An evidence‐based review of the scope and potential ethical concerns of teleorthodontics

Abstract

PurposeThe aim was to evaluate the scope and potential ethical concerns related to the use of teledentistry in clinical orthodontics.MethodsIndexed databases were searched up to and including October 2020. The eligibility criteria were as follows: (a) original clinical studies, and (b) case reports/series. Historic reviews, commentaries, experimental studies, and letters to the editor, were excluded. The pattern of the present review was customized to summarize the relevant information.ResultsA total of 4 clinical studies (out of 1016) were included in the present evidence‐based review. Three studies reported that teledentistry is useful in clinical orthodontics. In 1 study, a clear conclusion could not be derived regarding the benefits of teledentistry in clinical orthodontics. Two out of 4 studies did not obtain prior approval from an Institutional Review Board or Ethical Committee. Three studies did not report any measures that were undertaken to safeguard the electronic transfer of patient‐related health information.ConclusionsTeleorthodontics facilitates treatment planning/monitoring by sharing orthodontics‐based patient records among oral healthcare providers; however, the importance of direct patient supervision and routine follow‐ups during orthodontic therapy cannot be overlooked. Further studies are needed to establish ethical guidelines and a standard of care in this emerging field.

Is Teledentistry a Method for Optimizing Dental Practice, Even in the Post-Pandemic Period? An Integrative Review

“…By sharing orthodontics-based patient records across oral healthcare practitioners, teleorthodontics enhances treatment planning and monitoring; however, direct patient supervision and routine follow-ups throughout orthodontic therapy are still important in the orthodontics domain. Those were some of the conclusions drawn by Squires et al (2020) [54]. Another literature review, published by Maspero et al (2020), investigated the efficacy of teleassistance in orthodontics, as a way to manage patients at distance, in the context of the COVID-19 pandemic.…”

Teleorthodontics: Where Are We Going? From Skepticism to the Clinical Applications of a New Medical Communication and Management System

“…Conventionally, the diagnostic process in orthodontics is based on the analysis of specific records, such as intraoral and extraoral images, radiographic examinations, and cast stone/digital models [2]. Clinical evaluation, although essential, is not often sufficient to get a comprehensive diagnosis and to generate a detailed problem list, and the treatment planning is generally established after a deep analysis of the diagnostic records acquired [9], including, for example, hard-tissue and soft-tissue cephalometric and profile analysis [10,11].…”

“…e step further privacy concerns is the patients' consensus to the therapeutic limitations of teleorthodontics or remote monitoring systems. For example, in the case of virtual consultations, patients must be aware that a comprehensive in-office orodental and craniofacial evaluation is essential for orthodontic diagnosis and treatment planning and that the clinical information provided cannot be considered as based on a definitive diagnosis [2]. In the case of usage of dental monitoring system, due to the absence of specific guidelines, the authors of the present paper warmly suggest clinicians to generate an appropriate informed consent form attesting to the willingness of the patient to cooperate and being compliant with the monitoring protocol defined by the clinician or the medical staff.…”

“…Digital technology has revolutionized the conventional communication paradigm and information flow supporting clinicians in the diagnosis, treatment plan strategies, and healthcare management [1]. Concerning patient communication, telemedicine provides the exchange of patientrelated information with healthcare providers and/or related organizations using digital technology such as radiographic and photographic records and healthcare-related consultations [1,2]. Telemedicine boosts communication between specialists, for example, in those cases requiring a multidisciplinary approach, as well as allows patients to easily refer to a specialist for preliminary consultation, clinical follow-up, or treatment monitoring [3].…”

Teledentistry as a new service line—Not just a coping mechanism for the pandemic

“…During the COVID‐19 pandemic, teledentistry emerged as a safe and effective solution for triaging, diagnosing, and monitoring patients, 1–3 while eliminating their risk of contracting SARS‐CoV‐2. Unfortunately, many see teledentistry's value as being restricted to use during the pandemic.…”