Teleoral medicine towards accessible healthcare
i must admit
my favorite types of movies used to be
about apocalypses and pandemics
worldwide contagion outbreak
i don’t quite look at them the same way
anymore if there was a movie that i
thought i would be living out in real
life
this was not it it is incredible how
something so small and infinitesimal
has changed life as we know it however
things are looking up
on the bright side every day that goes
past we are learning on how to better
manage this
and on the bright side and this must be
everyone’s favorite thing to do
you can now visit the dentist yay
now at the peak of the outbreak in perth
one of the things that i was thinking
was
gee i hope i don’t have to see the
dentist during this time
well i’ve never had a toothache before
and nobody ever really wants a toothache
however i knew that it would be very
difficult to get in with my dentist
during this time
now you may not be aware but the dental
service industry in australia during
that time was under service restrictions
and the reason for this was multi-fold
first off the elderly immunocompromised
and the recently overseas needed to stay
home
some dental procedures like using a high
speed drill
can produce aerosols which is where
where particles in the saliva
are suspended in the air and this
actually puts the dentist and their team
most at risk
there was also the concern that we would
run out of personal protective equipment
like masks and gloves and we needed to
save those for frontline medical workers
now i’m a dentist myself and i know that
the dental practice is one of the
cleanest places that you could be in
because it is always being scrubbed and
sterilized
i also knew that if i were to really
have a toothache there would be multiple
private and public practices still open
to address urgent dental patients
but still i tapped my teeth together
nervously and prayed that it wouldn’t
happen
my husband is an engineer my
sister-in-law is a school teacher
my best friends are a lawyer an i.t
specialist and a fashion designer
now can you guess what was the one thing
that they all had in common during this
time
they were all able to work from home now
i’m not taking away from the challenges
of working from home
i know that there were issues with
accommodating to the change in working
space and pace
but they had the luxury to do something
that i and many other dentists were not
able to do
they could work from home now you might
be thinking
can a dentist can’t work from home can
they well that was one of the questions
that myself and the team at the
australian dental association of western
australia
set up to try to solve the concept of
tele-dentistry
or providing patients health information
without the need for a face-to-face
consult is not new
and we didn’t invent it however the
covet 19 pandemic gave us the impetus
and drive
to make this feasible accessible and
practical
and quickly to boot so how do you start
tackling a problem like this
where do we start well first of all
is this something that patients would
even want is there demand for
it you already know that i’m a dentist
i’m also a dental specialist an oral
medicine specialist
or what you might be thinking that’s
okay you’re not alone
there are only 33 oral medicine
specialists in australia so not
everybody knows what we do
in a nutshell we see a wide range of
oral facial conditions
now some of the more urgent things that
someone may want to see us for include
oral cancer
and oral facial pain during this time i
consulted with several patients
mr x who was from geraldton was
suffering acute jaw pain and was not
able to open his mouth
mrs y had a suspicious ulcer involving
her tongue that had been
that had been present for a long time
mrs z had oral burning and needed to
renew her script
and the list goes on and i know that my
experience was not unique
so there definitely is a need for oral
medicine and
dentistry services to continue during
this time do patients and dentists
have the technology and equipment to
make this work and if they have the
equipment
do they do they know what to do with it
well the good thing is that the
equipment and technology required for
tele dentistry is actually fairly
minimal
ideally what you would have is three
things an internet connection audio and
a camera
however even if you don’t have that a
phone line is sufficient to do a phone
consultation with the patient
so while teledentistry as a concept is
not new
many dentists had never done this before
so we needed to look closely at the
potential pitfalls
that may be facing the clinicians or
patients and these were numerous
they include patient security and
privacy record keeping
and medical legal considerations let’s
summarize the latter
the inability to perform a physical
examination may increase the risk of
misdiagnosis
there may be fragmentation of care where
the clinician that you’re consulting
with remotely is not your usual
clinician
many times a tele-dentistry concept will
need to be supplemented by a
face-to-face consultation
afterwards and of course anyone who has
been online knows that security and
privacy
is something that is important and
difficult to maintain
so while i looked into these and wrote a
guide to teledentistry
my friends at the australian dental
association of western australia
started lobbying health funds to make
this service accessible to patients
doctors sean archibald and david hallett
did a fantastic job
and the dental association soon unveiled
a new item number
to be able to provide this service and
the health insurance fund of australia
came on board i started to share my
experience with other medical
professionals and allied health
professionals
in that space to try and build the
networks and groundwork necessary
to bring this into the future now you
might be thinking why do we need to
bring this into the future can’t you
already see a dentist face to face
would you like to see your dentist via
computer screen
now it is clear that tele-dentistry is
not a substitute for dentistry
you will not be able to have a filling a
root canal treatment or have your tooth
extracted
via talent dentistry you will need a
face-to-face consult
however there exists a need for this
service in the armamentarium of a health
professional in today’s world
for starters it reduces their barriers
to care and improves access
particularly for patients in the remote
and regional areas
australia is a vast country sparsely
populated
with many remote and regional
communities that do not have the same
access to healthcare
you know that there are 33 oral medicine
specialists in australia
there is one per seven hundred thousand
australians to give you an idea of the
scale that is one specialist
for the population of england and
scotland combined and this statistic
only comes into play
if the population of australia was
homogenously scattered but we know that
that is not the case
let me paint a better picture for you
there is one oral medicine specialist
for a land mass three and a half times
the size of tasmania
if you are lucky or you may have access
to several specialists
if you live in a capital city so i know
that this is a
experience that is not limited to oral
medicine there are many other medical
specialties and allied health that have
the same experience
so tele-dentistry could be the answer to
help solving this disparity
it is still too soon for me to watch
pandemic movies brad pitt or not
however if there is a silver lining to
the coefficient 19 pandemic
it gave us the ignition to try and
address one of the biggest problems
facing health care
dentistry and oral medicine which is
reducing the barriers to access
now i know tally dentistry is not the
magic answer and there are many
limitations
however it feels like we are further
along the path today than we were
yesterday
have a clear plan moving forward and
have helped patients along the way
and i really could not ask for more so
today i would like to challenge you
to think about one of the problems
that’s facing your industry or your
community
what can you do to change it
you