The following provides direction for Ontario dentists on the acceptable use of teledentistry during the current State of Emergency. It does not authorize the use of teledentistry in any other setting or circumstance.
PDF version available here.
What is teledentistry?
Teledentistry is the provision of patient dental care at a distance, using information and communication technologies. All Standards of Practice, legal and professional obligations that apply to in-person care also apply to teledentistry.
Teledentistry can include modalities such as:
- Live video (synchronous): Live, two-way interaction between a person (patient, caregiver or provider) and a provider using audiovisual telecommunications technology.
- Store-and-forward (asynchronous): Transmission of recorded health information (e.g., radiographs, photographs, video, digital impressions and photomicrographs of patients) through a secure electronic communications system to a practitioner, who uses the information to evaluate a patient’s condition or render a service outside of a real-time or live interaction.
- Remote patient monitoring (RPM): Personal health and medical data collection from an individual in one location via electronic communication technologies, which is transmitted to a provider (sometimes via a data processing service) in a different location for use in care and related support of care.
- Mobile health (mHealth): Health care and public health practice and education supported by mobile communication devices, such as cell phones, tablet computers and personal digital assistants (PDA).
When can teledentistry be used?
In the current State of Emergency in Ontario, teledentistry must only be used
- by Ontario dentists (located in Ontario), on Ontario patients.
- to assist with the provision of emergency care - specifically, to assess and triage patients’ oral health care needs and to determine next steps.
A full emergency examination will not be possible using teledentistry alone.
In those few cases where telephone or virtual/remote management is insufficient, live/in-person clinical assessment may be necessary provided the dental practice has appropriate safety precautions and PPE in place.
Requirements for using teledentistry
The practice of teledentistry is the practice of dentistry.
Ontario dentists who practise teledentistry must continue to meet existing Standards of Practice and the professional, legal and ethical obligations that apply to oral health care that is provided in person.
When practising via teledentistry, Ontario dentists must:
- Confirm the identity of the patient, and provide the patient with proof of their identity and licensure status (if assessing a new patient). The College recommends that where possible, dentists use teledentistry to assess and triage existing patients.
- Obtain an appropriate medical history, verbal history of the patient’s condition and confirm the nature of the emergency before recommending next steps, which may include, among other things:
- advice and appropriate pharmacotherapy (if indicated);
- asking the patient to visit the practice for an in-person clinical examination or treatment appointment;
- facilitating a patient referral to an emergency office listed on the RCDSO’s website,
- facilitating a patient referral to allied health care providers for care needs that are outside the scope of dentistry, or;
- facilitating a patient referral to hospital for extreme emergency cases that cannot be managed in the dental office, including loss of life and limb.
- Identify the resources (e.g. information and communication technology, equipment, support staff, etc.) that are required, and only proceed if those resources are available and can be used effectively.
- Ensure that the reliability, quality, and timeliness of the patient information obtained via teledentistry is sufficient to justify providing or assisting in the provision of dental care.
- Use technology that will allow dentists to gather necessary information needed to proceed with treatment. For instance, should dentists need to prescribe medication for a new patient, technology with audio-video capacity will be required to allow for an adequate assessment prior to prescribing medication.
- Protect the privacy and confidentiality of the patient’s personal health information, specifically by:
- using technology that has privacy and security settings in accordance with the Personal Health Information Protection Act, 2004. At minimum, technology must have controls to ensure only the intended patient has access to the appointment and where personal health information is stored and/or transmitted, strong encryption must be used. If unsure, dentists can confirm with the service provider that the technology meets Ontario privacy requirements.
- conducting the teledentistry appointment in a private environment that will ensure patient information is not overheard or seen by other individuals; and
- confirming with the patient that they are in a private setting and that the technology they are using is secure.
- Keep appropriate records of the teledentistry appointment, in compliance with College’s Dental Recordkeeping Guidelines and note specifically that the care was provided through teledentistry.
Note: Call volumes are higher than usual; we will respond to queries as quickly as we can.