## 4 Discussion  
Although TM and teledentistry have existed since 1969, in Italy, they are now largely appreciated for their ability to minimize the risk of increased COVID-19 dissemination [11]. With the rapid development of the internet and smartphone apps, telemedicine has transitioned to a multimodal paradigm, offering greater possibilities and convenience. With the aim of preventing the spread of COVID-19, telemedicine allows for the follow-up of patients who can be remotely monitored, decreasing patient mobilization and reducing the risk of virus dissemination [12; 13]. The reduction in physical visits and possibility of provider-to-provider communication via the web reduces the risk of infectious exposure for healthcare providers [14]. Despite the high investment that is needed to apply a new TM program, this offers some economic advantages during pandemic emergencies, such as the reduction in costs related to the use of personal protective equipment (PPE) [15] and the option of healthcare providers performing their professional activities remotely when they are asymptomatic and in quarantine [16]. The increase in TM practice in pandemic emergencies is well documented by the Ohio State University Wexner Medical Center, which reported a jump in telemedicine visits from fewer than 100 per day to well over 2200 per day during March 2020 [17] and by NYU Langone Health (NYULH), which recorded a 683% increase in televisits between March and April 2020 [16]. Regarding oral medicine, there is a complete absence of literature regarding the long-term impact of pandemics on patients with oral potentially malignant disorders (OPMDs) and early-stage oral cancer. Therefore, for healthcare providers who manage OPMDs and oral cancer, a great concern is the risk of progression of these lesions and the harmful sequuela in the long term [18]. Although a virtual examination may lack the vital element of palpation, tele(oral)medicine could help to distinguish potentially malignant lesions from those that are truly malignant and require an immediate approach. To our knowledge, this is one of the first studies that evaluated the use of tele(oral)-medicine from a patient's perspective. Our sample included patients who were potential users of a tele(oral)medicine program in the future. The most interesting result from our survey was that a high percentage of participants (73.8%) declared that they were interested in using a new tele(oral)medicine service. This result was also in line with other studies in the specialist literature. [PERSON] et al. highlighted that 80% of the patients in their study who were affected by [PERSON]'s disease would likely use TM for follow-up appointments [19]. Similarly, [PERSON] et al. interviewed 97 patients to evaluate their attitude towards TM, and 66 (68%) participants affirmed \begin{table}
\begin{tabular}{l c c} \hline \hline
**Variable Related to Q23.** & **Chi-Square Value** & **F 1** & \(p\) **Value** \\ \hline City of Residence & 0.134 & & 0.714 \\ Profession & 4.241 & & 0.237 \\ Gender & 0.246 & & 0.620 \\ Age & & 4.788 & 0.032 \\ Time taken to get to the hospital from home & 1.383 & & 0.240 \\ Personal impact of home-hospital distance & 9.982 & & 0.041 \\ Mean annual days accessed to the ambulatory & & 0.967 & 0.328 \\ Waiting time before the visit & 9.020 & & 0.011 \\ Personal impact of waiting time before the visit & 4.036 & & 0.401 \\ Payment exemption of medical service & 3.941 & & 0.047 \\ Access to an IT device & 5.176 & & 0.023 \\ Ability to use IT devices & 9.317 & & 0.025 \\ Need for human contact during the visit & 7.612 & & 0.107 \\ Ability to use smartphone camera & 4.914 & & 0.178 \\ Reported difficulty in taking intraoral photos & 8.788 & & 0.032 \\ Patient’s interest in paying the visit through web & 31.097 & & 0.000 \\ \hline \hline \end{tabular} 1  
\end{table} 
Table 3: Summary of bivariate statistical analysis carried out considering as dependent variables Question 23.  
their willingness to participate in televisits [20].