Teledentistry is available for you at this time
Telemedicine has been around for some time in Ontario way before the COVID-19 pandemic. The process is a patient goes to a telemedicine clinic and consults the virtual physician on a screen in real time. There is usually a RN or RPN in the room to help with the procedure of taking BP, auscultation or even administer medications under the directions of the attending physician.
Occasionally, telemedicine is conducted at the patient’s home with the physician online via a laptop and they can see each other on their screens.
Due to the state of emergency surrounding COVID-19 and the lockdown of travelling and closures of non-essential services and operations, dentistry has been affected tremendously in a negative way. Since Ontario Public Health and the College of Dental Surgeons of Ontario have issued strong recommendations for dentists not to provide non-urgent care, we are only allowed to provide emergency dental services during this period of time.
Teledentistry became something new to us as a tool to help our patients during this state of emergency. However, our governing College has given us very strict guidelines on the acceptable way to teledentistry.
What is teledentistry? “Teledentistry is the provision of patient dental care at a distance, using information and communication technologies” The devices that serve as the media can be your laptop or desktop computers, your cell phones or a remote patient monitoring (RPM) device. It is like virtual/remote management.
The College has specified that it is only allowed to be used “to assist with the provision of emergency care – specifically to assess and triage patients’ oral health care needs and to determine next steps.”
It further emphasizes that a full emergency examination would not be possible using teledentistry alone. During the virtual assessment process, the dentist would ask the same questions and perform the same assessments as if the patient was in the office. They would ask questions like pertaining to medical history, verbal history of the patient’s conditions and confirm the nature of the emergency before recommending next steps. However, there are no other assessment tools and modalities available like touching and feeling the site in the mouth, or having a good visualization of the condition intraorally. There are no means to take radiographs of the site or conduct any tests.
So the information collected and the validity of the diagnosis can be very limited. However, we still can prescribe medications over the phone to the patient’s pharmacies. For example, if the symptoms and appearance are consistent with bacterial infection then we can prescribe antibiotics and if the patient is also having pain, then pain killers like Tylenol can be prescribed. Aspirin or other types of non-steroidal anti-inflammatory drugs like Advil should be avoided during this pandemic due to the possibility of aspirin-induced Reye’s syndrome. There are some other home remedies and procedures that patients can do to alleviate pain and discomfort during this crisis without having to see the dentist nearby immediately.
Below are some examples that I would suggest to my patients during the interview that may help:
- Swollen gums: make sure to brush and floss your teeth at the site of the swelling meticulously from the gum line, gently, with a soft manual toothbrush. That will keep the teeth clean and could dislodge food that may be stuck between the teeth or covered by the swelling. A saltwater rinse several times daily would be helpful. Avoid chewing on the swollen side and keep on a soft diet until the swelling comes down.
- Chipped tooth with sharp edges: if the chip is small and can wait, then place some paraffin wax or sugarless chewing gum on the sharp edges until your dentist can see you.
- Toothache due to a cavity: besides taking Tylenol for the pain, avoid sweets and brush the tooth with fluoride toothpaste regularly. You can also try placing clove oil in the cavity to numb the pain. It is an anesthetic with anti-inflammatory and anti-bacterial effects.
- Canker sore: besides an over the counter numbing gel like anbesol, you can dab some table salt directly on the ulceration. It will hurt for a few minutes and then the pain will go away due to the formation of a film over the sore.
One caveat about teledentistry is the protection of the patient’s personal health information. In order to meet the guidelines in the Personal Health Information Protection Act, 2004, at Affinity Dental Care, we use Doxy.me to conduct teledentistry with our patients. We always try to provide our patients with top-quality care and stay at the top of technology that is available to allow us to provide urgently needed dental treatments and consultations for our patients.
If the situation is deemed to be urgent and an in-person clinical examination and/or treatment is needed, then the patient will be assessed for the risk of COVID-19 before the office visit is arranged. Otherwise, the patient will be provided contact information for the public health unit at the hospital to have a swab done to rule out the disease before seeing the patient.
Call Dr. Wong at Affinity Dental Care in Burlington. If you are in the Burlington area and want to learn more about dental implants or any other dental service, call (289)-861-5111 to book a consultation appointment.