Orthodontic Remote Consultations during the Pandemic Helping Limit the Spread!

Dear Editor,

The global crisis caused by COVID-19 pandemic, has resulted in a worldwide endeavor to find ways to prevent the spread of the disease. Dentistry and orthodontics have been shown to be highly risky in terms of cross-infection, making tele-dentistry a practical tool to help reduce viral dissemination by eliminating direct person-to-person contact. Tele-orthodontics allows both patient and clinician to save time, money and ensure that the patients’ fears are alleviated. It is not only fundamental for the continuation of treatment but also from an emotional/psychological view, it helps reassure patients of their treatment progress. However, the reliability of records obtained from patients must be considered. For this purpose, benchmarks should be established for minimum desired quality and quantity of records. Digital orthodontics is a new area which requires basic standards to ensure that the quality of treatment is not compromised.

The following recommendations are mostly what we have been following in South-East Asia with good results, all of which could be incorporated into orthodontic practice:

• Orthodontists that perform virtual consultations must ensure a standard protocol with adequate records to ascertain that the treatment progress is as planned.

• Tele-orthodontic consultations should include video-calls, photographs and written chief-complaints by the patients.

• Written informed consents specifying the treatment plan, benefits, and potential risks, must be obtained from the patients or their legal guardians.

• For patients already under treatment, troubleshooting can be done by asking them to submit intra-oral photographs, taken with help from someone.

• New patients that require treatment should be encouraged to contemplate two-phase therapy: ‘aligners’ and ‘fixed-orthodontic-brackets’.

• Reviewing treatment progress, explaining outcomes or potential concerns, demonstrating wearing elastics and providing consultations and counseling, can be accomplished via tele-orthodontics [1].

• Virtual consultations across different regions can be compared, to improve the experiences of others so that a uniform model is established.

• Clinicians can make use of aligners to carry out parts of the treatment in patients that are yet to have their fixed appliances placed [2].

While some of these recommendations are helpful in the short term, most of them should be implemented in the post-pandemic scenario. It is noteworthy that there are a lot of patient-associated problems that cannot be sorted through remote consultations. While tele-orthodontics may be useful in getting initial opinions, an in-office visit is recommended for obtaining comprehensive diagnostic records [3]. Since orthodontic treatment is a continuous process, it is essential for an orthodontist to establish a rapport with the patient to ensure cooperation during treatment. With decreased face-to-face visits, it may become harder to build an ideal doctor-patient relationship. Also, problems such as broken wires, debonded brackets and wire-slippage cannot be resolved virtually and would require visits to the dental office.

By conforming our practice to highly secure standards, it would help put the orthodontist and patient at ease [4]. An additional consideration must be given to data privacy; while embracing technology, regulation should be observed so that virtual consultations are conducted in a professional manner leading to healthy outcomes.

CONFLICT OF INTEREST STATEMENT

None declared.

Notes:

Cite this article as: Marya A, Venugopal A. Orthodontic Remote Consultations during the Pandemic Helping Limit the Spread! Front Dent. 2021:18:1.