Teledentistry Offers Benefits to Both Patients and Clinicians

In 2024, the Health Resources and Services Administration reported that approximately 60 million Americans live in dental health professional shortage areas, representing 17.4% of the total population.¹ These regions lack oral health professionals and are unable to meet the population’s needs. Telehealth has emerged as a promising solution to bridge the gap in access to care, leading the way toward a more connected and responsive healthcare system.

           Telehealth has transformed healthcare into an electronic realm, enhancing efficiency and accessibility for both patients and providers.² The World Health Organization defines telehealth as the provision of healthcare in which the patient and clinician are not present in the same place but rather the care is provided via the exchange of information through electronic means.³ Telehealth appointments can be conducted through phone calls, video calls, and text messages.⁴

The substantial boom in telecommunication within healthcare surged during the COVID-19 pandemic. According to the Centers for Medicare and Medicaid Services, the use of telehealth increased from about 13,000 users a week before the pandemic to nearly 1.7 million users by the end of April 2020.⁵ The need for dental care accelerated the adoption of teledentistry.⁶

Modalities of Teledentistry

Teledentistry is an emerging mode of dental care that operates electronically by accessing medical and dental records, transferring digital images and radiographs, and facilitating communication between patients and providers.⁷ Teledentistry employs two modes of operation: asynchronous and synchronous. Asynchronous involves collecting and sending images, radiographs, and information to be evaluated later. Synchronous meetings involve real-time communication between patients and providers through video chat or phone calls.⁸ The advancement of technology has allowed oral health professionals to treat and communicate with patients more effectively.

Dentistry has experienced significant advances in technology. Digital radiographs, intraoral scanners and cameras, and electronic management systems are just a few examples of the technological innovations currently transforming the field. These advancements have not only been proven to be efficient and accurate but also user-friendly and patient-oriented.⁹

Paul Glassman, DDS, professor and director of community oral health at the University of the Pacific Dugoni School of Dentistry in San Francisco, created the virtual dental home model, which is a community-based system of dental care in which patients receive oral healthcare in nontraditional settings, such as schools and long-term care facilities, via telehealth technology through synchronous or asynchronous options.¹⁰ The model enables populations that face barriers to accessing traditional dental care to receive the oral healthcare they need.

Teledentistry connects patients and providers electronically, making it especially valuable for individuals in rural communities, those who are homebound, or those facing transportation challenges — groups that often experience barriers to receiving adequate dental care.¹¹ Studies demonstrate that 38% of rural counties in the United States do not have dentists to serve their communities.¹² Rural communities face many barriers to dental care such as too few oral health professionals in a geographical are and lack of transportation, dental insurance, and specialty providers.^13,14 Teledentistry can complement in-person care by allowing diagnostics collected in settings such as schools, nursing homes, or patients’ homes to be reviewed later by an off-site dentist; this is an example of the asynchronous model.¹⁵

Teledentistry During the COVID-19 Pandemic

Teledentistry experienced a global demand during the COVID-19 pandemic. Oral health professionals were at high risk for COVID-19 exposure due to the number of aerosols and droplets encountered during patient care.¹⁶ Many offices closed in March 2020. The American Dental Association (ADA) Health Policy Institute reported that 76% of the dental offices they surveyed were closed but continued to treat patients for emergency care, 19% were closed completely, and 5% were open but with limited hours of operation.¹⁷ For offices that remained open, the risk of exposure motivated many oral health professionals to limit patient contact, if possible, by working through different electronic platforms.

With shutdowns preventing patients from visiting dental offices, the need for oral healthcare continued to grow. Concerns about infection control for both patients and providers created an impetus to use an alternative method for delivering dental services. Consequently, this outbreak triggered a surge in demand for information technology in healthcare.¹⁸ The pandemic presented one of the greatest challenges in healthcare, compelling professionals to swiftly adapt their patient care approaches.¹⁹

Teledentistry addressed access-to-care issues during this period by using telecommunication systems to facilitate consultations between patients and providers via video chat as well as screening and triaging. Timely consultations may help prevent serious consequences from a lack of treatment.²⁰

Teleconsultation allowed patients and providers to meet through video chat and discuss chief complaints or symptoms. Teletriage was commonly used during the pandemic to more effectively refer patients to specialists or to offices that were accepting emergency-only patients. This practice of immediate referral streamlined the process, ensuring patients who needed care immediately preceded those whose treatment could be deferred.

