Teledentistry is a potentially transformative force in oral health delivery. By enabling remote consultations, diagnostics, and patient education, it offers a pathway to bridge geographical gaps, reduce costs, and improve access to care. However, like any innovation, teledentistry presents a complex interplay of opportunities, risks, and challenges that must be addressed to ensure its safe, equitable, and sustainable adoption.

How should these interactions occur and, more importantly, is there a role for us as clinicians to interact virtually with our patients on a routine basis now or in the near future? And even if we can, should we? Will teledentistry as a diagnostic and treatment modality be what composite resin has been to amalgam? Further, will venturing down this virtual “rabbit hole” create ethical, professional financial and legal issues from unintended consequences of implementing digital solutions in our workplace? 

History and application 

Teledentistry rose to prominence in Australia during the Covid-19 lockdowns, when strict regulations impacted the ability of patients to seek care. Virtual consultations enabled clinicians to diagnose simple issues over video calls and screen patients to determine if they needed urgent hands-on treatment. Yet this was not a new phenomenon. As far back as 1994, teledentistry has been used in diagnostics within the US military to help facilitate appropriate access to dental care.¹ 

Nowadays, teledentistry is yet to gain widespread routine application in general dental care due to the inherently personal and “hands-on” paradigm of dental service delivery. However, its use in monitoring the progress of orthodontic tooth movement in aligner therapy is becoming increasingly commonplace and well accepted. Besides this monitoring role, teledentistry may include the provision of services like teletriage, teleconsultation, telediagnosis and tele-education. All modalities have the potential to reduce the frequency of in-person visits or, in certain situations, the need to attend in person at all. For example, teleconsultations can occur directly between the patient and clinician, or between multiple clinicians who may each be involved in some aspect of the patient’s care. This enables those in remote areas to access the advice of specialists or other expert practitioners who may be located elsewhere, potentially reducing the time and cost required to determine if treatment is required in person, while ensuring that scarce healthcare resources can be optimally allocated to those patients genuinely in need of interventions.

Opportunities 

The emergence of teledentistry provides us with a platform to enhance care, should we choose to use it wisely. These opportunities primarily extend to improving reach, timeliness, costs and health outcomes in the following areas:

Improved access to care 

One of the most significant benefits of teledentistry is its ability to reach underserved populations, including rural or remote areas where dental professionals are scarce. Patients can receive preliminary assessments, follow-up consultations and oral health education without the need for long-distance travel. This is particularly valuable for elderly patients (including those in aged care facilities), individuals with disabilities and mobility impairment, and communities with limited transportation infrastructure. By screening patients prior to seeing them in-person, patient throughput can be enhanced. Where urgent care is required, this approach allows treatment to be expedited, reducing waiting lists. Earlier referral may also improve patient outcomes by preventing the exacerbation of oral disease. 

Cost efficiency 

Teledentistry can reduce both direct and indirect costs. For patients, it eliminates travel expenses and time away from work or school. For providers, it can lower overhead costs by reducing the need for physical clinic space for certain services and wages for support staff. Public health systems can also benefit from early detection and prevention, reducing the burden of advanced dental disease in susceptible populations. 

Enhanced preventive care 

Through regular virtual check-ins, patients can receive timely advice on oral hygiene, dietary habits, and early signs of dental problems. This proactive approach can help prevent minor issues from developing into serious conditions, ultimately improving population-level oral health outcomes. Teledentistry may prove to be the bridge to encouraging access to care amongst the approximately 30% of the population failing to visit a dentist regularly2.

Interprofessional collaboration 

Teledentistry facilitates collaboration between general dentists, specialists, and other healthcare providers. Digital imaging, patient records, and treatment plans can be shared instantly, enabling multidisciplinary care and more accurate diagnoses. It also enables stored data to be forwarded to clinicians for offline review and opinion generation.

Improved compliance, record keeping and consent 

Digital connections between patients and dental teams support more efficient care by enabling pre-appointment information to be completed online. In some cases, this approach is more reliable than traditional methods that depend on paper records, real-time exchanges, or delayed access to test results 

Improved patient screening and safety 

How many of us would prefer to avoid ever having to treat an aggressive, belligerent or blatantly rude patient? How frustrating is it to have patients attend for problems that might not require intervention, or are in an area of dentistry where we lack the appropriate knowledge or expertise? Teledentistry can enhance the screening of patients to enable them to be directed to clinicians best suited to manage their clinical needs and/or their temperament, or potentially their referral to a tertiary institution. Naturally this may incur risks, which are discussed below.

Risks 

Data privacy and security 

The transmission of patient records, images, and video consultations over digital platforms raises concerns about data breaches and unauthorised access. Inadequate cybersecurity measures could compromise sensitive health information, leading to legal and ethical repercussions. Where that data is stored may also prove problematic when dealing with third parties whose policies require assurance that the data will not leave Australia. There also remains a risk that interacting digitally with patients may open up opportunities for scammers to impersonate patients for personal or financial gain, including requests for prescriptions for restricted substances like Schedule 4 or 8 drugs.

Diagnostic limitations 

While high-resolution imaging and video conferencing have improved, remote consultations cannot fully replicate the tactile and visual assessments possible in person. Certain conditions may be missed or misdiagnosed, potentially delaying necessary treatment. So much of our diagnosis occurs without us consciously performing tests on a patient. We get a feel for what is happening and can process verbal and non-verbal cues, as well as implement specific interventions to explore an issue in detail. This may be lacking in teledentistry, in part or altogether.

