Dentistry Continuing to Adapt to and Use Telehealth Applications in Practice

 

Survey Finds 75% of Dentists Anticipate Steady or Increased Reliance of Telehealth in Coming Months - TeleHealth Utilization Opens Doors for Expanded Oral Healthcare, Increased Revenue, and Better Health Outcomes 

As the world continues to adapt to the Covid-19 pandemic, more dentists are turning to virtual applications to help stay in touch with patients and provide much needed diagnostic information.  

Obviously in the current environment, the less you expose others, the less their chance of infection.  That goes especially for those individuals who suffer from some type of health condition that increases the likelihood of them to be susceptible to Covid-19.  Some folks are better off and safer at home where they can control their environment and exposure.  

And yet, those same people can experience problems that require the expertise of a doctor.  In order to help these individuals and continue to keep them safe in the process, virtual consultations have become an increasingly popular option for all types of healthcare providers.

Now comes a report from the DentaQuest Partnership for Oral Health Advancement that shows just how important telehealth is becoming to dental providers.  Here is what their press release had to say:

Three in four dentists who are using telehealth anticipate a steady or increased reliance on the technology over the coming months as they continue to navigate the COVID-19 crisis and resume routine care, according to a new report by the DentaQuest Partnership for Oral Health Advancement. 

The report, based on an August survey of nearly 2,800 dental providers across 20 states, found that nearly a quarter (23%) of dental providers are seeing patients via telehealth or virtual platforms. Additionally, 11% of providers who are not currently utilizing telehealth for patient care have plans to use it in the near future. This utilization rate is consistent with the 27% of providers who were seeing patients via telehealth in June when dental offices were largely limited to providing urgent and non-elective services, showing significant promise for the longevity of telehealth in dentistry.

“The numerous challenges that the COVID-19 pandemic has brought to providers and the oral health community has created a real opportunity for a new path forward in dentistry,” said Dr. Sean Boynes, vice president of health improvement at the DentaQuest Partnership for Oral Health Advancement. “Now is the time for innovation, to create a new model of oral health care, one that will be cost-effective, efficient and more equitable for all. What we’re seeing is that telehealth adoption and application is fast becoming a key tool for dentists to provide care that enhances disease prevention and whole-person health.”

Telehealth—primarily done through phone calls and virtual video meeting software—has been used to provide a wide variety of dental services, including COVID-19 symptom screenings, mouth/teeth examinations, referrals, patient triage, pain management and oral hygiene instruction. Survey findings suggest that while dental providers are primarily using telehealth for prescribing medication and triaging patients, there is a significant opportunity to expand its use for more preventive services.

Among providers, the report found that those in public health settings used telehealth the most, along with those in states like Pennsylvania, Washington, Florida, Kentucky and Arizona — likely as a result of favorable payment and coverage policies in those states. Additionally, providers who are not seeing their patient volume return to near-normal levels, serve primarily Medicaid patients and anticipate long-term changes in dentistry were more likely to embrace telehealth. In fact, dentists with more than half of patients enrolled in Medicaid were 39% more likely to use telehealth platforms.

As a result of telehealth utilization, providers are finding increasing opportunities for financial sustainability. According to the report, telehealth users are 34% more likely to be familiar with alternative payment models (APMs) and 45% more likely to have an increased interest in learning about APMs. As the oral health industry begins to embrace value-based care and shift toward APMs, telehealth can provide additional revenue while enhancing dental care access for current and new patients. Furthermore, it can offer cost-savings by providing access to primary and preventive care and keeping patients out of emergency departments for non-emergency dental needs.

As growth in telehealth utilization continues in oral health, permanent policy changes are vital for the widespread adoption of telehealth-enabled preventive services, minimally invasive care and care coordination. Providers and state policymakers should act now to ensure that policies permit members of the dental workforce to deliver telehealth services, as well as update reimbursement policies so that both public and private insurers cover remote provider-patient interactions through live video or store-and-forward mechanisms.

“Telehealth brings a wide range of benefits to the future of oral health care. It is key to expanding value-based care in our communities and improving outcomes for both oral health and overall health,” said Dr. Myechia Minter-Jordan, president and CEO of the DentaQuest Partnership for Oral Health Advancement and Catalyst Institute, Inc. “As we continue to leverage telehealth as a short-term solution for the pandemic, we must ensure its longevity to make it part of the dental ecosystem moving forward. That means taking the necessary steps right now to remove barriers that may prevent the widespread adoption or utilization of telehealth in the future.”

