The Reality of Virtual Dentistry

By utilizing virtual methods to perform some of the non-surgical parts of practice—eg, consultations and diagnoses based on oral history—dentists can use more of their time performing high-production procedures, while simultaneously offering a convenient service to existing or potential new patients who might truly appreciate the ability to tackle many of their dental needs from home or work.

Patients looking for a new dentist currently have to sift through results of Internet searches, recommendations from friends, and dentists on a list of providers belonging to their PPO. However, now companies with established connections to practitioners can enable prospective patients to interview several dentists virtually regarding their dental needs so they can select one based on the virtual responses they receive.

For example, HealthTap (healthtap.com), a Palo Alto, CA–based healthcare startup, recently enabled member dentists to have “virtual office hours,” during which existing patients of their practice or potential new patients referred by HealthTap can request and receive video consultations. These consultations could also include uploading digital radiographs from previous dentists and oral images taken by themselves or another dentist along with their histories and treatment plans. HealthTap even handles collecting the fee from the patient for the dentist and provides numerous services to publicize the dentist’s virtual practice. Some of the services that could be handled during these virtual visits are postoperative evaluations, follow-ups for patients experiencing excessive discomfort after a procedure, consultations performed after a diagnostic-records-only appointment, treatment plan presentations, evaluation of facial swelling, etc.

Another virtual dentistry service is offered by Oral Eye (oraleye.com). This Irish-founded company has already signed on with Careington, a major player in the US insurance market, to allow its subscribers to connect with dentists via its iPhone app. The app has a unique interface that guides patients through a series of templates that use the built-in camera on the iPhone to take a standardized series of intraoral and extraoral photographs that become part of their record along with a narrative of their complaints and symptoms. Patients select from one or more dentists who have signed up with Oral Eye to submit their records for an opinion on their dental needs. Dentists can choose whether or not to charge a fee for their consultations when they sign up with Oral Eye; these fees are collected by Oral Eye and paid to the dentist. Dentists can then review requests at their leisure—or make good use of time unexpectedly freed up due to a cancellation or a procedure that went quicker than expected—and respond to the patient via the app with recommendations, which in the case of a prospective new patient, might translate into an office visit.

Toothscan (toothscan.net), a UK startup still in the prototype stage, has developed a home scanner that looks like a toothbrush. It emits a near-infrared low-wavelength light capable of detecting variations in density of teeth—ie, incipient or significant tooth decay—somewhat like a personal caries detection aid. The company hopes the device will be available to the public in the fall for about the cost of a high-end ultrasonic toothbrush. The device will work with a smartphone app that will show a diagram of the mouth and give results by having individual teeth glow green, yellow, or red. Consumers can also pair their device with their dentist’s office, so the dentist can get a report of their results and consult if necessary. Treatment recommendations for remineralization techniques can be instituted where appropriate, and this wellness center of the dentist’s practice can become an added profit center that simultaneously provides beneficial and conservative services to existing patients while also attracting new patients.

Another use of virtual dentistry has already been implemented in a pilot program developed by the University of the Pacific Dental School in San Francisco. Originally rolled out in nearby San Mateo County, the program, called “Virtual Dental Home,” uses the services of a registered dental assistant (RDA) or registered dental hygienist (RDH) who travels to underserved areas with a portable kit containing a collapsible chair, laptop, digital camera, and handheld x-ray unit. The RDA or RDH sends images to a dentist in an office remote to the patient, and the dentist can then make a diagnosis and prescribe appropriate treatment that may or may not involve the need for an office visit. The vision is to expand this program nationally and potentially internationally.

In the field of continuing education, Nobel Biocare (nobelbiocare.com) has taken its implant training classes to the next level with the utilization of virtual reality headgear made by Oculus Rift (oculus.com), which debuted earlier this year at conferences in Cologne, Germany, and San Francisco. The experience is enhanced by a 360° video, which is viewed in a custom-made virtual reality software application that is controlled by a touchless user interface and driven by head-tracking technology attached to the mask. The gyro sensor of the Oculus Rift Development Kit 2 detects how users move their head and adjusts the view accordingly to provide a stunning virtual reality experience where users feel as if they are the surgeon. Eventually, this technology could be used to enhance patient education as well as virtual consultations.

Embracing technology in the dental office means continually being open to ideas that allow practitioners to be more efficient and provide extra convenience for the patients they serve. Dentists who limit their use of technology to direct patient care in the office may find themselves at a disadvantage compared to colleagues who embrace virtual dentistry as an additional tool in their practice armamentarium.

The author’s son is the CEO of Facebook, which owns Oculus Rift.

Edward J. Zuckerberg, DDS, FAGD
General Dentist in part-time practice
Palo Alto, California
Owner
Painless Social Media LLC