The evolution of a teledentistry system within the Department of Defense.

Total Dental Access (TDA) is the teledentistry project within the Department of Defense. This project enables referring dentists from the US Armed Forces to consult with specialists on the status of a patient. TDA focuses on three areas of dentistry: patient care, continuing education and dentist-laboratory communications. One of the goals of this project is to increase patient access to quality dental care. The other goal is to establish a cost effective telemedicine system. This paper describes the evolution of a teledentistry system, the main features of POTS-based, ISDN-based and Web-based systems used, advantages, disadvantages and cost-effectiveness of these systems. Data has been collected on the frequency of use, technical problems occurred, avoided patient or specialist travel and the total number of consults. A cost-effectiveness analysis has been conducted on the data collected. The results of this analysis will be presented.