presentation about teledentistry

1. GOOD MORNING
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2. TELEDENTISTRY
SHIFAYA NASRIN
CRRI
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3. synonyms
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TELEDENTISTRY
TELEHEALTH
TELECONSULTATION
E-HEALTH

4. INTRODUCTION
• Dental care is being constantly transformed by
the opportunities which are provided by
technology and telecommunication
• Teledentistry is a relatively new field that
combines telecommunication technology and
dental care.
• Due to the enormous growth of technological
capabilities, teledentistry possesses the potential
to fundamentally change the current practice and
the face of the dental care
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6. TELEDENTISTRY
Cook defined it as “the practice of
using video-conferencing technologies
to diagnose and to provide advice
about the treatment over a distance”
TELEMEDICINE
“the combined use of
telecommunications and computer
technologies to improve the efficiency
and effectiveness of health care
services by liberating caregivers from
traditional constraints of space and
time and empowering consumers to
make informed choices in a
competitive marketplace”
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7. BENEFITS OF TELEDENTISTRY
Improved
access
Cost
efficiency
Patient
demand
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8. Dentists and dental hygienist in remote areas can link to
specialists in larger communities through teledentistry.
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9. HIGHLIGHTS OF TELEDENTISTRY
• Improve access to care
• Improve the delivery of health care,
• Lower its costs.
• Needed resource for dental consulting,
• Referral for specialized care,
• Dental monitoring,
• Dentist-laboratory communications,
• Continuing education.
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10. • Prime Minister, Julia Gillard, and Minister for Broadband, Communications
and the Digital Economy, Senator Stephen Conroy, look on Associate Proffesor
Matt Hopcraft conducts a teledentistry trial at Melbourne University.
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11. SCOPE OF TELEDENTISTRY IN INDIA
India has opened up to telemedicine to address
various issues like:
• inadequate health infrastructure and clinical
services,
• paucity of qualified doctors,
• non-availability of specialist care,
• the late discovery of the ailment,
• the delay in the delivery of the treatment due to
the greater time required for the transport of the
patients to urban healthcare facilities and the
provision of healthcare by inexperienced primary
healthcare service providers. 11

12. • In 1999, the Department of Information
Technology, the Ministry of Communications
and Information Technology (Government of
India) launched a pilot project which was
entitled, ‘Development of Telemedicine
Technology’, with the objective of reinforcing
the national healthcare delivery system
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13. The key specifications of the project
include
 To identify the appropriate technological
tools and services required to implement
telemedicine at the three premier hospitals
• All India Institute of Medical Sciences
(AIIMS), New Delhi,
• the Post Graduate Institute of Medical
Education and Research at Chandigarh
• the Sanjay Gandhi Post Graduate Institute of
Medical Sciences at Lucknow (Uttar Pradesh).13

14.  To develop and carry out system integration
to enable telemedicine technology and for
establishing telemedicine services
(teleconsultation and telediagnostic services
for the specialties of radiology, cardiology and
pathology and teleeducation) at three tertiary
level hospitals.
 To train clinicians in the use of telemedicine
technology
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15. Forms of teledentistry
Real time
consultation Store and
forward
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16. Real time
consultation
transfers the
information
immediately
dentist and patient at
different location can see,
hear and communicate with
each other using advanced
telecommunication
technology
Store and forward
allows data to be
stored in a local
database to be
forwarded as needed.
collecting all the patient
information and images ,storing
that data for review by a dentist
specialist at a later time. Later,
the dentist reviews the
information make a diagnoses
and a treatment plan.
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Real time consultation
Store
and
forward

