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ADA updates teledentistry policy

Services ‘must be consistent’ with in-person standards

November 05, 2020

By Jennifer Garvin

The ADA has updated its teledentistry policy to better serve dentists who rely on this technology to take care of patients.

The ADA, which first adopted policy on teledentistry in 2015, believes that examinations performed using this technology “can be an effective way to extend the reach of dental professionals” and can also “increase access to care by reducing the effect of distance barriers to care,” according to Res. 16H-2020.

The resolution also noted that “teledentistry has the capability to expand the reach of a dental home to provide needed dental care to a population within reasonable geographic distances and varied locations where the services are rendered,” and that “in order to achieve this goal, services delivered via teledentistry must be consistent with how they would be delivered in-person.”

The policy was adopted during the 2020 meeting of the House of Delegates.

It goes on to say that services delivered via teledentistry “must be consistent with how they would be delivered in-person.” Examinations and subsequent interventions performed using teledentistry “must be based on the same level of information that would be available in an in-person environment,” and stressed that “it is the legal responsibility of the dentist to ensure that all records collected are sufficient for the dentist to make a diagnosis and treatment plan.”

Dentists who deliver, direct or supervise teledentistry services should be licensed in the state where the patient receives services unless otherwise authorized by a state’s dental board, according to the policy. Patients have the right to know the identity and qualifications of oral health practitioners involved in the teledental encounter, costs they are responsible for in advance of the delivery of services, and be actively involved in treatment decisions, according to the policy.

Other key sections in the policy include quality of care, supervision of allied dental personnel, additional patient rights and technical considerations.

Teledentistry can take a number of forms, according to the resolution, including:

Synchronous live video. A two-way interaction between a person (patient, caregiver or provider) and a provider using audiovisual telecommunications technology.
Asynchronous/store and forward. This is when recorded health information — such as radiographs, photos, video, digital impressions or photomicrographs — is transmitted through a secure electronic communications system to a practitioner. The practitioner then uses the information to evaluate the patient’s condition or render a service outside of a real-time or live interaction.
Remote patient monitoring. Personal health and medical information is collected from an individual in one location then transmitted electronically to a provider in a different location for use in care. This could be used in a nursing home setting or in an educational program.
Mobile health. Health care and public health practice and education supported by mobile communication devices such as cellphones, tablet computers or personal digital assistants. This could include apps that monitor patient brushing or other home care.

The resolution also states that dental insurers — both public and private — should cover services provided through teledentistry at the same level as if the services were delivered in a traditional in-person encounter.

The ADA mandates that all policies are reviewed every five years. For this resolution, the ADA Council on Dental Practice, in consultation with other ADA councils and specialty groups, took the lead on reviewing and soliciting feedback on the policy.