During the early months of the COVID-19 pandemic, there was a dramatic increase in the use of teledentistry — a strategy that improved access to oral health services despite full or partial closures of dental practices.
A recent report by the Oral Health Workforce Research Center (OHWRC) at the University at Albany’s Center for Health Workforce Studies (CHWS) in the School of Public Health explored the use of teledentistry by safety-net organizations, which include Federally Qualified Heath Centers (FQHCs), to bridge access to care during the pandemic.
Teledentistry offers an effective way to conduct appointments involving triage, consultation, diagnosis, referral, follow-up and health education, reducing the number of in-person visits.
Even though teledentistry services are widely accepted by providers and patients alike, the most significant barrier preventing the adoption and expansion of teledentistry services is variability around teledentistry authorization and regulation. While some states have specific laws and regulations that support teledentistry, others do not. State-level variability in teledentistry regulation often limits the ability of safety-net clinicians to provide virtual oral health care.
OHWRC researchers conducted interviews of safety-net oral health providers and administrators, who described their experiences using teledentistry services. The majority of key informants expressed interest in continuing to provide services via teledentistry beyond the pandemic. However, barriers to teledentistry expansion were identified, including lack of Medicaid reimbursement, which is key for populations primarily served by safety-net organizations. Researchers found that after the expiration of the COVID-19 Public Health Emergency on May 11, 2023, only 14 states are continuing to offer Medicaid reimbursement for teledentistry services.
State-level restrictions on who is authorized to deliver teledentistry services pose additional barriers to service access. In some states, only dentists are allowed to deliver teledentistry services, limiting access to dental services that could be delivered by other oral health providers, including dental hygienists.
As part of their study, OHWRC researchers assessed state laws, regulations and policies related to teledentistry in the 51 regulatory jurisdictions of the U.S. to compile a state-by-state comparison of the barriers to and facilitators of the use of teledentistry. An interactive infographic was developed to illustrate current regulatory guidance for teledentistry by each state in the U.S.
“Teledentistry proved itself during the pandemic; we learned that it expanded access to care,” says CHWS Director Jean Moore. “Moving forward, we need to identify ways to reduce the variability in teledentistry regulation and authorization to enable its use and to improve access to quality dental services in the future.”