Thesis
Synchronous teledentistry in a university pediatric dentistry clinic: impact on access to care
University of Iowa
Master of Science (MS), University of Iowa
Autumn 2022
DOI: 10.25820/etd.006744
Abstract
Objectives: Teledentistry is a care modality suggested to enhance access to dental care for vulnerable children, but few studies have evaluated the impact of teledentistry on access to dental care. This study examined the impact of new patient synchronous teledentistry visits for children referred to a university dental setting and assessed whether having a new patient teledentistry visit improves access to care compared to referred patients seen only via in-person visits. Access to care was evaluated by comparing treatment completion and second-visit attendance.
Methods: A retrospective chart review was conducted for new patients in the Department of Pediatric Dentistry at The University of Iowa between July 1st, 2020, and June 4th, 2021. Treatment completion and second-visit attendance were compared between patients who had their first visit in person versus via teledentistry. Multivariable logistic regression analyses were used to compare treatment completion and second-visit attendance between the in-person and teledentistry groups after adjusting for potential confounders, including patient’s age, sex, distance traveled, insurance status, behavioral or neurological conditions, and treatment complexity. Separate analyses were conducted for patients treated in the OR (operating room) and dental clinic, in addition to the full sample.
Results: The final sample of new referred patients with an initial visit during the study period was n=654. Of those, 82 (12.5%) had their initial visit by teledentistry. In the dental clinic and OR subgroups, 11% (n=57/504) and 17% (n=25/150) had an initial visit by teledentistry, respectively. The mean driving distance was significantly higher for the teledentistry group than the control (100.68 [SD 53.99] miles vs. 74.37 [SD 35.19] miles (p<0.001), respectively). The dental clinic and OR subgroups had similar trends. Children in the teledentistry group were slightly more likely to complete treatment (84% vs. 74%; p= 0.159), complete the initial visit (95% vs. 89%; 0.074), and complete the second visit (83% vs. 74%; 0.090) than the in-person group. Treatment completion rates varied by care setting between the teledentistry and in-person groups; dental clinic (77% vs. 74%; p=0.584) OR (100% vs. 90%; p=0.127). Children seen by teledentistry did not have significantly different odds of treatment completion (OR, 0.974; 95% CI, 0.50 to 2.02; p=0.940) or second visit attendance (OR, 0.632; 95% CI, 0.35 to 1.29; p=0.695) relative to children with an initial visit in person.
Conclusion: Children seen for an initial visit by teledentistry or in-person visits can achieve comparable degrees of treatment completion and second-visit attendance. Our results suggest that teledentistry can effectively supplement in-person care for the management of dental treatment needs among vulnerable children.
Details
- Title: Subtitle
- Synchronous teledentistry in a university pediatric dentistry clinic: impact on access to care
- Creators
- Sofía Iribarren
- Contributors
- Julie C. Reynolds (Advisor)Kecia S. Leary (Committee Member)Amy B. Lesch (Committee Member)John Warren (Committee Member)Sean McLaren (Committee Member)
- Resource Type
- Thesis
- Degree Awarded
- Master of Science (MS), University of Iowa
- Degree in
- Dental Public Health
- Date degree season
- Autumn 2022
- Publisher
- University of Iowa
- DOI
- 10.25820/etd.006744
- Number of pages
- x, 114 pages
- Copyright
- Copyright 2022 Sofía Iribarren
- Language
- English
- Description illustrations
- Tables
- Description bibliographic
- Includes bibliographical references (pages 111-114).
- Public Abstract (ETD)
Objectives: Live-video visits using between dentists and patients are suggested to enhance access to dental care for vulnerable children, but few studies have evaluated their impact on access to dental care. This study examined the impact of new patient visit conducted via live video for children referred to a university dental setting and assessed whether having a live-video visit improves access to care compared to referred patients seen only via in-person visits. Access to care was evaluated by comparing treatment completion and second-visit attendance.
Methods: A retrospective chart review was conducted for new patients in the Department of Pediatric Dentistry at The University of Iowa between July 1st, 2020, and June 4th, 2021. Treatment completion and second-visit attendance were compared between patients who had their first visit in-person versus live-video. Statistical analyses compared treatment completion and second-visit attendance between the in-person and live video groups after adjusting for potential confounders, including patient’s age, sex, distance traveled, insurance status, behavioral or neurological conditions, and treatment complexity. Separate analyses were conducted for patients treated in the OR (operating room) and dental clinic, in addition to the full sample.
Results: The final sample of new referred patients with an initial visit during the study period was n=654. Of those, 82 (12.5%) had their initial visit via live video. In the dental clinic and OR subgroups, 11% (n=57/504) and 17% (n=25/150) had an initial visit via live video, respectively. The mean distance driven was significantly higher for the live video group than the control (100.68 [SD 53.99] miles vs. 74.37 [SD 35.19] miles (p<0.001), respectively). The dental clinic and OR subgroups had similar trends. Children in the live video group were slightly more likely to complete treatment (84% vs. 74%; p= 0.159), complete the initial visit (95% vs. 89%; 0.074), and complete the second visit (83% vs. 74%; 0.090) than the in-person group. Treatment completion rates varied by care setting between the live video and in-person groups; dental clinic (77% vs. 74%; p=0.584) OR (100% vs. 90%; p=0.127). Children seen by live video did not have significantly different odds of treatment completion (OR, 0.974; 95% CI, 0.50 to 2.02; p=0.940) or second-visit attendance (OR, 0.632; 95% CI, 0.35 to 1.29; p=0.695) relative to children with an initial visit in person.
Conclusion: Children seen for an initial visit by live video or in person can achieve similar degrees of treatment completion and second-visit attendance. Our results suggest that live video visits can effectively supplement in-person care for the management of dental treatment needs among vulnerable children.
- Academic Unit
- Preventive and Community Dentistry
- Record Identifier
- 9984362658902771
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