Why Pediatric Teledentistry

Pediatric Teledentistry has great potent1aj for improving the dental experience and oral health of many children. Despite being highly preventable, the most prevalent chronic diseases found in children are dental cavities (tooth decay) and periodontal disease.{1} Studies have shown that children are five times more likely to have dental cavities compared to asthma, and seven times more likely compared to hay fever.{1}

When left untreated tooth decay can lead to serious consequences and major health problems.{2} Some complications include toothaches, pain, disruptions in sleep patterns, inability to eat and drink, and dentoalveolar abscess.{1,2} These may not have as serious of an effect on adults, but tor children who are still developing, it can affect physical health, and result in below-average weight and height.{1,2} It is clear that the oral health of children has great impacts on their growth and development.

Close monitoring of oral health through Teledentistry can be a great tool for preventing cavities from going untreated and developing into something much worse. A study done by Estai et al. looked at Teledentistry as a novel option for improving the dental health of children in a school setting.{3} The main benefits they found from using Teledentistry included improved oral
health, a reduction in decay, and the prevention of disease.{3} Clearly, the correlation between Teledentistry and improved oral health in children is very strong.

Current Benefits of Pediatric Teledentistry

A recent study has also shown that pediatric dentists are most likely to provide Teledentistry services out of an dentists.{4} One of the many benefits of Teledentistry is that it greatly increases access to dental care and reduces patient wait times for appointments to see a dental specialist.{5} A Teledentistry program in New York, Finger Lakes Community Health, found that the wait times associated with consultations and surgery tor children who need to see a pediatric dentist went from an average of 9 months to only 3-4 weeks through Teledentistry.{5}

Virtual consultations in pediatric dentistry are also a great introduction to the patient for the dentist. The dentist can use the virtual consultation as a way to evaluate the child’s behaviour, so they can plan how to manage the child when they come into the office for surgery. {5}

Dental Visits for Children with Disability

Children with physical or intellectual disabilities generally bear greater oral pathology, due to their condition and other factors. They often require help with daily functioning, care, and interaction, including tasks involving the care of their oral health. A study was done by Botti et al., found that childrein with cerebral palsy were more affected by dental cavities than children without.{6} Similarly, the frequency of extractions and fillings was also more prevalent among children with disabilities in a study done by Grzic et al.{7} This data shows the importance of early and regular dental care for children with disabilities to prevent pathology, and treat conditions as soon as they are observed.{8}

As they are more susceptible to oral pathology, these children should be regularly seeing a dentist. However, visits to the dentist are a challenging experience for many. The dental experience can be overwhelming and sensory overload for many children with developmental disabilities, that they often have to go to the hospital to receive anesthesia for regular cleaning.{9} The bright lights and loud instruments at the dentist and the interaction with a new face, makes many children scared to visit the dentist and a difficult task for the family.

How Teledentistry can be Helpful for these Children

Teledentistry can be incredibly helpful for children with physical and developmental disabilities to maintain good oral health from the comfort of their own home and familiar surroundings. Routine checkups can be done at home through virtual appointments. This will avoid unnecessary travel and the stressful experience of the dental office for these children, meaning visits to the dentist will only occur when necessary. In the case of a dental emergency, parents can book a virtual appointment to speak with their dentist, to limit the number of trips to the dental office.

According to a study done by Dr. Chanpong and Dr. Haas, nearly 10% of Canadians are afraid of dental treatment and approximately 5.5% have high levels of anxiety.{10} For children with Autism Spectrum Disorder (ASD), approximately 40% of children have elevated levels of anxiety or an anxiety disorder.{11} Many chi1dren with Autism Spectrum Disorder (ASD} also avoid dental care because of the fear associated with dental procedures, ultimately resulting in the deterioration of their oral health.{12}

Teledentistry is also beneficial as it can serve as a medium to introduce the child to the dentist and desensitize the child to a new dentist. Teledentistry consultations can decrease levels of anxiety by making the child familiar with the dentist and discussing the procedure to be performed. This will likely increase the child’s dental experience and treatment compliance, with higher chances of successful treatment. Overall, Teledentistry and its benefits for pediatric dentists and children with a disability have great potential to make the dental experience significantly better for children of all abilities.

References

1. Benjamin, R. M. (2010). Oral Health: The Silent Epidemic. Public Health Reports, 125(2), 158-159. doi:10.1177/003335491012500202
2. T, S., Anandan, V., & Apathsakayan, R. (2017). Use of a Teledentistry-based Program for Screening of Early Childhood Caries in a School Setting. Cureus. doi:10.7759/cureus.1416
3. Estai, M., Kanagasingam, V., Mehdizadeh, M., Vignarajan, J., Norman, R., Huang, B., . . . Tennant, M. (2020). Teledentistry as a novel pathway to improve dental health in school children: A research protocol tor a randomised controlled trial. BMC Oral Health, 2o(1). doi:10.1186/s12903-019-0992-1
4. Marko Vujicic (2020) Linkedin profile, July,
https://www.linkedin.com/feed/update/urn:li:activity:6692453334097391617/
5. Case Studies of 6 Teledentistry Programs: Strategies to Increase Access to General and Specialty Dental Services (Rep.). (2016). Retrieved August 13, 2020, from Center for Health Workforce Studies website: http://www.chwsny.org/wp-content/uploads/2017/01/OHWRC_Case_Studies_ of_ 6 _ Teledentistry _Programs _2016.pdf
6. Botti Rodrigues Santos, M. T., Biancardi, M., Guare, R. O., & Jardim, J. R. (2010). ARTICLE: Caries prevalence in patients with cerebral palsy and the burden of coring for them. Special Care in Dentistry, 30(5), 206-210. doi:10.1111/j.1754-4505.2010.00151.x
7. Grzic R, Sakorcic D, Prpic I, JoKic i NI, Sasso A, Kovac Z. Dental Health and Dental Care in Children with Cerebral Palsy. Coll. 2011;35:761-4.
8. Dieguez-Perez, M., Novo-Garcia, M. D., Mourelle-Mortinez, M., & Bartolome-Villar, B. (2016). Oral health in children with physical (Cerebral Palsy) and intellectual (Down Syndrome) disabilities: Systematic review I. Journal of Clinical and Experimental Dentistry, 0-0. doi:10.4317 /jced.52922
9. Arlene Karidis October 12, 2. (2017, October 12). Visiting the dentist when your kid has special needs. Retrieved August 13, 2020, from https://www.todaysparent.com/family/special­needs/visiting-the-dentist-when-your-kid-has-special-needs/
10. Chanpong, B., Haas, D. A., & Locker, D. (2005). Need and Demand for Sedation or General Anesthesia in Dentistry: A National Survey of the Canadian Population. Anesthesia Progress, 52(1), 3-11. doi:10.2344/ 0003-3006(2005) 52 [3:nadfso]2.0.co;2
11. Elisabetta Burchi and Dr. Eric Hollander, Barb, Anonymous, N, M., Huma, Anon, . . . Shiloh. (n.d.). Anxiety in Autism Spectrum Disorder. Retrieved August 13, 2020, from https://adaa.org/learn-­from-us/from-the-experts/blog-posts/consumer/anxiety-autism-spectrum-disorder
12. Isong, I. A.., Rao, S. R., Holifield, C., Iannuzzi, D., Hanson, E., Ware, J., & Nelson, LP. (2014). Addressing Dental Fear in Children With Autism Spectrum Disorders. Clinical Pediatrics, 53(3), 230- 237. doi:10.1177/0009922813517169