Technology is all around us. From cell phones to streaming services, technology drives what we do and see every day. Yet dentistry and dental hygiene have been slow to adopt technology. Over the past few years, however, technology has been changing how dental professionals interact with one another and with patients. Many dental hygienists embrace technology while others fear it. This article will review some areas where technology can assist the dental hygienist and transform—not change—the technology conversation.
Medicine has been at the forefront of implementing technology. From the requirements of the Health Information Technology for Economic and Clinical Health Act of 2009 (HITECH) and the Affordable Care Act of 2010 (ACA) to the use of technologically driven diagnostic tools, medical professionals are using technology to benefit their patients. Technology within dentistry should not change how the dental professional treats patients, but rather enhance the overall patient experience, similar to how technology has enhanced the medical patient’s experience.
A report in Health Leaders Media, August 2018, states, “[Telehealth/telemedicine] resources are extending the value and relevance of telemedicine by addressing the quadruple aim to improve population health, enhance the patient experience, reduce costs, and increase provider satisfaction.”1 Utilizing technology in the form of practice management software, digital imaging, intraoral scanning, teledentistry, and disease-detecting solutions, hygienists can be an integral part of the technology conversation within the dental practice.
Starting with practice management software, the hygienist can be faced with the daunting task of understanding the software. Many practices don’t allow for adequate training of the entire team on the use of the software. Lack of training contributes to lost revenue and lost patient case acceptance and compliance. Additionally, teams often don’t understand the implications of not complying with HIPAA within the electronic chart and documentation. As a technology trainer, I ask questions of teams related to HIPAA risk assessments, and I am often confronted with a lack of knowledge regarding how the dental practice handles this vital information. HIPAA risk assessments are a component of the 1996 HIPAA law and need to be conducted by covered entities and business associates of any health-care organization. A risk assessment helps the organization ensure compliance with HIPAA’s administrative, physical, and technical safeguards. A risk assessment also helps reveal areas where the organization’s protected health information (PHI) could be at risk. With the growing number of cybersecurity threats and the demand for health-care PHI, dental and medical practices are prime targets for hackers. A number of companies provide risk assessments, but the Health and Human Services Office of Civil Rights offers a free online assessment for practices to use.2
Another area that often confounds team members is how the practice’s software performs specific tasks and determines practice or hygiene-specific metrics. As the dental profession moves toward the medical model of care, metrics will become even more important. The hygienist should understand the practice management software beyond just charting and documentation, and also utilize it to determine how the hygiene department is benefiting patients as well as the practice. Prophy-to-periodontal percentages, hygiene collections versus productivity, and recall percentages to active patients are just a few of the many metrics that can be determined by the software. Depending on the practice and the software, these metrics can be measured daily, weekly, or monthly.
Digital imaging—whether traditional 2-D imaging with sensors, phosphor plates, or 3-D cone beam images— provides dental professionals and patients with diagnostic capabilities that previously were unimagined. Cone beam computed tomography (CBCT) has revolutionized dental imaging by bringing in the third dimension of imaging. Traditional 2-D imaging provides only height and width, while 3-D imaging provides the depth.3 Two-dimensional imaging is good for diagnosing simple concerns, while 3-D imaging lends itself to more in-depth diagnosis and use in complex treatment planning. Digital imaging combined with intraoral photography assists teams in increasing patient case acceptance. The old adage, “A picture is worth a thousand words,” is so true in today’s digitally enhanced practice. Patients understand and can take ownership of their health when they see the effects of disease. They can be involved in the results of care rather than just being told about it or viewing issues on small black-and-white images.
In the same vein, utilizing patient education materials that are geared to each patient’s learning style and interests via technology-driven products offers patients relatable information while they are being entertained and informed. Digital health education materials can be viewed by patients anytime, anywhere, and they afford patients the ability to discuss their care with family members outside of the dental practice.
Over the past decade, intraoral scanning has taken hold within the dental industry. Initial scanners required powder and were only able to construct single-unit crowns, but digital scanners have evolved into today’s scanners that can be used to create in-house prosthetics and multiunit restorations. CEREC, iTero, 3Shape Trios, 3M True Definition, and Planmeca Emerald are just a few of the brands of scanners on the market. Depending on the philosophy of the practice and cost analysis, there are scanners available to fit every budget and use. Some scanners allow only for in-office scanning; the images are then sent to the dental lab. Others combine with in-office mills or 3-D printers to produce prosthetics in-house within a short time frame. When a scanner is used to obtain digital study models, patients no longer have to tolerate gooey, unpleasant impressions. From the single-unit crowns to implant restorations to orthodontic treatments, scanners provide teams and patients with ease of treatment in less time. Depending on the type of scanner purchased and its qualities, detailed information regarding the patient’s bite and alignment can be determined. Patients appreciate the time saved during treatment, and teams appreciate the opportunities to learn new skills while providing patients with the latest in technology.
