
than 1 hour.
Table 1 presents the concern of participants about data
security and patient consent. In this regard, the majority of
the 410 (81.02%) participants were concerned about gaining
patient consent, whereas 54 (10.7%) were not feeling either
way. However, most of the 471 (93.08%) respondents were
concerned about the condentiality of online data sent by
patients but 28 (5.53%) were not concerned. When asked
about digital forgery, more than three-fourths (79.64%) of
the participants were concerned about it and 35 (6.91%)
were not concerned about digital forgery. Furthermore,
the majority of the 436 (86.16%) participants were
concerned about hardware and software incompatibility in
teledentistry, although 28 (5.53%) were not concerned
about it. Regarding the reliability of teledental equipment,
many of the 436 (86.16%) participants were concerned
about it; however, a small number of 14 (2.76%) partici-
pants were not concerned.
Table 2 shows the responses on impact of teledentistry to
improve dental practice. In this regard, the majority of the
256 (50.6%) participants were not in favor of teledentistry
used for clinical diagnosis, whereas about one-fourth
(25.29%) of the participants disagreed. Furthermore, more
than three-fourths (79.64%) of the participants agreed that
teledentistry would help shorten their clinic waiting list,
whereas a small number of 47 (9.28%) respondents dis-
agreed. Regarding the question about teledentistry capability
to enhance dental guidelines and advice, the majority of the
342 (67.58%) participants were in favor of it, but less than
one-fourth (22.9%) were not feeling either way. However,
most of the 326 (64.42%) participants agreed that teledentis-
try will improve the interaction between peers, although 55
(10.86%) disagreed on it. Concerning that teledentistry
would provide a safe atmosphere for practicing dentistry
(e.g., COVID-19 pandemic), majority of the 416 (82.21%)
participants agreed on it but a small number of the 28
(5.53%) participants disagreed. Additionally, more than
two-thirds (71.73%) of the participants agreed that teleden-
tistry would make patients referral more ecient, although
61 (12.05%) disagreed on this.
Table 3 describes the application and usefulness of tele-
dentistry in dental practice. Out of 506 participants, more
than half of the participants (51.18%) agreed that teledentis-
try would enhance clinical training and continuing dental
education, while 82 (16.2%) disagreed, and 165 (32.6%) were
neutral about that. Regarding cost-eectiveness, the majority
of the 354 (69.96%) participants agreed that the teledentistry
would reduce costs for the dental practices, while 35 (6.9%)
disagreed on it. Concerning teledentistry, it would increase
treatment time spent with the patient; most of the 272
(53.75%) participants agreed on it. However, less than one-
fourth (17.58%) disagreed. With reference to the question
of teledentistry that would necessitate an extra appointment
for taking photographs, the majority of the 300 (59.28%)
contestants agreed, whereas 96 (18.97%) disagreed. Regard-
ing the inquiry that teledentistry would save time compared
with a referral letter, the majority of the 355 (70.15%) partic-
ipants agreed on it, but a small number of 35 (6.91%) have
disagreed. The concern on setup and backup of teledentistry
by participants depicted that about 124 (24.50%) dentists
believed that it would be an expensive option; however, the
majority of the 200 (39.52%) disagreed. Lastly, whether tele-
dentistry would be an adequate diagnostic tool in clinical
practice, less than half (40.11%) of the participants agreed,
and surprisingly, 193 (38.1%) were neutral.
Table 4 illustrates the application and usefulness of
teledentistry for patients. The majority of the 300 (59.28%)
participants agreed that teledentistry would save money for
patients, while 68 (13.43%) disagreed. Furthermore, most
of the 320 (63.24%) participants agreed that teledentistry
would improve communication with patients, and 62
(12.25%) have disagreed. However, more than two-thirds
(76.67%) of the participants agreed that teledentistry would
be helpful for patient education; however, 49 (9.68%) partic-
ipants disagreed. Moreover, the majority of the 423 (83.59%)
3BioMed Research International
participants agreed that teledentistry would help to avoid
unnecessary travel to dental clinic, but a small number of
28 (5.53%) participants disagreed. More than two-thirds
(69.16%) of the participants agreed that teledentistry would
be helpful in monitoring the patients condition, whereas
61 participants (12.05%) disagreed. Additionally, 244
(48.22%) participants agreed that teledentistry would be
convenient and well received by patients, 68 (34.43%)
disagreed, and 194 (38.3%) were neutral. Nevertheless, the
majority of the 342 (67.58%) participants agreed that tele-
dentistry would be useful for patients in remote areas, with
35 (6.91%) participants who disagreed with it. Lastly, more
0
20
40
60
80
100
120
140
England
Australia
South Africa
Germany
Italy
China
Canada
United States
Newzealand
Malaysia
Indonesia
Singapore
Srilanka
India
Bangladesh
Pakistan
Saudia Arabia
Dubai
Kuwait
Bahrain
Qatar
Egypt
Jordan
Abu dhabi
Turkey
Russia
Iran
Frequency
Geographic location of Job
Figure 1: Distribution of responses from dierent countries.
