title: Synchronous teledentistry in a university pediatric dentistry clinic
title: impact on access to care
titleType: Subtitle
Creators: name: Iribarren, Sofía
Publisher: name: University of Iowa
Year: 2022
Subjects: Access to care
E-health
Teledentistry
Telehealth
Treatment completion
Visit attendance
public abstract

description: Objectives: Teledentistry is a care modality suggested to enhance access to dental care for vulnerable children, but few studies have evaluated the impact of teledentistry on access to dental care. This study examined the impact of new patient synchronous teledentistry visits for children referred to a university dental setting and assessed whether having a new patient teledentistry visit improves access to care compared to referred patients seen only via in-person visits. Access to care was evaluated by comparing treatment completion and second-visit attendance.
description: Methods: A retrospective chart review was conducted for new patients in the Department of Pediatric Dentistry at The University of Iowa between July 1st, 2020, and June 4th, 2021. Treatment completion and second-visit attendance were compared between patients who had their first visit in person versus via teledentistry. Multivariable logistic regression analyses were used to compare treatment completion and second-visit attendance between the in-person and teledentistry groups after adjusting for potential confounders, including patient’s age, sex, distance traveled, insurance status, behavioral or neurological conditions, and treatment complexity. Separate analyses were conducted for patients treated in the OR (operating room) and dental clinic, in addition to the full sample.
description: Results: The final sample of new referred patients with an initial visit during the study period was n=654. Of those, 82 (12.5%) had their initial visit by teledentistry. In the dental clinic and OR subgroups, 11% (n=57/504) and 17% (n=25/150) had an initial visit by teledentistry, respectively. The mean driving distance was significantly higher for the teledentistry group than the control (100.68 [SD 53.99] miles vs. 74.37 [SD 35.19] miles (p&lt;0.001), respectively). The dental clinic and OR subgroups had similar trends. Children in the teledentistry group were slightly more likely to complete treatment (84% vs. 74%; p= 0.159), complete the initial visit (95% vs. 89%; 0.074), and complete the second visit (83% vs. 74%; 0.090) than the in-person group. Treatment completion rates varied by care setting between the teledentistry and in-person groups; dental clinic (77% vs. 74%; p=0.584) OR (100% vs. 90%; p=0.127). Children seen by teledentistry did not have significantly different odds of treatment completion (OR, 0.974; 95% CI, 0.50 to 2.02; p=0.940) or second visit attendance (OR, 0.632; 95% CI, 0.35 to 1.29; p=0.695) relative to children with an initial visit in person.
description: Conclusion: Children seen for an initial visit by teledentistry or in-person visits can achieve comparable degrees of treatment completion and second-visit attendance. Our results suggest that teledentistry can effectively supplement in-person care for the management of dental treatment needs among vulnerable children.