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Don’t Practice Teledentistry Using a Rube Goldberg Machine

It is heartening that across the nation more and more dentists are trying their hand at using teledentistry during the COVID-19 pandemic. The ATDA has fielded many calls from clinicians who don’t know where to start. In an earlier blog, we presented a quick start framework for where to begin. Many clinicians who got up and running have expressed frustration in the work flow and actual operations that they implemented in the past few weeks. What it has come down to is whether an asynchronous (store and forward) or synchronous (live) system was chosen. I have practiced both types of teledentistry. They each have an important role in teledentistry. Different experts have shared their opinion in recent trade articles. I would like to share my experience. Digital photos from an asynchronous methodology are better diagnostic tools. By virtue of most smartphones having very high resolution and the possibility of taking pictures close to the oral cavity, the clinician can see great detail to differential determine the problem. Digital video from an asynchronous methodology permits real-time face-to-face communication with patients versus conversation via text messaging but fails to often have the same resolution when a desktop/laptop camera is used (lighting, distance from oral cavity). The caveat here is that intraoral cameras do exist and are high resolution but they are not economically practical for the patient to have for at home use. Peer-reviewed dental literature on teledentistry methodologies appears to have borne these opinions out in the few studies that have been published.

The point of this blog is to say, don’t get frustrated!  Try different methods and determine for yourself what works best for what situation. Remember, the goal is access to care for the patient and the benefit for the clinician is greater efficiency, effectiveness, and cost saving to render that care.


Good luck!

Marc Ackerman, DMD, MBA, FACD

Executive Director, ATDA

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