Table 1: Distribution of responses concerning about data security and patient consent among participants (n= 506).
S.no Item Very
concerned n%
Little
concerned n%
Not feeling either
way n%
Not particularly
concerned n%
Not concerned at
all n%
1. Gaining patient consent for
teleconsultation 295 (58.3) 115 (22.7) 54 (10.7) 21 (4.2) 21 (4.2)
2. Condentiality when data are
sent online 337 (66.6) 134 (26.5) 7 (1.4) 7 (1.4) 21 (4.2)
3. Potential for digital forgery 303 (59.9) 100 (19.8) 68 (13.4) 21 (4.2) 14 (2.8)
4. Incompatible hardware and
software 272 (53.8) 164 (32.4) 42 (8.3) 7 (1.4) 21 (4.2)
5. Reliability of teledental
equipment 264 (52.2) 172 (34.0) 56 (11.1) 7 (1.4) 7 (1.4)
Table 2: Distribution of responses about the impact of teledentistry to improve practice (n= 506).
S. no Item Disagree
strongly n%
Disagree
n%
Neutral
n%
Agree
n%
Agree
strongly n%
1 Teledentistry would help in patient diagnosis 33 (6.5) 95 (18.8) 256
(50.6)
102
(20.2) 20 (4.0)
2 Teledentistry would help shorten the waiting list 7 (1.4) 40 (7.9) 56
(11.1)
363
(71.7) 40 (7.9)
3 Teledentistry would enhance dental guidelines and advice 7 (1.4) 41 (8.1) 116
(22.9)
295
(58.3) 47 (9.3)
4 Teledentistry would improve the interaction between peers 7 (1.4) 48 (9.5) 125
(24.7)
265
(52.4) 61 (12.1)
5Teledentistry would provide a safe atmosphere for practicing dentistry
(e.g., COVID-19 pandemic) 7 (1.4) 21 (4.2) 62
(12.3)
278
(54.9) 138 (27.3)
6 Teledentistry would make patients referral more ecient 7 (1.4) 54 (10.7) 82
(16.2)
274
(54.2) 89 (17.6)
4 BioMed Research International
than half of the participants (51.18%) agreed that teledentis-
try should be covered by dental insurance plans, but few of
the 48 (9.48%) participants have disagreed.
Table 5 presents the ANOVA test analysis. The analysis
showed the statistical signicance of the study participants
age, gender, qualication, and work experience with
domains of teledentistry. The dentists that belonged to vari-
ous age groups had a dierence in opinion regarding
patients security and consent (ANOVA test; pvalue =
0.001), impact teledentistry on dental practices (ANOVA
test; pvalue = 0.001), usefulness of teledentistry for patients
(ANOVA test; pvalue = 0.015), and eciency of teledentis-
try in dental clinics (ANOVA test; pvalue = 0.035). Similarly
for qualication, a signicant dierence was found with all
four domains of teledentistry studied (ANOVA test; p=
0:003,p=0:001,p=0:004, and p=0:001), respectively.
The consultants, general dentists, and resident dentists
scored lower in data security and patient consent than other
domains. As for work experience in years, data security and
patient consent, teledentistry impact to improve dental prac-
tice and application, and usefulness of teledentistry for
patients were statistically signicant (ANOVA test; p=
0:002, 0.027, and 0.006). This could be explained by observ-
ing the mean scores between the groups, where all the expe-
rience groups scored less in data security and patient consent
domain of teledentistry. On the other hand, there was no
statistical signicance (ANOVA test; p>0:05) between
gender and all domains of teledentistry.