18. TELEDENTISRY SERVICES
SPECIALIST
REFEREL SERVICES
PROFESSIONAL
EDUCATION
Patient
consultation
CONSUMER
MEDICAL AND
HEALTH
INFORMATION
REMOTE PATIENT
MONITORING
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19. • POTS (plain old telephone system)
• Networked programs
• Point-to-point connections
• Primary or specialty care to the home
connections
• Home to monitoring center links
• Web-based e-health patient service sites
TELEDENTISTRY DELIVERY
MECHANISMS
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20. • Networked programs link hospitals and clinics
with outlying clinics and community health
centers in rural or suburban areas by the use of
dedicated high-speed lines or the Internet
• Point-to-point connections using private
networks , used by hospitals and clinics that
deliver services directly, or contract out
specialty services to independent providers, at
ambulatory care sites
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21. • Primary or specialty care to the home
connections involves connecting primary care
providers, specialists and home health nurses
with patients using single line phone video
systems for interactive clinical consultations
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22. • Home to monitoring center links are used for
patient monitoring, home care and related
services that provide care to patients in the
home, using normal phone lines and internet
• Web-based e-health patient service sites
provide direct consumer outreach and
services over the Internet. Under
telemedicine, these include sites that provide
direct patient care
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23. Technology and Equipment for
Designing a Teledental Model
There is not a recommended list of equipment,
hardware or software for designing a teledental
model.
 Factors determining selection of technology
and equipment for designing a teledental
model:
- budget,
- Technology
-infrastructure
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25. COMPONENTS THAT FACTOR INTO
DESIGNING A TELEDENTAL MODEL
information
technology (IT)
infrastructure,
networks,
telecommunication
services,
data security,
real time video
conferencing vs.
store and forward
communication,
comfort with
technology
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26. TELEDENTAL APPLICATION SOFTWARE
Dental
management
software
Imaging
software
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27. FOUR COMPONENTS TO CONSIDER
WHEN CHOOSING MANAGEMENT
SOFTWARE
Dental records
Dental billing
Appointment scheduling
Reporting requirements
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28. • Dental records – allows for the collection of
data critical in the clinical management of
patients, including patient charts and
histories.
• Dental billing – may be a factor in choice of
software. The billing and revenue component
of management software allows for the
management of patient financial records.
•
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29. • Appointment scheduling – management of
appointments and scheduling can be a part of
the management software. The software is
designed to track patients from the moment
they are entered into the system and also
tracts missed, rescheduled, and canceled
appointments.
• Reporting Requirements – Most dental
management software has built in reports.
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30. TELEDENTAL EQUIPMENT
Extra oral digital camera
Intra oral digital camera
Video conferencing system
Digital radiographic system
Portable dental radiographic system
Laser and Fluorescence Caries Detection Devices
Computer
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33. ORAL MEDICINE
• High resolution images and a broad spectrum
of colors (32-bit or more), is able to provide
high quality consultation even with the
colleagues at a distance of several hundreds of
kilometers (between two or several experts at
a time) lesions are electronically
photographed using a 50 mm macro lens and
circular illumination system, and clinical and
anamnestic data are stored in a textual file
with minimal resolution of 600 dpi.
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34. • The files are renamed according to the
patients’ identification numbers in order to
avoid confounding and identity errors.
• Specialist then analyze independently the
obtained images and clinical information. They
make the diagnosis (usually one or two) and
electronically return the results
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36. Through teledentistry consultations and imaging, diagnosis of oral
pathology and oral conditions in remote areas can be improved
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38. PROSTHODONTICS
CAD- CAM
 Dentists and dental technicians who are not
very skillful , the usual practice is to request
teledentistry help of computerized dentistry
specialists.
 The resulting project file is encrypted and sent
by e-mail to a teleconsultant for model analysis,
projection of the shape of restoration, of its
height and interjaw relationships using a virtual
articulator
 The completed project is then encrypted and
returned to the clinic, usually by e-mail
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39. PEDIATRICS AND PREVENTIVE DENTISTRY
• reducing their fear and anxiety in children
compared to clinical examination in real time.
• An intraoral camera - take dental photographs
from any available angle; in addition,
sufficiently strong and focused illumination
from the camera itself is required, as well as
optical or software reduction of light reflected
from the smooth surface of the teeth.
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40. • Together with high resolution, the obtained
digital image is able to demonstrate initial
caries stages or enamel and dentine
pigmentations.
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43. ENDODONTICS
• Teledentistry methods based on internet,
diagnosis of periapical lesions can be adequately
assessed.
• Based on that, a necessary plan can be devised
for a proper endodontic or oral surgical
management of these lesions.
• Teledentistry based on internet as a medium for
distant communication enables its use
worldwide, wherever the world wide web is
present as a wire or wireless connection,
reducing the costs of management and increasing
the availability of urgent help to all patients
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45. The method is based on the creation of digital
information for each of the teeth of interest
sequence of digital extra oral photographs
(frontal and bilateral),
• sequence of digital intraoral photographs
(vestibular portion of the alveolar ridge in the
area at the level of tooth root, palatal/lingual
portion of the alveolar ridge of the target
tooth, and dental crown),
• retro alveolar dental digital x-ray,
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46. • anamnestic information in the format of text.
• Using mobile Internet connection, photographs and
text are uploaded to an on-line server.
• Distant consultants, specialist in endodontics, are
informed via their mobile phones about the received
request,
• after which they download the digital images and
accompanying data. They establish the diagnosis and
suggest a treatment, then post these information on an
on-line server, which informs the consultation-
requester dentist about the received response
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47. ORTHODONTICS
• Orthodontic specialists, after taking dental
impressions of the jaws, instead of casting jaw
models in plaster, send the impressions by
special postal service to specialized companies
for 3D digitization of working models;
• then they create digital 3D models using
patent-protected systems for 3D scanning and
digitization, form a computer file, and return it
via Internet to the therapist.
• The therapist share this digital model of the
jaws with others via network, effectuating
necessary consultations with his colleagues.
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50. ORAL AND MAXILLOFACIAL SURGERY
• The advances and availability of smartphone
technology have contributed to the feasibility
and availability of telemedicine in oral and
maxillofacial surgery.
• Smartphones are able to read and display 3D
computer reconstructions of head skeleton,
giving instantly the necessary information to
distant teleconsultants in oral and
maxillofacial surgery.
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52. • Even on the move, they are able to record the
consultation and send an answer.
• It is very useful in emergency conditions
requiring immediate interdisciplinary
consultation.
• Maxillofacial surgeons are thus able to monitor
the condition of their patients even after very
complex interventions, such as osteotomies,
removal of ameloblastic fibromas, and so on
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53. • Implant placement
• Complicated impaction removal
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56. TELEDENTISTRY AND ITS USE IN
RURAL AREAS
• In rural areas, shortage of specialists, the lack
of comprehensive and sophisticated health
care is a problem.
• increase the accessibility of the specialists to
the rural and underserved communities for
their dental needs, decreasing the time and
the cost which are associated with the
speciality consultations
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57. TELEDENTISTRY AND ITS APPLICATION
IN DENTAL EDUCATION
• The Web-based, self-instruction educational
system
• Interactive video-conferencing
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58. The Web-based, self-instruction
educational system
• Web-based dental continuing education or the
CE courses
• that lack of face to face communication with
their peers and instructors could result in
dissatisfaction.
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59. Interactive video-conferencing
Includes :
 a live interactive video-conference with a
proper camera set up where the patient’s
information can be transmitted
 supportive information (such as the
patient’s medical history, radiographs, etc)
that can be sent before or at the same time
(for example, via fax) as the videoconference.
The advantage - the user can receive an
immediate feedback
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60. TELEDENTISTRY AND ITS ROLE IN POSTGRADUATE
EDUCATION AND DENTAL PRACTICE
• Good tool for educating postgraduate students and for
providing continuing updates for the practicing
dentists.
• In interactive video-conferencing, the patient
information is evaluated first (with or without the
patient’s presence), which allows for the interaction
and feedback between the educator and the students.
• The patient cases can be reviewed thoroughly and at
the students’ pace. The cases can be discussed at
length after all the clinical data have been collected
and transmitted, without the patient being present at
the scheduled meeting. This enhances the students’
enthusiasm and provides new learning opportunities
for the dental students and the practicing dentists.
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61. TELEDENTISTRY IN VARIOUS
COUNTRIES
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Areas adoped
teledentistry
Service provided Technology
University of Minnesota
School of Dentistry
to increase access to dental
specialty care in rural Min
real-time videoconferencing
technology
The Melbourne Dental
School’s Oral Health
Cooperative Research
Centre
dental health care amongst
aged and remote patients
using the National Broadband
Network
Arizona Department of
Health Services, Office of
Oral Health (OOH)
Increase availability of the
oral health workforce and
accessibility of oral health
services to underserved
populations and
underserved areas in
Arizona
to increase access to dental
care for underserved and at-
risk populations
The Children’s Hospital Los
Angeles Teledentistry
Project, +
University of Southern
California’s Mobile Dental
Clinic
increases and enhances
the
quality of oral health care
provided to children living
in remote rural areas of
California,
ISDN