Read the full report here.

New Study Indicates that Covid-19 Fatality Rate has Dropped 30% Since April 2020

 

 

In the early days of the Covid-19 pandemic, the fear on everyone’s mind was the fatality rate.  With so little known about the disease in those first few weeks, the general public was terrified… and rightfully so.  It seemed to practically be a death sentence.  That may have been due to media focus on overwhelmed hospitals or simply fear of the unknown, but no matter the source, the fear was real and often palpable.  I distinctly remember a meeting with my staff in March where we were discussing how the world was rapidly changing due to infections.  At that meeting, many staff indicated their concerns about the risks that were (and still are) inherent in the practice of dentistry.  Many were concerned, not only about their personal health, but the health of their families if they somehow managed to become exposed and take the infection home.  

 

Now we are approaching a year since the SARS-CoV-2 virus first appeared in Wuhan China.  While infection rates in the U.S. have continued to climb in a near exponential fashion, fatality rates have not increased at the same proportion as infections.  A lot of this has to do with the incredible amount of study and the distribution of this knowledge that has been done by the world’s leading infectious disease experts.  This has lead to an incredible number of lives saved.  While Covid-19 remains a serious threat, at least we have learned how to help more people recover.

 

 A recent story on Reuters states the following:

 

(Reuters) - The likelihood that a coronavirus infection will prove fatal has dropped by nearly a third since April due to improved treatment, researchers at the University of Washington’s Institute for Health Metrics and Evaluation (IHME) said on Thursday.

In the United States, COVID-19 now kills about 0.6% of people infected with the virus, compared with around 0.9% early in the pandemic, IHME Director Dr. Christopher Murray told Reuters.

He said statistics reflect that doctors have figured out better ways to care for patients, including the use of blood thinners and oxygen support. Effective treatments, such as the generic steroid dexamethasone, have also been identified.

Experts have struggled to accurately measure a crucial metric in the pandemic: the fatality rate, or percentage of people infected with the pathogen who are likely to die. The difficulty is exacerbated by the fact that many people who become infected do not experience symptoms and are never identified.

IHME said it had been using an infection-fatality rate (IFR) derived from surveys after accounting for age. Older people are at much higher risk of dying from COVID-19 than younger people.

“We know the risk is profoundly age-related. For every one year of age, the risk of death increases by 9%,” Murray said.

The Seattle institute, an influential source of COVID-19 forecasts, said it has also determined that the fatality rate for COVID-19 is worse in communities with high levels of obesity.

The group said it has now switched to an IFR that varies over time - declining since the first pandemic wave in March and April by around 0.19% per day until the beginning of September.

It also varies across locations as a function of obesity prevalence, and continues to vary based on population distribution by age.

IHME said its analysis of age-standardized fatality rates from more than 300 surveys suggests a 30% decline since March/April.

Despite that positive trend, infections and hospitalizations have spiked across the country in recent weeks. The group said its modeling suggests 439,000 cumulative U.S. deaths by March 1, and a peak of daily deaths in mid-January at 2,200.

 

The University of Washington’s Institute for  Health Metrics and Evaluation has some amazing data and graphical ways of viewing that data.  If you have any interest in projections of the Covid-19 pandemic, I highly advised giving this site a visit.

Register Now for the 2020 Foundation for Airway Health Virtual Airway Summit!

This year's meeting will be virtual - and registration and CEs are free for all registered dentists and hygienists.  The Foundation is partnering with the Dental Sleep Practice publication to present a stellar lineup of presenter and airway / sleep presentations. Topics range from recognition and screening to diagnosis, treatment, and the business of incorporating sleep in a practice. As the Foundation reaches more of the public and raises awareness about hidden airway problems, more practitioners of all disciplines will be needed to provide care.  In October 2017, the American Dental Association adopted a policy to aid dentists on the front lines help their patients with potentially life-threatening disorders to increase proper recognition and treatment of sleep-breathing disorders. Our Airway Summit provides a unique opportunity to improve outcomes for your patients with these conditions. Whether beginning your sleep education or expanding to new levels, the Airway Summit offers something for you and your care teams.  Leading dental educators, scientific academy representatives, allied health organizations, representatives from industry and members of the public will offer information about what the dental team must know, and can do to impact positive health change for patients. Learn from nearly 15 leading experts in the field from around the globe.