Another form of teledentistry is telemonitoring, which is used to track patients’ treatment progress and disease progression.²¹ During the pandemic, patients were able to stay connected with their oral health professionals even while under quarantine. Many oral health professionals liked using teledentistry because it was time- and cost-efficient, which resulted in continued use after the COVID-19 restrictions were lifted.²⁰

Current Uses of Teledentistry

Teledentistry continues to be used as part of a continued effort to bridge the barriers to care.²² In 2018, teledentistry generated $38 billion in revenue, a figure projected to triple to $130 billion by the end of 2025.¹⁹ According to the ADA, teledentistry technology delivered asynchronously and synchronously will be covered by public and private programs as if they were delivered in person.²³

The ADA has officially created two current dental terminologies explicitly for teledentistry (Table 1). Both codes are reported in addition to other procedures delivered to the patient on date of service.²⁴ Many states have not yet begun to comprehensively embrace the use of teledentistry. Each state has regulatory bodies within its governing system that dictate laws and regulations regarding the provision of oral health service and these vary widely across the US.²⁵ The governing systems that regulate teledentistry laws vary by state, encompassing dental practice acts or dental board authority, telehealth/telemedicine statutes or regulations, dental board directives, and Medicaid regulations.

Not only do regulatory bodies differ among states, but the types of permissible teledentistry services also vary. While some states allow only video chat services, others permit both video and audio services. Additionally, the accepted modalities range from exclusively synchronous sessions to both asynchronous and synchronous meetings. State legislation on teledentistry spans from highly detailed and specific to broad statements open to interpretation. The US lacks a nationwide regulatory framework for teledentistry.²⁶

Clinical Applications of Teledentistry

Currently, oral health professionals are successfully using teledentistry during various clinical applications such as while providing guidance with at-home fluoride varnish applications, interviews for oral-systemic health management goals for patients and caregivers, oral hygiene instructions, supporting pain management strategies, evaluating dental conditions and abnormalities, pre- and post-operative consultations, nutritional counseling, and tobacco cessation.²⁷ For example, at-home fluoride varnish applications are facilitated by sending fluoride kits directly to the patient’s residence. An oral health professional then meets with the patient and his/her parent/guardian via telecommunication platforms, such as videoconferencing, to provide step-by-step guidance on proper application techniques. This process ensures that patients receive professional support while completing the procedure in a convenient, home-based setting.

Teledentistry benefits those who face barriers to care such as geographical distance to a dental provider, difficulty in taking time off work, or advanced age. Hybrid approaches are also used that begin with a teledentistry meeting with a licensed dentist to discuss chief complaints, medical history, and treatment options. Further into treatment, the patient can be referred to a specialty office, or an allied dental professional can meet at the patient’s residence to deliver further treatment.

Allied dental professionals can also gather photos and diagnostics to send to the supervising dentist to make further treatment decisions and evaluate treatment outcomes as well. General dentists and specialists can also share these diagnostics to ensure the best possible outcome for their mutual patient.²⁶ This approach is particularly beneficial for homebound patients and older adults.²⁷

Teledentistry is also used in mobile dentistry programs, which improve access to care for children in low socioeconomic and rural areas by providing treatment in alternative setting such as Head Start programs and school-based health centers.²⁸ Prophylaxes, dental exams, radiographs, and the application of sealants and fluoride varnish are examples of services provided through mobile dentistry programs. Research shows that teledentistry results in a 10% to 15% cost savings compared to in-person visits.^29,30

Evidence suggests that dental hygienists are uniquely positioned to support and, in some cases, lead teledentistry initiatives, particularly in preventive care, diagnostics, case management, and community outreach. For example, a study found that dental hygienists were able to identify dental caries via teledentistry with accuracy comparable to dentists in children ages 4 to 7.³¹

Dental hygienists can participate in on-site, school-based programs where they collect diagnostic information including radiographs and intraoral photographs. These diagnostics can be transmitted to an off-site dentist via telehealth systems. Subsequently, the dentist provides the diagnosis and develops treatment plans for both restorative and preventive care.

These findings underscore how dental hygienists can meaningfully engage in remote screening, intraoral imaging, patient education, preventive protocols, and virtual follow-up. As reimbursement models, legislation, and digital infrastructure evolve, dental hygienists may increasingly serve as the “telecare bridge” between patients and supervising dentists, especially in underserved or rural settings.

Conclusion

Teledentistry — an efficient and cost-effective mode of dental care —is a promising solution to expanding access to care, especially for vulnerable populations. This approach has gained significant traction since the COVID-19 pandemic due to government-mandated shutdowns and quarantine protocols. Following high satisfaction rates during the pandemic, many states have continued to use teledentistry to address the challenges patients face in accessing dental offices or health centers. Some states have specified guidelines on the practice and scope of teledentistry, clarifying how oral health professionals should operate within their regions. However, many states still need to establish legislation regarding teledentistry to enable both patients and providers to effectively utilize this mode of dental care. The use of teledentistry is not consistent throughout the US and is nowhere near the utilization of telehealth on the medical side. This may be due to oral health professionals’ lack of knowledge regarding teledentistry or laws and regulations that limit teledentistry’s use.

Teledentistry should be encouraged for adoption in dental practices and oral health professionals should embrace technological advancements regarding telecommunication for the benefits of their practice and their patients.

References

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From Dimensions of Dental Hygiene. November/December 2025; 23(6):18-21.