Figure 2 shows the preferred communication tool for tel-
edentistry. The most preferred methods of communication
were videoconference 127 (25.09%), phone 124 (24.50%),
social media 101 (19.96%) (WhatsApp®, Facebook®, Insta-
gram®, skype®, Imo messenger®, snapchat®, and Linke-
dIn®), and in person or face to face 87 (17.19%).
Figure 3 demonstrates the use of teledentistry in respect
to dierent dental specialties. The majority of participants 92
(18.18%) recommended the use of teledentistry in the spe-
cialty of oral medicine. Teledentistry use was recommended
in operative dentistry, the second highest by the participants
60 (11.85%). In periodontics, it was suggested by 55
(10.86%), whereas in pedodontics, 54 (10.67%) participants
opted for the use of teledentistry.
4. Discussion
Due to the current ongoing SARS-CoV-2 pandemic, tele-
dentistry is becoming an increasing option which is proving
to be benecial to both the patients and dentists, for their
Table 3: Application and usefulness of teledentistry for dental practice (n= 506).
S. no Item Disagree
strongly n%
Disagree
n%
Neutral
n%
Agree
n%
Agree
strongly n%
1 Teledentistry would enhance clinical training and continuing education 7 (1.4) 75 (14.8) 165
(32.6)
210
(41.5) 49 (9.7)
2 Teledentistry would reduce costs for the dental practices 7 (1.4) 28 (5.5) 117
(23.1)
284
(56.1) 70 (13.8)
3 Teledentistry would increase treatment time spent with the patient 7 (1.4) 82 (16.2) 145
(28.7)
230
(45.5) 42 (8.3)
4Teledentistry would necessitate an extra appointment for taking
photographs 14 (2.8) 82 (16.2) 110
(21.7)
273
(54.0) 27 (5.3)
5 Teledentistry would save time compared with a referral letter 7 (1.4) 28 (5.5) 116
(22.9)
307
(60.7) 48 (9.5)
6 Teledentistry would be too expensive to set up 14 (2.8) 186
(36.8)
182
(36.0) 82 (16.2) 42 (8.3)
7 Teledentistry would provide sucient information about patient illness 28 (5.5) 82 (16.2) 193
(38.1)
163
(32.2) 40 (7.9)
Table 4: Application and usefulness of teledentistry for patients (n= 506).
S. no Item Disagree
strongly n%
Disagree
n%
Neutral
n%
Agree
n%
Agree
strongly n%
1 Teledentistry would save money for patients 14 (2.8) 54 (10.7) 138 (27.3) 279 (55.1) 21 (4.2)
2 Teledentistry would improve communication with patients 32 (6.32) 30 (5.92) 124 (24.5) 272 (53.8) 48 (9.5)
3 Teledentistry would be helpful patient education 24 (4.74) 25 (4.94) 69 (13.6) 320 (63.2) 68 (13.4)
4 Teledentistry would help to avoid unnecessary travel to dental clinic 8 (1.58) 20 (3.95) 55 (10.9) 320 (63.2) 103 (20.4)
5 Teledentistry would be helpful in monitoring the patients condition 7 (1.4) 54 (10.7) 95 (18.8) 322 (63.6) 28 (5.5)
6 Teledentistry would be convenient and well received by patients 34 (6.71) 34 (6.71) 194 (38.3) 188 (37.2) 56 (11.1)
7 Teledentistry would be useful for patients in remote areas 16 (3.16) 19 (3.75) 129 (25.5) 191 (37.7) 151 (29.8)
8 Teledentistry should be covered by dental insurance plans 24 (4.74) 24 (4.74) 199 (39.3) 204 (40.3) 55 (10.9)
5BioMed Research International
Table 5: Comparison of independent variables with domains of teledentistry among participants (n= 506).
