Advances in teledentistry shouldn’t imperil patient health

Orthodontists in practice throughout California embrace new technologies as a way to improve service delivery and access to care, but we want to caution policymakers and consumers that its utilization should not come at the expense of patient health and safety.

Access to care and measures to protect consumer health do not have to be mutually exclusive.

As our reliance on technology has increased during the pandemic, it has also underscored situations where technology is no substitute for in-person experiences.

A recent opinion piece in Capitol Weekly highlighted the benefits of telehealth, and in particular teledentistry, as a safer and more accessible means of providing care during the pandemic. The author also applauded the California State Senate for “rejecting legislation that would have created more barriers to teeth straightening services by requiring unnecessary in-person visits.”

We believe that the utilization of telehealth is appropriate in many cases, but that any effort to deem in-person exams “unnecessary” prior to beginning orthodontic treatment places consumers at significant risk.

As our reliance on technology has increased during the pandemic, it has also underscored situations where technology is no substitute for in-person experiences. While some routine care may be appropriate for telehealth, complex procedures still require the careful oversight of a licensed professional and in-person examination.

The movement of teeth, for example, without appropriate diagnostics can have significant harmful and irreversible effects on patients including loss of teeth, a misaligned bite, shortened roots, and receded gums. For this reason, an in-person exam and current radiographs are needed before beginning treatment to understand more fully what is going on beneath the gums, to avoid complications, and to determine if patients are suitable candidates for orthodontic treatment.

The rejection of legislation that would require such an examination jeopardizes patient safety and falls well below the standard of care that regulates the practice of orthodontists in brick-and- mortar settings.

While orthodontists throughout the state will continue to seek out and utilize technology that provides affordable treatment options and broadens access to care, we do not want to sacrifice patient health and safety in the process. We encourage our elected representatives to keep these facts in mind as they legislate telehealth technology in the current and future sessions.
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Editor’s Note: Dr. Boyd Martin is President of the California Association of Orthodontists.