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Teledentistry-Assisted Affiliated Practice Model

This innovative program enables Arizona residents to receive necessary dental care through a low-cost, dental hygiene-based approach.

Since 2004, Arizona has allowed qualified dental hygienists to enter into an affiliated practice relationship with a dentist to provide oral health care services for underserved populations without supervision in public health settings. Northern Arizona University’s Dental Hygiene Department in Flagstaff has developed a teledentistry-assisted affiliated practice dental hygiene model that places dental hygienists in the role of the mid-level provider as part of a digitally linked oral health care team. Easy-to-implement digital technologies allow the affiliated practice dental hygienist to digitally acquire and transmit diagnostic data to a distant dentist for triage, diagnosis, and referral, while providing preventive services.

Figure 1. A dental hygienist uses a handheld X-ray device in this teledentistry model.

The dental hygienist uses a laptop computer, dental office management software, handheld X-ray device (Figure 1), phosphor plate X-ray image receptors or intraoral X-ray sensors, X-ray scanning device, intraoral camera, digital caries detection device, and an intraoral cancer screening device. Diagnostically efficacious patient data are acquired from remote areas as aseptically and securely as they are in the traditional dental office.


After completing the required training, dental hygienists are taught to set-up remote patient service facilities and transmit digital diagnostic data. Patients benefit by receiving preventive services locally, having their overall oral health evaluated by a professional oral health care team, and scheduling appropriate treatment with minimal travel time. Affiliated practice dental hygienists are able to provide preventive services in a mid-level practitioner model that promotes additional professional opportunities. The affiliated practice dentist can fill his or her appointment schedule with new patients who need dental services only a dentist can provide. Sponsoring agencies benefit by being able to provide more services for less cost.

From Perspectives on Dental Hygiene, a supplement to Dimensions of Dental HygieneNovember 2014;12(11):37.

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