Variable Data security and patient consent
Mean (SD)
Capability of teledentistry to improve dental practice
Mean (SD)
Usefulness of teledentistry for dental practice
Mean (SD)
Usefulness of teledentistry for patients
Mean (SD)
Age (years)
2034 7:81 ± 3:91 21:36 ± 4:63 23:87 ± 5:96 28:64 ± 6:64
3544 9:66 ± 6:28 22:19 ± 5:44 23:44 ± 6:53 30:48 ± 6:29
4554 9:82 ± 4:64 24:6±5:14 24:76 ± 3:07 28:76 ± 3:07
5564 5:65 ± 0:48 24:8±3:86 25:4±3:87 32:6±1:92
pvalue 0.001∗∗ 0.001∗∗ 0.0350.015
Gender
Female 7:64 ± 3:68 21:84 ± 4:85 23:99 ± 6:21 29:26 ± 6:69
Male 9:9±6:57 21:67 ± 5:42 23:47 ± 6:14 29:55 ± 5:88
pvalue 0.103 0.771 0.208 0.181
Qualication
Consultant/
specialist 7:8±4:17 23:09 ± 5:04 24:76 ± 6:42 30:41 ± 6:06
General dental
practitioner 8:43 ± 5:06 21:15 ± 4:623:52 ± 5:96 29:14 ± 6:49
Resident/
graduate
research
8:93 ± 4:98 21:04 ± 5:25 22:54 ± 5:82 27:54 ± 6:22
Other 7:99 ± 2:05 20:99 ± 1:02 24:13 ± 2:05 27:58 ± 3:59
pvalue 0.003∗∗ 0.001∗∗ 0.004∗∗ 0.001∗∗
Work
experience (in
years)
157:56 ± 3:73 21:34 ± 4:54 23:88 ± 6 28:9±6:57
610 10:01 ± 6:19 22:07 ± 5:923:67 ± 5:84 29:35 ± 6:84
1115 9:18 ± 5:78 23:48 ± 3:85 24:03 ± 4:52 30:81 ± 5:73
More than 16 7:87 ± 4:15 22:14 ± 6:13 24:78 ± 6:51 30:37 ± 3:93
pvalue 0.002∗∗ 0.0270.087 0.006∗∗
pvalue 0.05; ∗∗pvalue <0.000; SD: standard deviation.
6 BioMed Research International
own protection. Teledentistry is capable of improving
patients access to oral health and improves delivery of oral
health care and perhaps at lower costs as well [13]. Further-
more, teledentistry can also act to bridge the gap between
urban and rural healthcare as well.
In this study, the majority of the participants were con-
cerned about patientspersonal data being shared over the
internet, as their patients were found more comfortable
sharing their data in person with dentists. These results cor-
respond with a study with similar results about the concerns
for data privacy [14]. For professionals, there is a lot of dif-
ference between teledentistry and traditional face-to-face
appointments. So, the majority of the participants expressed
their concern regarding their clinical diagnosis given by
them using the teledentistry platform. However, these results
contrast with a study where the majority (80%) of the con-
sultants gave accurate diagnoses using teledentistry [15].
Due to the mode of transmission of COVID-19, a large
number of dentists agreed that teledentistry is a safe envi-
ronment to perform dentistry. These results were coinciding
with study literature where dentists reported their readiness
in performing teledentistry [12]. Regarding continuing
clinical practice and dental education, the majority of the
dentists agreed that teledentistry is useful [16]. Moreover,
the majority of the dentists agreed that teledentistry is a
cost-eective method for consultations, which corresponds
to a study by Estai et al. [17]. This is primarily due to a
smaller number of resources being used to perform teleden-
tistry as compared to traditional appointments.
Since there are dierent equipment required for teleden-
tistry, it was found in our study that appointment timings, as
well as extra appointments, might be needed for patients.
However, these results contrast in literature where it was
found that teledentistry reduces the number of face-to-face
0
20
40
60
80
100
120
140
Frequency
Preferred communication tool for teledentistry
Forum
Videoconference
Social media
Fax
Email
Phone
In person
Figure 2: Distribution of preferred teledentistry communication tool among participants (n= 506).
60
30
50
25
55 54
92
18 20
45 50
Frequency
Branch of dentistry
Operative dentistry
Prosthodontics
Endodontics
Orthodontics
Periodontics
Pedodontics
Oral medicine
Oral surgery
Oral radiology
Community dentistry
Dental hygiene
Figure 3: Distribution of teledentistry use in dierent dental specialties.
7BioMed Research International
appointments with the patients [18]. Concerning the dier-
ent equipment required for teledentistry, many agreed to it
being a less expensive tool. This could be due to the fact that
almost all of the people are equipped with mobile phones
and internet connection that is required for teledentistry
[19]. Keeping in mind the current pandemic situation, the
majority of the participants agreed that teledentistry is a
better option than visiting a dental clinic and monitoring
the patients condition as well. This might be due to the anx-
iety related to contracting coronavirus when visiting the
clinics [20].