63. Challenges……
• The teledentistry examination is not a face-to-face. You
have to rely on judgment of the other practitioner’s
examination.
• Productivity can be another issue as new practitioners
become accustomed to the technology.
• Teledentistry initially takes a longer time compared to
their regular office visits. When they get used to the
system, they get more efficient.
• In India uneducated population, below the poverty line
and lack of infrastructure is major challenge.
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64. Future prespective of teledentistry
Various measures that can be employed for the effective
implementation of teledentistry are:
• The instructors of the teledentistry education courses
need to be well versed with computer knowledge and
they should have adequate teaching experience
• The practitioners who are engaged in teledentistry must
have a license in each state in which they practice
• Dentists who are engaged in teledentistry must make
every effort to ensure the security of their systems, as
well as of any data that they may transmit.
For example, data encryption, password protection and
user access logs can help in deterring most of the
people and in protecting patientconfidentiality 64

65. conclusionWith all the technological developments taking place
in the field of teledentistry, practitioners may
eventually link up to virtual dental health clinics and
an entirely new era of dentistry can be created. The
future might also see distant telemedical control of
robotized instruments in situations with long-term
unavailability of dental care, e.g., during space flights,
on transoceanic ships, and in various rural areas. The
results achieved so far are very encouraging, setting
the road signs for future investigations. However, a
number of things have to be addressed before
teledentistry can rise to its peak. Further studies
involving greater number of participants will be
required to validate the various aspects of teledental
applications. 65

66. REFERENCES
• Journal of Clinical and Diagnostic Research. 2011 November
(Suppl-2), Vol-5(7): 1486-1488
• International Journal of Clinical Cases and Investigations 2011.
Volume 2 (Issue 6), 49:53, 6th November, 2011
• Telemedicine in Dentistry (Teledentistry)
Branko Mihailovic, Milan Miladinovic and Biljana Vujicic
• Teledentistry an art and science of healing: rajan shilorkar ,
kosha pritesh ruparalia, chandra mani more, pritesh ruparalia
• Telehealth Technologies, Paul Glassman, Michael Helgeson,
Jenny Kattlove CDA journal ,volume:40, number: 7
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