Digital divide 

Not all patients have equal access to the internet, smartphones, or computers. Those in low-income or technologically underserved areas may be excluded from the benefits of teledentistry, exacerbating existing health inequalities. The unfortunate reality is that many remote locations that lack access to health care also have poor internet coverage. Dentists and other oral health professionals, particularly those located in remote areas, may also incur added costs in equipping surgeries or other workplaces with reliable internet of sufficient bandwidth to enable video calls and the transfer of large imaging files. If digital networks fail, even for a short period, teledentistry comes to a halt, unlike most face-to-face interactions.

Regulatory and liability issues 

The legal framework for teledentistry is still evolving. Questions remain about cross-jurisdictional licensing, malpractice liability, and reimbursement policies. Who is responsible for a misdiagnosis or missed diagnosis where multiple clinicians have conjointly been consulted virtually? What professional obligations do we have if we suspect a patient is not sharing all relevant information to us virtually and how do we encourage them to attend for further in-person assessment? What if they don’t wish to comply and our provisional diagnosis proves to have been in error? How will we demonstrate that we did not cross professional boundaries in our virtual discussions with our patients where we lack the presence of a DA to witness the appropriateness of that interaction? These risks are in one sense nothing new; however, without clear regulations, both patients and providers face uncertainty in this emerging service delivery paradigm. 

Added to these issues, clinicians will need to ensure that virtual patient visits remain well documented as part of the clinical record. Making an audio- or audio-visual recording of those visits requires patient consent and is currently insufficient for regulatory compliance. Use of AI to transcribe such visits could prove contentious. There remains considerable risk that the bulk of these records will need to be wholly produced by the clinician (rather than with a DA making notes) and if consultations occur in rapid succession, details may be missed.

Teledentistry may also increase the risk of patients “doctor shopping” for opinions and lead to increased complaints or claims.

Further challenges 

Training and adoption 

Dental professionals must be trained not only in the technical use of teledentistry tools but also in adapting their clinical workflows to a virtual environment. Resistance to change, lack of familiarity, and perceived complexity can slow adoption. Managing change in a workplace is always a challenge, particularly where staff may lack computer literacy skills and interact more slowly in these platforms than they might do face-to-face. 

Integration with traditional care and relationship building 

Teledentistry should complement, not replace, in-person care. Determining which services are appropriate for remote delivery and ensuring smooth referral pathways to physical clinics is a logistical and clinical challenge. Most patients desire to know the clinicians rendering them their treatment, forging trusting relationships in the process. Teledentistry may improve access to care, but how might we avoid making it fleeting, impersonal and lacking in long-term continuity? We’ve grown to realise in the post-Covid era that virtual contact for professional education and the like, while very convenient, can result in a loss of networking and quality interaction. Part of the ongoing challenge may be to not compromise the quality of the patient experience. 

Career growth  

There is already a trend towards reducing commission percentages for contractors and associates in private practice. Teldentistry’s adoption may increase the time that clinicians spend in a virtual space, which could impact on remuneration and job satisfaction. 

Clinicians always learn from each other. Those starting out in their dental career stand to learn so much from the colleagues around them, often by what seems to be “professional osmosis.” While teledentistry may broaden interdisciplinary interactions with specialists and other providers for many, it could also create opportunities for niche providers to contract dentists (especially those desperate for work) to provide round-the-clock teledentistry services. Such dentists may then be denied opportunities to consult colleagues about their own care of patients and upskill in the delivery of hands-on dental care over time. 

Clinicians quickly lose confidence in performing complex and/or time-consuming procedures and there remains a risk that those clinicians who move into a primarily diagnostic or educational role in teledentistry may lose their hands-on clinical skills.

Payment 

As a society we are growing accustomed to free access to enormous quantities of information. While our patients expect to pay for professional advice, how much they may be willing to pay in future remains uncertain. Ensuring payment is received from patients can also be challenging where electronic payment mechanisms are offline. Issues of informed financial consent, although able to be overcome through clear indications of pricing for teledentistry visits up front, may be further complicated when health fund or other claims are simultaneously involved.

Resourcing increased demand for clinical services 

While improved access to diagnosis and education is laudable, challenges may remain in delivering much-needed clinical treatment to those in need. Teledentistry will need to be accompanied by resourcing throughout the whole healthcare value chain if it is to reliably deliver improved long-term oral health outcomes. 

Conclusion 

The future of teledentistry will likely involve hybrid models that combine virtual and in-person care. This will ensure diagnosis is followed up where appropriate with in-person consultation and treatment. Advances in artificial intelligence, intraoral scanning, and remote monitoring devices could further enhance diagnostic accuracy and patient engagement. Policymakers, dental professionals, and technology developers will need to continue to work collaboratively to ensure those challenges are overcome within a rapidly evolving space, enabling teledentistry to be thoroughly integrated into clinical service delivery.

Given that, it seems teledentistry will not be a passing fad but holds immense promise for transforming oral healthcare delivery by expanding access, reducing costs, and fostering preventive care. Yet, its success depends on addressing some inherent risks and overcoming significant challenges. Without appropriate guidelines and safeguards, there remains the risk of professional and reputational damage for providers who fail to exercise appropriate caution and discernment in managing their interactions with patients, either virtually or in-person. 

Clearly, direct in-person patient examination remains the “gold standard” for care in almost all clinical situations. Dental Protection encourages its members to carefully consider how teledentistry may be used as an adjunct to comprehensive patient care.

References 

1 Hamdy, T.M. Teledentistry: a comprehensive review of applications, challenges, and future directions. Discov Med 2, 201 (2025). https://doi.org/10.1007/s44337-025-00445-z