Highlights of this year's Airway Summit include: Building Better Airways Diagnose and Treat Sleep Disordered Breathing: An Overview  Clinical Implications of HRV Sleep Disordered Breathing and Related Malocclusion Co-morbidity in Early Childhood Introduction of Orofacial Myofunctional Therapy Healthcare Inequality: Where are we now?  Oral Appliances: Which one?

 

Dentistry Today Names Dr. Paul Feuerstein Editor-in-Chief

Sometimes nice guys finish first.  It is with a great deal of pride and emotion that I happily announce that my buddy Dr. Paul Feuerstein has been named Editor-in-Chief of Dentistry Today.  I have known Paul more than half of my life and I can attest to the what a wonderful and deserving guy he is.

Paul is truly one of dentistry's "good guys" and truly one of the nicest people I've ever known.  He's the kind of guy other people strive to be like.  He sets a tremendous example of honesty and integrity for others to follow.  I am truly honored to say he is my friend (even if he does work for a competitor publication!)

Congratulations buddy!  You've earned this!

Here is the official announcement:

Dentistry Today, the nation’s leading clinical news magazine for dentists, proudly announces the appointment of Paul Feuerstein, DMD, as Editor-in-Chief. He will succeed Damon Adams, DDS, who is retiring December 31. 

“It has been an honor and privilege to serve as the Editor-in-Chief of Dentistry Today since 2008. I often said that the best part of my work here at the publication was not the editing, but rather the blessings in life that come from serving and working with others,” Adams said.

“Dr. Paul Feuerstein, who has faithfully served Dentistry Today for a number of years now as our Technology Editor, will be taking over at the helm of the editorial team.” 

Feuerstein will begin his new role with the January 2021 issue. 

“My passion for new equipment, new products, and how things work has played a major role in my entire dental career. I spend an inordinate amount of time at dental meetings and online talking to colleagues and manufacturers, as well as reading literature, to continue learning about the profession. My patients have been the primary beneficiaries of this quest, but my secondary passion is sharing this information with all of you through writing, lecturing, and meetings,” Feuerstein said. 

“The opportunity to have Dentistry Today as a forum caps off many years of private practice, which I continue to do, and provides a chance to explore all things that run a dental practice—from the high tech to sealants and prophys,” Feuerstein said. “I hope you will all join me in this new adventure.” 

Dentistry Today is excited to see what Dr. Feuerstein, given his love and passion for digital technology, brings to the publication’s print and online presence and how he will expand its reach in the dental community. 

 

CDC Expands Definition of Who is a ‘Close Contact’ of an Individual with Covid-19

 

In the continuing and ongoing struggle of the global pandemic that is Covid-19, one of the most difficult aspects for healthcare providers is attempting to keep up (even now) with the continuing evolution of knowledge and guidance being provided by those doing research into the infectious aspects of the virus.  Things can change daily, and when they do we are expected tone able to put those advised changes into practice immediately.  It's a challenge, but that's why we do what we do.  As my grandfather used to say, "Son if it was easy... everyone would be doing it."  That's just one of the reasons I spend so much time trying to bring the profession up to speed.  

I'm no virologist or epidemiologist, so I'm trying as hard as I can to keep up and when I find something out, I figure I should tell my fellow practitioners as well.

With that in mind, here is the latest from the CDC on their definition of "Close Contact" of an Individual with Covid-19.  

Close Contact

Someone who was within 6 feet of an infected person for a cumulative total of 15 minutes or more over a 24-hour period* starting from 2 days before illness onset (or, for asymptomatic patients, 2 days prior to test specimen collection) until the time the patient is isolated.

* Individual exposures added together over a 24-hour period (e.g., three 5-minute exposures for a total of 15 minutes). Data are limited, making it difficult to precisely define “close contact;” however, 15 cumulative minutes of exposure at a distance of 6 feet or less can be used as an operational definition for contact investigation. Factors to consider when defining close contact include proximity (closer distance likely increases exposure risk), the duration of exposure (longer exposure time likely increases exposure risk), whether the infected individual has symptoms (the period around onset of symptoms is associated with the highest levels of viral shedding), if the infected person was likely to generate respiratory aerosols (e.g., was coughing, singing, shouting), and other environmental factors (crowding, adequacy of ventilation, whether exposure was indoors or outdoors). Because the general public has not received training on proper selection and use of respiratory PPE, such as an N95, the determination of close contact should generally be made irrespective of whether the contact was wearing respiratory PPE.  At this time, differential determination of close contact for those using fabric face coverings is not recommended.

