Using Teledentistry to Provide Interceptive Orthodontic Services to Disadvantaged Children

Socially disadvantaged children have limited access to orthodontic services. Therefore, an effort to expand access by providing limited orthodontic services to these children using teledentistry was undertaken.

Objectives: This study examined the feasibility of a general dental practitioner providing interceptive orthodontic services to disadvantaged children with realtime supervision from an orthodontist at a remote site.

Methods: Medicaid eligible children were treated at either the Yakima Valley Farm Worker's Clinic (Toppenish, WA) by a general dentist supervised by an orthodontist via teledentistry (N=33) or by orthodontic graduate students with direct orthodontist supervision (N=96) at the Odessa Brown Children's Clinic (Seattle, WA). Care was limited to interceptive treatment only. Pre- and post-treatment orthodontic study models for both groups were scored by a calibrated examiner using the Peer Assessment Rating (PAR) to compare outcomes.

Results: There were no significant differences in pre- or post-treatment PAR between the groups. Both groups had significant improvement in PAR with 35.6% for the teledentistry group and 44.1% for the direct supervision group (p<0.001).

Conclusions: The results of this study suggest that interceptive orthodontic treatment provided by sufficiently trained general dentists and supervised remotely by orthodontic specialists through teledentistry is a viable approach to reducing the severity of malocclusions in populations of disadvantaged children where referral to an orthodontist is not feasible.

Supported by NIDCR Grant U54 DE14254