Teledentistry can be particularly useful in remote areas
which might not be accessible due to the lockdown situation
imposed by governments worldwide. Furthermore, educat-
ing patients about their treatment and diagnosis is a vital
part of their appointments with doctors. The majority of
the participants agreed that teledentistry is a useful tool for
patient education. These ndings correlate with studies in
literature where teledentistry can be benecial for not only
patient education but for dentists and dental students as well
[21]. Teledentistry can be used by dierent dental specialties
according to their use. In our study, we found that oral med-
icine, followed by operative dentistry, and periodontics had
its most use of teledentistry. This could be due to a greater
number of patients presenting with dental problems that
require these specialists.
Teledentistry can be performed using many platforms such
as mobile phones, video conferencing, and social media. In our
study, we found that video conferencing was the most preferred
method followed by phone, although few participants stated
that face-to-face appointments are a better option. This could
be due to a lack of awareness of the use of technology and the
unavailability of tools required for teledentistry [22].
Despite the strengths of this study such as the inclusion
of dentists globally, it has some limitations. Firstly, the self-
administered questionnaires are prone to self-reported bias-
ness. Lastly, the dentists working in the rural areas can be
considered which could provide a better view of teledentistry
in such localities.
To help manage the patients in a better way, teledentistry
is becoming an emerging way for dentists to treat their
patients keeping in mind the current COVID-19 pandemic.
Dentists, as well as healthcare professionals, should be
taught how to use teledentistry by conducting programs
such as continuing dental education and awareness
programs to benet both the dentists and the patients.
5. Conclusion
The present study described that the dental professionals
participated in this study have adequate insight and a posi-
tive attitude towards the application of teledentistry. Hence,
dental professionals can be engaged in the teledentistry
approach. However, the study participants showed technical
perception, ethical consideration, and patient security
concerns towards teledentistry. Although teledentistry is an
area of expansion, there are still some barriers to its use. In
particular, further research is required on the optimum
modalities and the costs and benets. With this studys
limitation, further investigation is needed to understand
the implementation and challenges of dental institutes and
practitioners.
Data Availability
The raw data used to support the ndings of this study are
included within the article.
Conflicts of Interest
The authors declare no conict of interest.
AuthorsContributions
AM, MSK, DM, and MKA planned and designed the present
work and AM, NA, and MSK were responsible for realizing
the work. NA, AM, and AL were responsible for the data
acquisition and analysis. AM, MSK, AL, MSH, and DM
drafted and revised the manuscript. NA, AM, and MKA
approved the nal version of the manuscript. All authors read
and approved the nal manuscript. MSH and MKA contrib-
uted equally to this work and are corresponding authors.
Acknowledgments
The authors thank all the participants, Bahria University
Medical and Dental College, and Altamash Institute of
Dental Medicine, Pakistan, for the support and facilitation
in this study. The authors extend their appreciation to the
Deanship of Scientic Research at Jouf University for funding
this work through research grant no. DSR-2021-01-0391.
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9BioMed Research International
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A novel β-coronavirus (2019-nCoV) caused severe and even fetal pneumonia explored in a seafood market of Wuhan city, Hubei province, China, and rapidly spread to other provinces of China and other countries. The 2019-nCoV was different from SARS-CoV, but shared the same host receptor the human angiotensin-converting enzyme 2 (ACE2). The natural host of 2019-nCoV may be the bat Rhinolophus affinis as 2019-nCoV showed 96.2% of whole-genome identity to BatCoV RaTG13. The person-to-person transmission routes of 2019-nCoV included direct transmission, such as cough, sneeze, droplet inhalation transmission, and contact transmission, such as the contact with oral, nasal, and eye mucous membranes. 2019-nCoV can also be transmitted through the saliva, and the fetal–oral routes may also be a potential person-to-person transmission route. The participants in dental practice expose to tremendous risk of 2019-nCoV infection due to the face-to-face communication and the exposure to saliva, blood, and other body fluids, and the handling of sharp instruments. Dental professionals play great roles in preventing the transmission of 2019-nCoV. Here we recommend the infection control measures during dental practice to block the person-to-person transmission routes in dental clinics and hospitals.
