POTENTIAL OF TELEDENTISTRY IN THE DELIVERY OF ORAL HEALTH SERVICES IN DEVELOPING COUNTRIES

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A.J. Tella¹, O.M. Olanloye¹ and O. Ibiyemi²

1. Dental Centre, University College Hospital, Ibadan, Nigeria.
2. Department of Periodontology and Community Dentistry, University of Ibadan, Nigeria.

Abstract

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.

Keywords: Telemedicine, Teledentistry, Rural, Remote, Developing countries

Introduction

In both developed and developing countries, the importance of adequate and everyday routine and emergency medical and dental services for everyone cannot be overemphasized. However, over the years, the need has arisen for a wider reach of these services where medical experts may not be readily available. This is particularly so for developing countries where access to qualified medical personnel especially specialists by residents of rural and remote areas still remains a challenge. Several barriers to oral health care in rural area have been found, these barriers include lower health care provider to population ratio, cost of dental care, poor infrastructure and inadequate dental facilities. Other barriers include longer travel distances to dental facilities, lack of transportation to obtain dental care, lack of awareness about oral health, geographic barriers to care, poverty and cultural barriers. As a result of this discrepancy in oral health care delivery and availability between rural and urban areas, different modalities have been explored one of which is teledentistry.

The term “Teledentistry” was first used in 1997, when Cook defined it as “… the practice of using video conferencing technologies to diagnose and provide advice about treatment over a distance”⁸. It uses electronic medical records, ICT and the internet to provide consultation at a distance⁸. Teledentistry can be applied in four ways namely teleconsultation, teleeducation, telemonitoring and telesurgery.

In teleconsultation, the local general dentist in a remote area can seek consultation from a specialist by transmitting data as the patients are being attended to or stored data of patients to the specialist. Practitioners in rural remote areas can receive continue medical education through interactive video-conferencing and web-based self-instruction which have been developed and stored.

Meanwhile in telemonitoring, patients’ condition can be monitored by the patient recording and transmitting data to physician by telephone, facsimile or the internet. Patients’ condition can also be monitored by continuous data collection and automatic transmission to another physician involved in the management of the patients. Using telesurgery, specialists in urban areas assist surgeons in rural remote areas via video and audio connections in the internet to provide adequate surgery to patients.

This technology allows collaborations between multiple dental practitioners with a view of reaching accurate diagnosis and adequate treatment plan of patients seen in areas where there is shortage or unavailability of dentists or dental specialists. Therefore, the purpose of this review is to investigate the history of teledentistry and its practical application in overcoming the rural-urban oral health care problems.