Role of telemedicine and mid-level dental providers in expanding dental-care access: potential application in rural Australia

Abstract

Despite great progress in oral health over the past three decades, the rates of caries remain high in Australia, particularly among underserved populations. The reasons for poor oral health amongst underserved populations are multiple, but rests with socio-economic determinants of health. The present review considers international workforce models that have been created to enhance the recruitment and retention of dental providers in rural areas. Several strategies have been developed to address care access problems in rural areas, including the use of telemedicine and mid-level dental providers (MLDPs). Despite ongoing opposition from dentistry organisations, the Alaska and Minnesota workforce models have proven that developing and deploying dental therapists from rural communities has the potential to address the unmet needs of underserved populations. It is more efficient and cost-effective for MLDPs to perform triage and treat simple cases and for dentists to treat complicated cases. The use of MLDPs is intended to increase the capacity of the dental workforce in areas that are too isolated to entice dentists. Telemedicine has emerged as one solution to address limited access to health care, particularly in locations where there is a lack of providers. Telemedicine not only provides access to care, but also offers support, consultations and access to continuing education for practicing dental providers in rural areas. This strategy has the potential to free up resources to increase care access and reduce oral health disparities, thereby contributing to closing the rural-urban oral health gap.

Dental Care Access and the Elderly: What Is the Role of Teledentistry? A Systematic Review

“…Teledentistry belongs to the natural process of the digitalization of modern society and medicine. It is able to improve services, breaking down barriers and allowing also people with limited or no possibility to access to dental care [33,34]. The relationship between health and inequalities has been deeply investigated by considering different professional and social conditions, showing that mortality rates increase in proportion to economic and social hardship, lower incomes, education, and social class [35].…”

An evaluation of a referral management and triage system for oral surgery referrals from primary care dentists: a mixed-methods study

“…Remote clinical triage has been utilised in several settings 43 and for various clinical disciplines, but the efficiency of this approach for oral surgery referrals based on the described case complexity assignments has not been assessed. 44,45 The use of consultant-level triage was considered as a 'reference standard', and designating an experienced clinician to lead the service was thought, by many, to ensure safe and appropriate triage in the absence of established pathways.…”

A dental workforce strategy to make Australian public dental services more efficient

“…The oral health workforce profile has changed since the landmark 1993 Nuffield Foundation report recommended the establishment of the ‘oral health therapist’, to complement existing dental services mainly provided by dentists [27]. It is widely recognised that the OHT workforce provides high-quality and cost-effective dental services within their scope of practice, which enables dentists to focus on more complex procedures [28, 29].…”