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Williams (2025) - Effect of an Initial Synchronous Teledentistry Visit on the Efficiency of Dental Treatment Initiation for Pediatric Patients609.66 kB
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Thesis
Effect of an initial synchronous teledentistry visit on the efficiency of dental treatment initiation for pediatric patients
University of Iowa
Master of Science (MS), University of Iowa
Spring 2025
DOI: 10.25820/etd.007819
Abstract
Objectives: Teledentistry has emerged as a potential care modality to improve access to dental care, especially for children facing geographic, financial, and structural barriers. While prior studies have shown that teledentistry may support diagnostic accuracy and follow-up attendance, its efficiency in initiating dental treatment remains underexplored. This study examined the efficiency of an initial synchronous teledentistry visit in preparing pediatric patients for treatment at a subsequent in-person visit. Specifically, it evaluated whether treatment initiation at the second encounter differed between children initially seen via teledentistry and those seen in person. A secondary aim was to assess whether the type of asynchronously submitted diagnostic information (radiographs, intraoral photos, or both) influenced treatment initiation outcomes. By focusing on the second encounter as a critical point of care, this study sought to determine whether teledentistry can function as a reliable entry point into pediatric dental treatment without delaying care and to identify factors that may enhance or hinder its efficiency in clinical settings.
Methods: A retrospective chart review was conducted using dental records of patients referred to the Department of Pediatric Dentistry at the University of Iowa between July 1, 2020, and May 31, 2024. The study compared treatment initiation at the second encounter between patients whose initial visit was conducted in person versus synchronous teledentistry. Bivariate analyses and multivariable logistic regression were used to compare second-visit treatment initiation rates between groups and evaluate the impact of asynchronously submitted diagnostic information (radiographs and intraoral photographs) among teledentistry patients. The multivariable analysis adjusted for potential confounders, including age, gender, dental insurance status, rurality/urbanicity of residence, driving distance, chronic medical conditions, dental condition complexity, and the behavior management modality.
Results: Of the 799 patients included in the study, 181 (23%) had their first visit via teledentistry, and 618 (77%) had an in-person visit. Among in-person patients, 49% received treatment at their initial encounter. At the second encounter, treatment initiation rates were similar between teledentistry (87%) and in-person (91%) groups; this difference was not statistically significant (p = 0.13). Teledentistry patients were more likely to reside over 100 miles from the clinic (18% vs. 8.1%; p < 0.001), have public insurance (77% vs. 71%; p = 0.025), present with moderate dental issues (3–4 sextants affected: 50% vs. 34%; p < 0.001), and require nitrous oxide (59% vs. 44%; p < 0.001) for behavior management. They were less likely to have chronic medical conditions (23% vs. 33%; p = 0.008). Multivariable analysis indicated that teledentistry patients had 39% lower odds of receiving treatment at the second encounter compared to in-person patients, though this was not statistically significant (OR = 0.61; 95% CI: 0.30–1.2; p = 0.2). Among teledentistry patients, submitting only radiographs was associated with higher odds of treatment initiation at the second encounter compared to submitting both radiographs and intraoral photos, though this finding was not statistically significant (OR = 2.3; 95% CI: 0.72–8.0; p = 0.2).
Conclusion: Teledentistry demonstrated comparable efficiency to in-person visits in initiating dental treatment, with similar rates of treatment initiation at the second encounter. While patients who submitted radiographs appeared more likely to begin treatment at the second encounter compared to those who submitted intra-oral photographs or both, this observation did not reach statistical significance. These findings suggest that with appropriate selection criteria and protocols, teledentistry has the potential to efficiently initiate timely dental treatment.
Details
- Title: Subtitle
- Effect of an initial synchronous teledentistry visit on the efficiency of dental treatment initiation for pediatric patients
- Creators
- Shenice Williams
- Contributors
- Julie C Reynolds (Advisor)John Warren (Committee Member)Kecia S Leary (Committee Member)Chandler Pendleton (Committee Member)
- Resource Type
- Thesis
- Degree Awarded
- Master of Science (MS), University of Iowa
- Degree in
- Dental Public Health
- Date degree season
- Spring 2025
- DOI
- 10.25820/etd.007819
- Publisher
- University of Iowa
- Number of pages
- viii, 99 pages
- Copyright
- Copyright 2025 Shenice Williams
- Language
- English
- Date submitted
- 04/28/2025
- Description illustrations
- illustrations, tables
- Description bibliographic
- Includes bibliographical references (pages 96-99).
- Public Abstract (ETD)
- Objectives: This study examined whether real-time video conferencing (synchronous teledentistry) can facilitate efficient initiation of dental treatment for children. It compared the efficiency of teledentistry visits with traditional in-person visits, focusing on treatment initiation at the second appointment. Additionally, it explored how different types of diagnostic materials submitted during or before the teledentistry visit (such as X-rays or photos) might influence the start of treatment. Methods: Researchers reviewed dental records of 799 pediatric patients referred from local dentists to the Department of Pediatric Dentistry at the University of Iowa between July 2020 and May 2024. Statistical analyses compared second-visit treatment initiation rates between patients whose initial visit was conducted in person versus teledentistry and assessed whether the type of diagnostic information provided affected this outcome. Results: Out of the total patients, 181 (23%) began care through teledentistry, while 618 (77%) had their first visit in person. At the second appointment, treatment initiation rates were similar between the teledentistry group (87%) and the in-person group (91%). Children who used teledentistry were more likely to live over 100 miles from the clinic, have public insurance, and present with moderate dental issues. They were less likely to have chronic medical conditions. Submitting only X-rays showed a non-significant trend toward the likelihood of initiating treatment at the second visit. Conclusion: Teledentistry demonstrated comparable efficiency to in-person visits in initiating dental treatment. With appropriate protocols, it offers a viable option for timely dental treatment, particularly for those facing access barriers to dental services.
- Academic Unit
- Preventive and Community Dentistry
- Record Identifier
- 9984831021402771
Metrics
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