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Introduction As a result of the COVID-19 pandemic, teledentistry has been used more frequently due to social distancing regulations to minimise the need for face-to-face attendances. Aims Evaluate uses of teledentistry within Newcastle Dental Hospital's Paediatric Dentistry New Patient Service. Establishes potential roles of teledentistry within paediatric dentistry and advantages and disadvantages of this service method. Methods Service evaluation of 653 new patient teledentistry appointments at Newcastle Dental Hospital across a one-month period (13 May- 12 June 2020). Discussion By implementing a telephone consultation as the first point of contact with our team, we were able to reduce the number of face-to-face appointments required by over a third. Teledentistry can be used for numerous applications within paediatric dentistry including initial triage, remote assessment, reinforcement of prevention, implementing initial management and building rapport. Conclusion Teledentistry is an emerging field and has the potential to improve patient journeys, reduce waiting lists and reduce unnecessary face-to-face attendances which is especially important both within and beyond the current COVID-19 pandemic to maximise safety and minimise inconvenience for both parent and child. However, care must be taken to ensure a clinician is confident in their diagnosis prior to discharging or delaying management of a patient.
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The upheaval of providers and their patients has led to many changes in the way people live and work. In addition to the changes in Personal Protective Equipment (PPE) guidelines, there has been evidence of rapid adoption of telehealth services. In April of 2020, the American Dental Association’s Health Policy Institute released a report stating that 1 in 4 dentists nationally were utilizing teledentistry to perform limited evaluations. Many of these dentists are new to teledentistry, and unfortunately, direct‐to‐patient consultations yield limited clinical outcomes. The more traditional methods of using teledentistry have been extending the reach of dental care for over a decade, using an allied team member such as a dental hygienist or expanded‐function dental assistant. As dentistry adapts to this new environment, it is important that there be adequate awareness of the diverse uses of teledentistry to meet the needs of the population. This brief, outlines one dental clinic’s attempt at providing a broad use of teledentistry.
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Dental care is considered to be an example of complex manual interventions in the medical sector. The vision presented describes the organization of dental care based on the application of modern telecommunication technologies. In developed countries, general dental practitioners have a positive attitude toward incorporating teledentistry into their practice. In PubMed there is a tendency to increase the states by telehealth key words and tags, including teledentistry. Those health care tendencies show a steady trend toward the broadening of teledentistry services.
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In developing countries, access to qualified medical personnel especially oral health care specialists by inhabitants of rural and remote areas remain a challenge due to the fact that these personnel are mostly located in urban communities. Teledentistry is an approach that will eliminate the problem of distance between qualified oral health care personnel and potential patients in rural and remote communities. The objective of this review is to investigate the history of teledentistry and its practical application in overcoming the rural-urban oral health care problems. A scoping search of literature using keywords associated with telemedicine and teledentistry and its application was undertaken via PubMed and Scientific Electronic Library Online (SciELO). Literature published in English in the last 10 years (2008 - 2018) were selected. The review summarises the available literature related to origin and method of delivering teledentistry and its use in dental practice and education. It shows that teledentistry has the ability to improve access to and delivery of oral health care at a relatively lower cost as well as supplementing traditional teaching methods in dental education. However, despite the promising nature of teledentistry in improving oral health care provision, it is associated with some attending problems and challenges.
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Background and aims Dentistry involve close face-to-face interaction with patients, hence during the COVID-19 pandemic, it has mostly been suspended. Teledentistry can offer an innovative solution to resume dental practice during this pandemic. In this review, we provide a brief overview of applications of teledentistry. Methods Articles on teledentistry, relevant to this review, were searched and consulted from PubMed, Google Scholar, and Cochrane database. Results Teledentistry is the remote facilitating of treatment, guidance, and education via the use of information technology instead of direct face-to-face contact with patients. Teleconsultation, telediagnosis, teletriage, and telemonitoring are subunits of teledentistry that have important functions relevant to dental patients. There are many challenges for acceptance of teledentistry by the dentists as well as patients, which need to be addressed urgently. Conclusion Teledentistry can offer a novel solution to resume dental practice during the current pandemic, hence, the need of the hour is to incorporate teledentistry into routine dental practice. If not fully replace, at least teledentistry can complement the existing compromised dental system during the current pandemic.