The next step for tele-dentistry

Dental Monitoring, a new smartphone-based tooth-correction-monitoring system, promises to transform how orthodontists treat their patients, writes Shane Conroy

When orthodontist Dr William Dabney, who practises in Virginia, USA, stumbled upon the Dental Monitoring display at a London conference, he immediately knew he was looking at a game changer.

The Paris-based company was debuting its new smartphone app that allows orthodontists to remotely monitor the progress of their patients’ treatments through the analysis of patients’ teeth using photos and videos self-shot through their smartphones.

Dr Dabney, who has been in private practice in the US for more than 30 years and later became the clinical director of Dental Monitoring for the US and Canada, saw the potential of Dental Monitoring as a tool to improve the care of his remote patients.

“Some of my patients live up to two hours from my practice, and I wanted to respect their time by not bringing them and their family into my office for what could be done with a phone call,” he says.  “I had been looking for something like Dental Monitoring for about four years, so I was immediately hooked.”

The rise of tele-dentistry

Tele-dentistry is not a new concept for Australian dentists. Internet giant Google backed a Victorian tele-dentistry trial in 2014 that found internet speeds between three and five megabits per second (Mb/s) would be required to run virtual dental appointments via live video calls.

As the NBN continues to be rolled out around Australia with the promise of providing 12 Mb/s at its lowest speed tier, that looks like an easy target to achieve. Indeed, another tele-dentistry trial by the University of Melbourne’s Institute for a Broadband-Enabled Society (IBES) involved visual examinations of 43 remote patients over the internet. More than half of the patients examined were saved a trip to Melbourne to see a dental specialist.

While results like that suggest tele-dentistry is here to stay, innovations such as Dental Monitoring are pushing tele-dentistry beyond clumsy live video calls and into the next generation of computer-assisted personalised medicine.

The Dental Monitoring app essentially turns your patients’ smartphones into remote monitoring devices. After the patient downloads and activates the Dental Monitoring app, the orthodontist sets text alerts that notify the patient when they need to take and upload photos or video of their teeth through the app.

The photos or video are sent to Dental Monitoring for analysis and tooth movement is measured against the last upload. The photos or video and a progress report are sent to the orthodontist, who can then communicate with the patient through the app.

For example, red alerts notify the orthodontist of an unexpected situation where immediate action is required, orange alerts recommend not-so-urgent treatment, and green alerts are issued when a treatment objective has been successfully reached.

Orthodontists can send corresponding messages to their patients through the app, either asking them to come in for treatment or reassuring them that their treatment is on track with no need for a face-to-face check up.

The move to personalised medicine

While Dr Dabney originally intended to use Dental Monitoring to save his remote patients the inconvenience of unnecessary face-to-face appointments, he quickly found he could also use the technology with his local patients.

“Taking digital scans is definitely more comfortable for patients than making moulds, [and] with Dental Monitoring, we know what work is required before a patient arrives for an appointment.”—Dr Vandana Katyal, CCC Smiles, Sydney

“I know in Australia patients can be hours away from treatment with some flying in from the outback, so remote monitoring makes complete sense for them,” he says. “But you can also use the technology for patients living in downtown Melbourne or Sydney to monitor their tooth brushing, elastics and your mechanics.

“Using Dental Monitoring for all my patients in this way has allowed me to make my practice proactive rather than reactive. By that I mean we can get ahead of problems and provide better treatment plans on a purely individual basis.”

It’s all part of the trend to personalised medicine that is revolutionising healthcare across the board as artificial intelligence and computer learning are increasingly used to provide individualised healthcare.

“Right now, artificial intelligence can diagnose skin cancer better than your dermatologist and predict your susceptibility to a heart attack more effectively than your doctor,” says Dr Dabney. “Dental Monitoring is based on an algorithm that continually improves on a deep learning curve, so I’m interested in the future data that will be able to tell us which treatment plans are more effective depending on how the patient’s body reacts.

“This is how personalised dentistry will replace medicine for the masses.”

Digitising dentistry

Orthodontist Dr Vandana Katyal owns CCC Smiles in the Sydney suburb of Mosman. She has embraced a fully digital workflow since opening the practice two years ago, and has been using Dental Monitoring for a little over six months, with more than 30 patients on the system.

“We are one of the very few practices to have no analogue treatment planning,” she says. “Everything is digital—from digital scanning to email automation for appointment reminders. Dental Monitoring has added to our digital workflow.”

Dr Katyal says that digitising the patient experience increases patient comfort and convenience, improves communication with patients, and gives her practice a competitive edge.

“We know that taking digital scans is definitely more comfortable for patients than making moulds, and patient education is much easier. When I show them a 3D computer simulation of what they will look like after treatment, they get it instantly,” she says.

“And with Dental Monitoring, we know what work is required before a patient arrives for an appointment, which means we can be better prepared for appointments and not run over time.”

Dr Katyal says that Dental Monitoring not only improves patient care and saves unnecessary chair time which delivers a financial benefit to her practice, but also ensures she stays in contact with patients who may not be ready for treatment.

“Even if a patient is not ready for treatment yet, we can continue to build our relationship with them through Dental Monitoring. For example, they may need to be monitored so I can see when a baby tooth falls out or when their wisdom teeth erupt a little bit further. Then, when they’re ready for treatment, I can notify them through the app,” she says.

“I have no doubt in my mind that this is the way to go for every practitioner.”

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