Senate Democrats introduce bill to shore up PPE supply

 

Senate Democrats on Wednesday introduced a bill that would shore up the supply of protective equipment for health care workers as the U.S. faces another surge of COVID-19 cases. 

The bill would appropriate $10 billion for the government to purchase large quantities of masks, gloves, gowns and face shields, Senate Minority Leader Charles Schumer (D-N.Y.) told reporters Wednesday. 

The bill would also create a $1 billion grant program to help small businesses “retool” their facilities to manufacture protective equipment on a larger scale.

Democrats introduced the bill as COVID-19 cases surge nationwide in the largest wave of the pandemic. While shortages of protective equipment are not as widespread today as they were at the beginning of the pandemic, they still persist and are likely to get worse as cases continue to rise.

"We must do everything in our power to avoid a repeat of the widespread shortages," Schumer said. 

"We must act to ensure that these heroes have the resources they need to do their jobs, serve our country and help save us from this pandemic," he added. 

The pandemic has caused a worldwide shortage of personal protective equipment (PPE) as every country is competing for the same gear.

Most PPE is manufactured in China, giving the U.S. limited control over the supply chain as other countries compete for the same equipment. 

American business owners have said they are interested in making protective gear but need more financial support from the federal government to hire more workers, buy more manufacturing equipment and ensure they’re not left with unsold surplus.

Public health experts have called on the Trump administration to invoke the Defense Production Act (DPA), which would allow the government to exert more control over the supply chain and compel companies to manufacture needed items.

• President-elect Joe Biden has said he plans to use the DPA to bolster the supply of PPE so the national supply “exceeds demand.” 

“We've also spoken to many experts including those on the Biden transition team, and their reaction has been very positive,” Schumer said.

The bill is unlikely to pass in the current political environment, where Senate Republicans and Democrats have been in a stalemate for months on the next round of COVID-19 relief legislation. 

MouthWatch Publishes Essential Whitepaper - “Teledentistry: Post-COVID-19 Use for Safe, Efficient and Evidence-Based Care

 MouthWatch, LLC, a leader in innovative teledentistry solutions, digital case presentation tools and intraoral imaging devices, recently published a highly relevant whitepaper entitled, “Teledentistry: Post-COVID-19 Use for Safe, Efficient and Evidence-Based Care.”  Written by CDC Consultant and infectious disease expert, Margaret Scarlett, DMD, the paper presents teledentistry as a viable, problem-based solution for dental professionals and patients alike. 

According to MouthWatch CEO and founder, Brant Herman, “Due to COVID-19, one of the long-term changes in how dental practices connect with their patients will be the adoption of a new teledentistry-driven protocol that will virtually assess the patient’s need for oral care, improve the safety and efficiency of the care provided in the dental office, and also enable the virtual follow-up with the patient on recently-provided care.”

The whitepaper goes into great detail and is organized by the following main topics:

• Introduction to Teledentistry
• Teledentistry’s Battle-Tested ROI (Military Origins) 
• Successful Civilian Services (Public Health Proving Ground)                                      
• Policy Changes (Recommended by several government agencies)
• Current Uses 
• Post-Pandemic Teledentistry

“The main takeaway of this whitepaper is that teledentistry will continue to be a problem-based solution to increase patient volume and increase practice efficiency during and post-pandemic,” said Dr. Scarlett. “What’s more, teledentistry will soon take its rightful place as must-have dental technology.”

 

“Teledentistry: Post-COVID-19 Use for Safe, Efficient and Evidence-Based Care” is available as a free download at http://mwtch.co/gtpcw. For more information on MouthWatch TeleDent, visit www.MouthWatch.com/TeleDent

About MouthWatch LLC:

Headquartered in Metuchen, New Jersey, MouthWatch, LLC is a leader in innovative teledentistry solutions, digital case presentation tools and intraoral imaging devices. The company is dedicated to finding new ways to constantly improve the dental health experience for both patient and provider.

In 2020, the company received the following awards and accolades: The 2020 Cellerant Best of Class Award for TeleDent™, the provider-focused, patient-friendly teledentistry platform. TeleDent also won Dentistry Today’s  2020 Top Innovative Products Award and Dentistry Today’s 2020 Reader’s Choice Award. The affordable / high quality MouthWatch Intraoral Camera was honored with the Dentistry Today Top 100 Products Award. MouthWatch was also ranked #1303 in the 2020 Inc. 5000 list of the Fastest Growing Privately Held Companies. For more information, visit www.MouthWatch.com.