Pictured above is the model for a virtual dental home concept at the University of Pacific School of Dentistry. Using cloud technology, the university is able to manage a program that delivers care to virtual dental homes for traditionally underserved populations. You can read more about this program in the winter issue of Mouth, available online now.
Is teledentistry and the virtual dental home the future of dentistry? While only time will tell, this model serves as an attempt to address dentistry’s barriers to care issue. But before we can look into its efficacy, we are faced with the question: Is this model ethical?
As dental professionals, we are bound by a code of ethics centered on the principles of patient autonomy, beneficence, non-maleficence, justice, and fairness when determining the dental work we perform and the means by which we perform it.
Patient Autonomy: “self-governance”
The dentist has an obligation to respect the patient’s independence and privacy.
Non-maleficence: “do no harm”
The dentist has the duty to refrain from harming the patient, including the determination of when dental care can be referred to a dental auxiliary.
Beneficence: “do good”
The dentist’s primary duty is to beneficially serve the patient and public through the delivery of proficient and appropriate dental care.
The dentist should be fair in their dealings with society, including actively seeking ways to improve access for dental care for all patients in a population.
The dentist has the duty to communicate truthfully to the patient.
In this model the dental auxiliary’s scope of practice differs from the current model and therefore requires special considerations. While the possibility of harming patients through the placement of interim-therapeutic restorations (ITRs) and radiographic exposure exists, these are risks commonly associated with dental treatment. Since the dentist is able to review the diagnostic information prior to any irreversible procedures being performed and determine if the patient needs to come into the dental office to receive dental treatment, this method provides a safe means of dental care.
The allied dental personnel can provide education, triage, case management and preventative procedures to patients onsite, reaching a population that was previously unable to receive dental care. Furthermore, onsite dental personnel are more familiar with the community and may provide a better means of communicating the importance of oral health to the target population.
While certain precautions must be made when determining the scope of practice and oversight of the dental allied personnel, it is our ethical obligation to attempt to reach the millions of people who are unable to receive dental care every year. To deprive the population of dental care may therefore be seen as unethical. It is time for dental professionals to take the lead in solving the barriers to care problem in this country, and teledentistry may be a piece of the answer.
What is your opinion on this new model? Do you think this has potential to solve the barriers to care issue and do you think this is considered ethical?
~Kris Mendoza, Los Angeles ’15, District 11 trustee