Teledent—Australia’s first online radiology reporting service

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Teledent
Photography: Elizabeth Bull, Lizzy C Photography

An unforeseen health issue saw Dr Louise Brown create Teledent, Australia’s first online radiology reporting service. By Kerryn Ramsey

When Dr Louise Brown launched Teledent in 2015, all the other dental maxillofacial radiologists in Australia were working for medical radiology practices. Patients would be referred by dentists to get their X-rays taken, but no-one was available to specifically report on OPGs and CBCT images taken in-house by dentists. Dr Brown was certain that by making it easy for dentists to have their images interpreted and reported upon by a specialist, Teledent would fill a niche in the market.

The business is in very good hands as Dr Brown is a registered specialist in the fields of dento-maxillofacial radiology, periodontics and public health dentistry. The one-person operation provides online reporting through a custom-built website. “It was a challenge setting up Teledent from scratch,” she says. “Once I found a website developer who understood what I wanted, we developed the website, did test runs and then launched it. It took about six months of testing to get it right.”

How it works

Users upload their images—everything from intraoral bitewing radiographs through to cone beam CTs—onto the Teledent website and click a button to request a report. Clinical information about the patient is also provided. There is also provision for the user to upload previous photos or images that may assist Dr Brown in preparing her report.

The case is added to a waiting list and once the report is finished, Dr Brown uploads the result to the users account, ready for download. All information is encrypted and removed from the website after 30 days.

“I aim for a three-day turnaround,” she says. “If a dentist needs a rush report, I can do it in 24 hours. If it’s an emergency, I’m available by phone. I’ve had dentists ring me when they’re halfway through implant surgery and want me to look at a scan.”

During her time running Teledent, Dr Brown has also identified some nasty malignancies, particularly in the maxillary sinuses. Sometimes she will see something she has never seen before. In those cases, she will run the images past a couple of medical radiologists for a second opinion.

Periodontic passion

After graduating from the University of Melbourne in 1983, Dr Brown worked for a year in general practice but was certain it wasn’t really her calling. “I knew at the end of final year that I was going to specialise,” she recalls. “I picked up the prize for periodontics; it was something I really loved. I also liked public health dentistry. So, my two favourite areas were probably the two most unpopular subjects at that time.”

Dr Brown continued to work in general practice while completing her master’s degree. She was accepted for a National Health and Medical Research Council (NHMRC) fellowship to do a PhD at the University of Adelaide. Another NHMRC fellowship allowed her to undertake post-doctoral research at the University of North Carolina. While there, Dr Brown completed a Master of Public Health degree plus research in periodontal epidemiology.

I aim for a three-day turnaround If a dentist needs a rush report, I can do it in 24 hours. If it’s an emergency, I’m available by phone. I’ve had dentists ring me when they’re halfway through implant surgery and want me to look
at a scan.

Dr Louise Brown, Teledent

On returning to Melbourne in 1993, Dr Brown set up her periodontal practice in the Melbourne suburb of Ivanhoe, relocating to Kew in 2001. “Thankfully, my business was successful from the start,” she says. 

Dr Brown attributes the success of that practice to choosing a good location with no competition. At other practices, she felt that patients were turned over too quickly and appointment times were too short. Dr Brown based her business model on spending longer with each patient, discovering that clients didn’t mind if she charged more to do that.

“As a specialist, I also discovered that you don’t need a huge number of referring dentists,” she says. “What you need is a small number of loyal referrers who really look after their patients.”

With a large client base and engaged referring dentists, the future was bright. But, of course, fate often has other plans.

“I developed rheumatoid arthritis,” says Dr Brown. “My hands were so swollen I couldn’t even get gloves on them. Ethically, I had to make the decision to stop treating patients. I sold my practice in 2012 and undertook the postgraduate dental maxillofacial radiology degree at the University of Queensland. This was my first step towards Teledent.”

Radiology future

Dr Susan Wise, owner and periodontist at South Eastern Periodontics and Implants in McKinnon, Victoria, has been a long-time user of Teledent, uploading three to five cases per week. She was dissatisfied with medical radiologists, finding their reports to be extremely brief and not adequately detailed about dental pathology. 

“Dr Brown was a practising periodontist for over 25 years,” says Dr Wise. “She uses her extensive clinical experience when interpreting images and is extremely thorough in her reporting. I want my own OPGs properly reported and also use Teledent as a second opinion when receiving OPGs from other practices. Louise is very approachable and happy to discuss interesting and complex cases.”

Dr Brown is passionate about professional education. She was the first female president of the Australian & New Zealand Academy of Periodontists. She holds the honorary positions of professor and associate professor at the Universities of Adelaide, Melbourne and Queensland, La Trobe University and Charles Sturt University. She also provides approved training courses for the purposes of applying for Extraoral and CBCT Radiation Licences.

One thing Dr Brown would like to see is more specialty training opportunities for dental professionals in the field of dento-maxillofacial radiology. “The option of studying overseas has been made much more difficult with COVID,” she says. “There’s still the University of Queensland course but numbers are very restricted. It would be wonderful if training for dento-maxillofacial radiology could be integrated with medical radiology training.”  

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