Dental Tribune America

Teledentistry is here to stay—dental associations change gear to regulate

By Jeremy Booth, DTI
March 16, 2020

CHICAGO, U.S./LONDON, U.K.: A growing number of consumers are opting for remote orthodontic treatment, and it is likely that such services will continue to be available to them. While dental associations on both sides of the Atlantic may not fully support the practice, they are now seeking to clarify how it can be provided to patients safely. In the U.S., examples of generic regulations for teledentistry have been issued by the American Association of Dental Boards (AADB). The General Dental Council in the U.K. has asked service providers to confirm what procedures they are following and how its registrants may be involved.

The AADB released a directive in early March that unpacks the nomenclature surrounding remote care, also known as telehealth or teledentistry, and advocates for state-level regulations for its provision in dentistry. Generic examples of proposed legislation by unnamed U.S. states were given in the directive, which states that the information it contains aims to increase access to dental treatment but also to regulate those providing it.

Teledentistry” is defined by the directive as using “electronic and digital communications to provide and deliver dentistry and dental hygiene-related information and services.” The directive specifies that the practice of teledentistry must be carried out by individuals who hold a valid dental or dental hygienist license issued by the board of dentistry and that the actual treatment must occur where the patient is located when the treatment is initiated. The directive states that those licensed to provide teledentistry services must comply with all state and federal regulations relating to the provision of dental care and that a parity of care must be established between remote encounters and those taking place at dental clinics. Patients engaging teledentistry services can only be treated by a licensed dentist or by a licensed dental hygienist who is supervised by a licensed dentist who has delegated authority to him or her, the directive states.

The document defines various regulatory examples and the nomenclature concerning aspects of the practice of teledentistry, including photography and digital imaging, the evaluation of cases and patient history, the use and retention of electronic communications and dental records, and advertising and the representation of services.

According to the American Dental Association (ADA), U.S. states that have already passed laws to regulate remote dental care include California, where it is now mandatory for service providers to have patients’ radiographs reviewed prior to the movement of teeth, and Arizona, Ohio, Oregon, South Dakota and Tennessee, where the delivery of remote services must be consistent with that provided in person. Massachusetts currently has bills pending that would further define protocols for providers of health care, including those providing oral health care, according to the ADA.

The leading provider of remote orthodontic care in the U.S., SmileDirectClub, said in a statement that it was grateful to the AADB for proposing language for remote orthodontic treatment that prioritizes patients and their access to care. “Today’s consumer struggles to access orthodontic care due to cost, limited time and limited access to a doctor’s office, and telemedicine has been proven to be a safe and efficacious means for delivering teeth straightening solutions,” the statement read. These comments from the company are markedly different in tone to those it made in October when California passed its new regulations, and they support what Dental Tribune International last week reported as being a change of tack by the provider.

The full directive text of the AADB’s generic regulations directive can be accessed here.

General Dental Council contacts service providers

The GDC in the U.K. made a statement in late February in which it said that its statutory objective is to protect the public and that the treatment of malocclusion falls within the practice of dentistry. As such, it continued, individual dentists involved in the practice must be registered with the GDC, act within the scope of their practice and adhere to the GDC’s standards for dental teams. “Anybody practicing dentistry while not registered with the GDC could be subject to prosecution for illegal practice,” the association warned.

The GDC said that it had contacted companies providing remote service in the U.K. to clarify the procedures that they are following and how GDC registrants may be involved. In response, the British Orthodontic Society said, in a press note, that it had cautiously welcomed the actions and statement from the GDC and that it was looking forward to hearing the results of its evidence gathering.

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