Technology-driven diagnostic tools include caries and oral cancer detection aids, in addition to risk-assessment programs for oral cancer, periodontal disease, and caries. Examples of caries detection tools include the Diagnodent, Sopro camera, and Spectra Caries Detection. Oral cancer screening tools include the Velscope, ViziLite, Identifi, and OralID. Although detection aids have been criticized at times for resulting in false positives or negatives, they are adjunctive devices that aid in patient assessment and can be used to supplement visual and tactile evaluations. The risk-assessment programs offered by a variety of vendors offer hygienists and patients unbiased assessment of patient risk for the big three: cancer, periodontal disease, and caries. Risk assessments such as PreViser, Colgate’s Gum Health Physical, and Philips CARE provide the team and patient with a variety of information.
Having a disinterested third party (the technology) inform patients of their disease status moves the needle forward to patient compliance. Patients appreciate technology in all of its forms. Using a third-party technology for disease risk empowers the patient to proceed rather than have the mentality, “Oh, the doctor needs a new car … ,” which could be associated with the risk if voiced by the doctor or the hygienist. Whether good or bad, patients often trust technology more than verbal information given by dental professionals.
As in medicine, the growth of teledentistry is rapidly expanding. Patients appreciate the convenience of contacting their dental practice with live asynchronous updates. Dental teams and practices can reach more patients with fewer resources, while providing appropriate care and treatment to those physically unable to get to a dental practice. Products such as MouthWatch and OperaDDS can give dental professionals and patients the tools they need to maintain oral health.
With all of the technologies that are available to the dental professional, it can be a daunting task to incorporate them. As hygienists, we are the educators of the practice for both team members and patients. By using our skills and knowledge, we can be leaders of the team in regard to technology. Through proactively researching available products and technologies, we can play a key role in the adoption of technology within the dental practice. As leaders and transformers, we need to advocate for training and discussion about all aspects of any new technology that our practices are considering. Without adequate input and training on new technologies, the doctor could be setting up the team and the practice for failure. Technology is a great adjunct to any practice, but when team members are left out of the conversation or not adequately prepared to use the technology, patients will suffer.
Discussing how technology can enhance patient care and the practice with the team and doctor is not an easy conversation. Hygienists can be the leaders within the practice as they engage and empower other team members, the doctor, and the patients regarding how technology can benefit them in dentistry as it does in their everyday lives. Many vendors of technology products supply practices with in-office training sessions, remote assistance, and online videos and tutorials. However, teams must remember that anything found on the internet through social media pages or YouTube may or may not present accurate information. The best source of information is found on the manufacturer’s website or in training modules. Attending continuing education programs on technology and then returning to the practice with information to share with the team is another way hygienists can assist in learning about technology. Take the leadership role and learn as much as you can about the technologies that are improving dentistry and dental hygiene.
References
1. Roth M. 4 ways telemedicine is changing healthcare. HealthLeaders website. https://www.healthleadersmedia.com/innovation/4-ways-telemedicine-changing-healthcare. Published August 28, 2018. Accessed July 29, 2019.
2. Security risk assessment tool. HealthIT website. https://www.healthit.gov/topic/privacy-security-and-hipaa/security-risk-assessment-tool. Updated July 29, 2019. Accessed July 29, 2019.
3. 2d versus 3d dental imaging, which one is better? Progressive Dental website. http://progressivedentalhouston.com/2d-verses-3d-dental-imaging-which-one-is-better/. Accessed July 29, 2019.
Ann-Marie DePalma, MEd, RDH, CDA, FAADH, FADIA, is a technology advisor for Patterson Dental, a writer for RDH magazine, and an author in dental hygiene textbooks. She is the 2017 Massachusetts College of Pharmacy & Health Sciences Esther Wilkins Distinguished Alumni recipient. She is a continuous member of the American Dental Hygienists’ Association and an active member of the Massachusetts Dental Hygiene Association.
