Letters to the Editor

Attend Anywhere

We read with interest the recent Dental Update article ‘Remote Working in Dentistry in a Time of Crisis’ and are in agreement with the authors that in a world that has become heavily reliant upon technology, perhaps the COVID-19 pandemic presents the perfect opportunity for dentistry to adapt and make better use of teledentistry, specifically, the ‘virtual consultation’ concept.¹

In the midst of an extremely challenging time for all dental care professionals, where evolving standard operating procedures are almost outdated as soon as they are published, virtual consultations provide a stable alternative, allowing dentists to initiate a ‘triage first’ model for consultations, in an era where nine-out-of-ten UK adults use the internet every week.^2,3

We wish to share our experience following the rapid implementation of virtual consultations via the unique ‘Attend Anywhere’ service in our Trust, which enables patients to not only see and experience the dental setting prior to coming in for a clinical exam, but also to meet the very team members who will become a core part of their continuing care. We feel that virtual consultations could therefore have a positive impact on anxious patients too, acting as a method of acclimatization and desensitization from the comfort of their own home or office.

During the COVID-19 pandemic, the National Health Service (NHS) has released guidance that permits the use of non-medical applications to contact patients where there is no practical alternative.¹ Use of an NHS-approved tool, however, and not commercial products such as Skype, WhatsApp or Facetime, provide the clinician with the knowledge that what they are using complies to all necessary standards, as well as conforming to the required General Data Protection Regulations (GDPR).^1,2 Patient feedback has been wholly positive, with many commenting on the ease of use and interactive nature, especially given that the service can be accessed anywhere, anytime, anyplace, on any device capable of an internet connection.¹

Virtual consultation, in the current climate, may be most applicable in cases where: clinicians are self-isolating or working remotely; a patient is shielding or self-isolating due to coronavirus symptoms; a patient needs advice and reassurance only; a patient is in a care home where staff are available to help.²

Of course, setting up a suitable network is likely to require a significant, initial financial investment and present technical challenges; there would also be concerns regarding missed diagnoses and confidentiality issues.⁴

Dental defence organizations are also realizing the importance of online consultations and the value they have in maintaining social distancing measures and reducing unnecessary travel, with some organizations releasing initial guidance discussing advantages and pitfalls linked to online consultations.

A ‘blended’ approach could be implemented in acute cases to highlight the site and size of a swelling to facilitate remote antibiotic prescribing, where appropriate, or in possible high-stakes diagnoses, where patients are able to let clinicians remotely view lesions and triage accordingly, prior to a face-to-face consultation. The British Orthodontic Society have already released video guidance for patients on how best to take photos and videos to aid triage that could easily be adapted and applied across all dental care.⁵

Virtual consultations have the potential to become an integral part of everyday dentistry, saving time, money and bringing patient care closer to home.