Even during a global pandemic, a primary concern for all health care providers is providing urgently needed care for all patients in a safe, controlled environment to protect patients and providers. Researchers, doctors, dentists and all other health care and front-line providers have banded together for “strength in numbers” amid the global novel coronavirus pandemic to help provide care. Together they have addressed shared challenges and created fast, safe solutions for access-to-care concerns for patients.
Understanding the need to maintain flexibility and fluidity through the crisis, while still meeting the needs of patients, the University of Florida College of Dentistry worked quickly and efficiently under the leadership of Micaela Gibbs, D.D.S., M.H.A., interim chair of the department of community dentistry and behavioral science, to launch a teledentistry appointment process for patients through Zoom, a video communications platform commonly used for video and audio conferencing, chats and webinars.
The University of Florida’s partnership with Zoom includes a protected health information, or PHI, safe network to ensure a safe and secure delivery of teledentistry and telemedicine consultations and appointments at UF Health and UFCD, alike.
Gibbs and a team of dental faculty piloted the teledentistry program for several weeks, providing consultations and care for patients of record at the college’s Gainesville, Naples, Hialeah, St. Petersburg and Wildlight dental centers. After fine-tuning details, the teledentistry service opened April 6, to not only current UFCD patients of record, but also anyone with emergency oral health needs amid the COVID-19 outbreak.
“It’s really important through situations like COVID-19 to make sure a plan is in place to provide care for our patients,” Gibbs said. “We are proud to be able to offer this service as a continuity of care option that not only supports patients in need, but heeds universal recommendations about social distancing and recommendations from the Centers for Disease, Control and Prevention, or CDC, as we collectively work to manage and stop the spread of coronavirus.”
The teledentistry process allows patients to remain at home for screening and appropriate care management. Many assessments and diagnoses of patients can be handled without an in-person visit to the dental office, including antibiotics prescriptions and other palliative efforts. Teledentistry also offers an avenue for care that keeps patients with dental problems out of emergency rooms.
When possible, Gibbs and UFCD faculty are including the DMD student-dentist on Zoom consultations with current patients of record, enabling teledentistry to double as an educational tool.
“In its purest form, teledentistry increases access to care,” Gibbs said. “This is for patients who live in rural communities where there is little access to oral health care. It’s for the elderly who are hunkering down at home, abiding by CDC recommendations, and it’s for those patients who may be confined to a wheelchair or have other difficulties leaving the home.”
Gibbs developed the logistics of program, collaborating with departments in the college and at UF Health to execute and launch the teledentistry enterprise. The process is simple for patients who submit an online consultation request form that reaches the team of dentists immediately. A dentist from a designated team of college faculty then connects with the patient via a secure Zoom meeting invitation to begin the consultation and develop a plan for care.
One of the most beneficial parts, Gibbs said, is that each teledentistry consultation gets patients involved with their own care. For example, a patient who calls with tooth pain will be guided by UFCD dentists through a round of questions to help him or her describe the exact problem. ‘First wash your hands, then feel your tooth. Is it loose? How loose does it feel? Are your gums swollen? Are your gums soft or hard?’
Answers to questions throughout the examination help UFCD dentists work through a decision tree for care, serving as a triage tool for next steps.
“Teledentistry helps us connect patients to care efficiently,” Gibbs said, “and when we can involve the DMD students, the benefit is even greater for everyone. A one-on-one teaching moment with students coupled with efficient access to care for patients in need is exactly what this is all about.”
The college has fielded over 250 teledentistry requests since the service commenced at the end of March.
“On a normal day, an average of 12 patients visit UF Health’s Emergency Department for tooth pain,” Gibbs said. “Not only are we ensuring our own patients are able to be seen throughout this crisis, we’ve worked with UF Health to reduce the number of patients who visit their emergency room with oral health emergencies during a critical period of time in our state, when the main focus is on treating and preventing the spread of the COVID-19 disease.”
Launching the teledentistry option additionally helps preserve personal protective equipment for those health care workers on the front lines of the coronavirus pandemic.
On March 14, UFCD became one of the first dental schools in the country to suspend all elective and non-emergency dental care, initiating the college’s response to COVID-19, including the organization of an emergency screening protocol for patients from all of the college’s dental centers in the state who present with oral health emergencies amid the pandemic.
The American Dental Association, or ADA, issued a recommendation on March 16 to postpone all elective dental procedures across the country.
Along with the ADA’s recommendation, the College of Dentistry and all health care providers across Florida worked for nearly two months under an Executive Order issued March 20 from Governor Ron DeSantis to stop all non-essential, elective medical procedures.
“What this team accomplished so swiftly to accommodate the needs of our patients throughout the state during the coronavirus pandemic is nothing short of remarkable,” Dean Isabel Garcia, D.D.S., M.P.H., said. “The response has been wonderful, and through their leadership we have put in place a sustainable model for providing safe oral health care health care during a public health crisis.”