A Study to Assess Patients' Perception and Acceptance of Teledentistry for Care During the Covid-19 Pandemic.

Background: With the aim of preventing the spread of coronavirus disease 2019 (COVID-19), teledentistry allows for the follow-up of patients who can be remotely monitored, decreasing patient mobilization and reducing the risk of virus dissemination. The aim of this cross-sectional pilot survey was to assess patients' perception and acceptance of a teledentistry program during the COVID-19 pandemic. Materials and
Methods: Demographic characteristics of the patients were recorded, and a 24-question survey was completed. A Chi-square test and an analysis of variance (ANOVA) test were performed with a significance level set at P ≤ 0.05.
Results: Forty-eight percent patients declared an interest in the use of a teledentistry. Furthermore, 45% participants preferred this type of visit to a conventional dental visit.
Conclusion: Our study showed that teledentistry appears to meet the expectations and needs of our patients. Copyright:

INTRODUCTION

The World Health Organization (WHO) has classified coronavirus disease 2019 (COVID-19) a pandemic due to its global spread. To minimize the virus transmission and flatten the COVID-19 case curve, Indian authorities implemented physical distancing measures based on WHO norms. This had a tremendous impact on the delivery of health services because the people of India, like any other citizen of the world, needed to be looked for in terms of their health.[123] Teledentistry is defined by WHO as the delivery of health-care services utilizing information and communications technology (ICT) for disease diagnosis, treatment, and prevention, as well as research and education in the health profession. Teledentistry can help with communication and engagement not just between the patient and the health-care practitioner, but also between the providers themselves. Indeed, it can help to bridge gaps in the nonhomogeneous distribution of health-care services by removing geographic and temporal obstacles to some extent. Teledentistry provides for less attendance at the care sites, lowering the danger of COVID transmission. This is especially advantageous for patients and practitioners who need to be shielded. These encounters can be used in conjunction with face-to-face meetings to save time and money by avoiding the need to travel to see a specialist if the problem can be solved with guidance or to validate the appropriateness of a referral. Although teledentistry is not new, it is currently only employed on a small scale, and its benefits have yet to be completely investigated. Video consultations allow professionals to keep in touch with their patients without having to see them in person. Furthermore, patients and health-care staff, particularly those who are more vulnerable members of the society, can feel safe by decreasing nonessential interaction and the psychosocial impacts of dread and worry. Because consultations are conducted remotely, there is also the added benefit of supporting sustainability in dentistry by lowering carbon emissions.[456789101112] Nonetheless, there is a scarcity of published information demonstrating patient readiness and acceptance of teledentistry services, making future service supply difficult to plan.

MATERIALS AND METHODS

A telephone survey was administered by a trained interviewer during April 2021. The sample size obtained was 100 patients. Only patients aged >18 years old were included. Patients who met the following criteria were excluded from the study: those aged >75 years, those who did not answer telephone calls after three tries, those who did not give consent, those with language difficulties, and those with mental disabilities. Each participant was informed about the study, including the following information: interview duration (mean duration: 20 min), aim of the survey, guarantee of participant anonymity, and the option to withdraw from the study. The survey consisted of 24 multiple-choice questions divided into four different domains: sociodemographic variables (gender, age, civil status, city of residence, occupation, etc.), factors that may influence the patient's experience, skills in the use of technology (ability to use information technology [IT] devices, ability to use smartphone cameras, etc.), and interest in teledentistry services. The answers were encoded and entered into an Excel spreadsheet (Microsoft Office 2016, Redmond, WA, USA). Statistical analysis was performed using Statistical Package for the Social Sciences (SPSS) software version 25.0. (IBM, Chicago, IL, USA). The statistical significance level was set at P ≤ 0.05. Ethical approval is taken. 29-01-2021

RESULTS

The sex distribution of the patients was 50% males and 50% females, with a mean age of 35.44 ± 10.52 years. The majority of the patients had access to digital devices and possessed enough skill to use these resources. Also, 89% patients claimed to own a computer or a smartphone connected to the internet in their home; 54.7% patients stated that they were skilled in the use of these technologies; of the remaining 45.3% patients, 11% stated that they had the possibility of being supported in the use of these technologies by a relative and/or a close friend. Regarding the complexity of taking an intraoral photograph, 38% patients answered that this procedure was “possible” and 8% patients answered “easy” [Figure 1]. The greatest advantage identified by patients in favor of this technology was the ability to remain at home, while the absence of physical contact was regarded as the greatest disadvantage. The most interesting result from our survey was that 48% of participants declared that they were interested in using a new teledentistry service. Furthermore, 45% participants declared that they preferred e-platform type of visit to a conventional dental visit [Figure 2].

Figure 1

Reported difficulty in taking intraoral photos by the study population

Figure 2

Reported interest in teledentistry service by the study population

DISCUSSION

With the rapid development of the internet and smartphone apps, teledentistry has transitioned to a multimodal paradigm, offering greater possibilities and convenience. With the aim of preventing the spread of COVID-19, teledentistry allows for the follow-up of patients who can be remotely monitored, decreasing patient mobilization and reducing the risk of virus dissemination. The reduction in physical visits and possibility of provider-to-provider communication via the web reduces the risk of infectious exposure for health-care providers. The most interesting result from our survey was that a decent percentage of participants (48%) declared that they were interested in using a new teledentistry service. This result was also in line with other studies in the specialist literature. Peacock et al.[2] highlighted that 80% of the patients in their study who were affected by Parkinson's disease would likely use telemedicine for follow-up appointments. Similarly, Valikodath et al.[3] interviewed 97 patients to evaluate their attitude toward telemedicine, and 66 (68%) participants affirmed their willingness to participate in televisits. Abdulhai et al.,[4] through interviewing 129 patients, reported that 115 (89.2%) participants were amenable to teledentistry for routine follow-up visits. Furthermore, Villa et al.,[5] through evaluating the opinions of 100 patients, emphasized that almost two-thirds of patients thought teledentistry made it easier to achieve their medical care and 84.7% were very satisfied with their telehealth session. Through the analysis of 11,352 surveys, Bleustein et al. evaluated patients' perceptions regarding waiting time before a scheduled appointment and reported that waiting time is perceived to be not only the main cause of patient dissatisfaction, but also a determinant of care quality.[6] In addition, according to Mohebbifar et al., telemedicine (TM) represents a growing opportunity to reduce patient waiting time.[7] Therefore, the opportunity to take payment for the visit through the web and the possibility of performing a digital reception of the patient preceding the visit represent a possible means to further reduce the waiting time before a visit and to achieve a higher quality of care. The world digitalization will increase the demand for these services by patients. Barr et al. interviewed 1003 participants to evaluate their knowledge about eHealth, stating that 79.4% of the studied sample had the possibility of accessing the internet.[8] This result is lower than the level of digitalization of our sample: 89% patients claimed to own a computer or a smartphone connected to the internet. The possession of IT devices and digital skills constitutes a fundamental prerequisite for the use of teledentistry. Considering that physical touch is key to the relational, physical, and psychological well-being in adults,[910] the absence of physical contact could be considered as one of the main limiting factors in applying teledentistry.

CONCLUSION

The COVID-19 outbreak wreaked havoc on the dentistry community and is influencing how we provide treatment in the future. According to our findings, the teledentistry service looks to be promising among our patients, providing an opportunity to meet their expectations and demands. Dentists may want to consider adding teledentistry in their usual clinical practice after the COVID-19 crisis is over to benefit patients who must travel great distances or rely on family members or transportation to attend in-person clinical sessions.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.