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KBIA’s Health & Wealth Desk covers the economy and health of rural and underserved communities in Missouri and beyond. The team produces a weekly radio segment, as well as in-depth features and regular blog posts. The reporting desk is funded by a grant from the University of Missouri, and the Missouri Foundation for Health.Contact the Health & Wealth desk.

Missouri Dentists, Advocates Look to Teledentistry as a Possible COVID-19 Solution

Green Leaf Dental Care

Many things have changed for dental practices since the beginning of the coronavirus pandemic – starting with several months of closures dealing with only oral health emergencies. Now, dentists are having to figure out how to preserve PPE, or personal protective equipment, enforce social distancing and minimize the risk of disease spread as they reopen their practices.

And while these are serious challenges, some practitioners and oral health advocates are encouraged at a possible positive outcome of the ongoing pandemic – the increased interest in and implementation of teledentistry.

Credit Rebecca Smith / KBIA
Gary Harbison is the Executive Director of the Missouri Coalition for Oral Health.

Gary Harbison, the Executive Director of the Missouri Coalition for Oral Health, said he’s worried about the long-term impact of the ongoing coronavirus pandemic on the oral health and overall well-being of Missourians.

“People are getting out of their routines, and they're trimming stuff out of their life because they just don't have the money to do it,” Harbison said, “and we know from the past dental is often one of those things that people put off.”

But he does think one good thing has come out of the ongoing pandemic, as dentists and the general public are more open to the idea of teledentistry.

Now, you may be wondering how that would work or, really, what does that even mean?

“So, it allows you to extend your practice and stay in touch with people, follow up on people you just saw and you needed to see how they're doing and they were supposed to come into the office,” said Nathan Suter.

Dr. Nathan Suter is the dentist and owner of Green Leaf Dental Care in House Springs, and the founder of Access Teledentistry, a consulting firm that helps dentists figure out how teledentistry could be integrated into their practices. 

He’s been using teledentistry for several years now, has advocated for the practice at the statewide level and was recognized by the American Dental Association this year as one of the “10 Under 10: Recognizing the ‘unsung heroes’ of the profession” for his advocacy and the development of a teledentistry training workshop.

Suter said that since the beginning of the coronavirus pandemic, he’s hosted lots of educational webinars – which have been watched by more than 5,000 dentists.

Credit Green Leaf Dental Care
Dr. Nathan Suter is a leading expert on teledentistry in Missouri. He adopted the practice several years ago and has been educating others ever since.

“It's very satisfying to know that something that we were doing and we knew was working for many public health applications to bring teledentistry – to bring dentistry, dental care and increase access to care to the underserved [is being recognized],” Suter said. “And now people are seeing that, and not only seeing how it's good to respond to COVID-19, but the potential new normal for dentistry.

Suter says there are several forms of teledentistry – some, where hygienists go do cleanings in patients’ communities, take x-rays and then have the dentist view those at a later time to see if any additional treatment is needed.

But some forms are more basic. Suter said it boils down to a relationship between patient and dentist, so people feel comfortable reaching out before they have a dental emergency.

They can send photos of dental issues or get things checked out remotely, via text or Skype or Zoom, without having to drive to the dentist’s office and without having to go to the emergency room for pain relief. 

Which Suter and others agree is especially important during the ongoing coronavirus pandemic, as hospitals’ resources can be stretched thin

Plus, Suter said “it also allows you to triage emergencies, safely, without them having to come in and the staff would have to use precious PPE up.”

On the legislative side, Suter said things have also gotten a little easier, at least temporarily, as HIPPA regulations have been relaxed when it comes to telehealth. It is now permissible for medical and dental practices to use more basic and readily available technologies, like FaceTime and Zoom.

But teledentistry may not be the answer for everyone. Dr. Mack Taylor, the chief dental officer for the SEMO Health Network in the Bootheel, said they spoke with Dr. Suter about implementing teledentistry into their practice as they reopen their offices post shutdown.

Credit SEMO Health Network

But it just didn’t fit in with the community being serviced due to broadband access, as well as technological literacy issues.

“They [our patients] may only have limited data, minutes, or available service in their location. This makes video calls difficult or impossible,” Taylor said. “We also have many elderly patients who have smartphones but may be unsure of how to utilize services besides voice calling and texting, for instance. A voice call can allow us basic triage opportunities, but without visual capabilities we can’t get a lot of the information we need.“

Dr. Suter admitted that teledentistry isn’t the answer for everyone, but he hopes that, in the future, more dental practices will at least consider adopting the technology – so practices can stretch further into underserved and often rural areas, and every Missourian can find a dental home.

“That's the thing that I hope,” Suter said. “Is that teledentistry just allows us to maybe expand the way we think about the dental home and how we can extend past our physical walls and have virtual access to our provider, and see if that, hopefully, can increase the amount of people that can see the dentist.”

Rebecca Smith is an award-winning reporter and producer for the KBIA Health & Wealth Desk. Born and raised outside of Rolla, Missouri, she has a passion for diving into often overlooked issues that affect the rural populations of her state – especially stories that broaden people’s perception of “rural” life.