Ivan José Correia-Neto; Gabriel de Toledo Telles-Araujo; Raquel D’Aquino Garcia Caminha; Liliane Lins-Kusterer & Paulo Sergio da Silva Santos
The year 2020 will be remembered as the year in which the Covid 19 pandemic precipitated an unprecedented major disruption in the healthcare system, which led to a period of greater appreciation and expansion for Telemedicine. According to the World Health Organization (WHO), Telemedicine is defined as the use of telecommunications and virtual technologies to provide health outside traditional health facilities (Dasgupta & Deb, 2008; Telles-Araujo et al., 2020; Sen Tunc et al., 2021).
With the advance of the COVID-19 pandemic, many countries stopped several activities considered “non-essential” due to the need for social isolation and face-to-face care in dental clinics as part of this category. Therefore, the only alternative to alleviate the clinical challenges of the physical distance between patient and professional and not leave the first unattended was to amplify the use of Teledentistry. Specifically, focused on the provision of remote oral health services to reduce the need for physical contact between the patient and the health care provider (Telles-Araujo et al., 2020).
Unsurprisingly, Teledentistry is becoming popular and more widespread, which has led to more professionals using this technology in their isolation daily clinical routine. In addition to facilitating the communication and interaction between dentist and patient, it also promotes interest in communication between the health care providers (Jampani et al., 2011). Besides minimizing geographic and temporal barriers, this tool can fill gaps in the heterogeneous distribution of the provision of oral health care. It also includes the possibility of specialized teleconsultation for generalist dentists in the public network. Therefore, this resource can reach a substantial number of people, providing more benefits for those who live in remote areas or attend underdeveloped health care units (Dasgupta & Deb, 2008; Jampani et al., 2011; Giraudeau et al., 2021).
Teledentistry aims to reduce inequality access, triage cases with possible severe morbidity, and allow through online transmission the control of patients with lesions who were already under periodic follow-up. For those who are unable to return to the office for some situation despite the pandemic, this tool can also help to define the best moment and the need for a face-to-face consultation (Jampani et al., 2011; Correia Neto et al., 2021). It makes this modality a good resource for optimizing and reducing office visits and does not compromise the necessary check-ups (Maspero et al., 2020; Suter et al., 2020).
Due to its increase in the pubic calamity for the past two years of the pandemic, it is important to emphasize there are limits in the practice of it. For example: when the individual is seen by a dental professional for the first time, they are not allowed to perform diagnosis, prescription, and definition of a treatment plan according to the Brazilian Resolution of the Federal Council of Dentistry (RESOLUTION CFO-226, of June 4, 2020) (Conselho Federal de Odontologia, 2020). The Resolution also clearly states the obligation to record all care provided remotely.
In the current scenario of COVID-19, Teledentistry has brought numerous advantages (Table I), but nothing can compare to the accuracy of the patient's clinical-in-person diagnosis (Fricton & Chen, 2009; Bradley et al., 2010; Daniel & Kumar, 2014; Estai et al., 2016, 2017). Teledentistry has its gains and limitations (Table II), which generates a lack of acceptance on the part of dentists, considering it complex, making them resistant to new skills (Fricton & Chen, 2009; Bradley et al., 2010; Daniel & Kumar, 2014; Estai et al., 2016, 2017; Meurer et al., 2020).
Some professionals believed that this modality of dental care would be “cold” and “distant”, however over time it was observed that some patients reported being more satisfied (Bradley et al., 2010; Estai et al., 2016, 2017) After all, it is clear that the absence of physical contact needs to be rewarded by empathic skills in online communication, such as listening, showing attention, ensuring verbal clarity, adequate facial expression, and coherent intonation. Online consultations allow the exchange of different types of data, such as written or voice messages, as well as therapeutic suggestions, video messages for a better assessment of the patient's needs, and descriptions of the problems in their own words. It is known that high-quality images are the most common means of communication in Teledentistry, which highlights the importance of investing in Teledentistry due to the practicality and low cost that a system can offer to clinicians and patients. In the current context, it is a necessary measure for accessibility between the patient and the healthcare provider.
Although we agree with Meurer et al. (2020), when the author states that the choice of software and applications for Teledentistry practice should follow the LGPD guidelines for a safe, efficient, and risk-free practice for the patient and professional. Instant messaging applications (WhatsApp, Telegram, Instagram, SMS, Messenger) and video calling applications (GoogleMeets, Skype, Facetime, WhatsApp) has become a fundamental and accessible tool to fill the gap the pandemic brought to the health care system. Those applications are popular and reachable for the population, since they are used from their smartphones. Several studies have addressed the benefits and contribution of Whatsapp for teledentistry (Pentapati et al., 2016; Koparal et al., 2019; Gebbia et al., 2020; Tamba et al., 2021).
How to cite this article
CORREIA-NETO, I. J.; TELLES-ARAUJO, G. T.; CAMINHA, G. R. A.; LINS-KUSTERER, L. & SANTOS, S. P. S. Teledentistry: Main concerns in the new pandemic era. Int. J. Odontostomat., 16(4):460-462, 2022.