Virtual Care: Expanding the Reach of Preventistry


Written by Dr. Edward Coryell

Ensuring Access to Care

As the vice president of clinical affairs for Advantage Dental+, I help provide clinical oversight as a member of the management team for the Advantage Dental’s 70+ practices, most of which are located in Oregon. Anything that happens within the practice from implementation of technology, design of processes, development of standard operating procedures or policies, etc., rolls up through the clinical leadership team. Working in close collaboration with other functional areas within our management team, the clinical management leadership provides recommendations of best practices which the practice owners desire and utilize to determine how care is delivered in their practices.

The mission of Advantage Dental is to improve the oral health of all. Much of our focus is around expanding access to oral health care, which is why many of our locations are strategically located in rural areas where there is a huge need for care but few providers. This is a driving factor of why we partnered with MouthWatch to improve our teledentistry services – Allowing us to reach beyond the dental chair, especially in these rural areas.

Beginning Our Teledentistry Journey

Advantage had already begun implementing teledentistry prior to COVID-19, but the pandemic accelerated the deployment and utilization of the technology. At the height of the pandemic, just like every other dental practice, Advantage Dental had to limit patient access. During this time, we used teledentistry primarily for emergency care and to maintain a basic level of access to help meet the oral health needs of our patients.

The pandemic encouraged the regular use of teledentistry among many of our providers and may have helped reduce the duration of the learning curve. After all, the more you use teledentistry, the more proficient you become.

We realized that a virtual care modality, whether it be synchronous (live calls) or asynchronous (store and forward), could help us reduce the need for office visits for reasons other than infection control. When does a virtual appointment make the most sense? Sometimes it’s as simple as addressing a parent’s concern, “Don’t worry, Ms. Smith, that’s normal for your child’s development at this age.” In the case of a patient who is experiencing pain, the virtual consultation may result in the provider saying, “I can see you are really swollen, Mr. Smith. I’ll prescribe an antibiotic before we schedule you to come into the office.

Expanding Preventistry™

Now that we’ve returned to something closer to normalcy, it’s become more apparent that teledentistry is in perfect alignment with the everyday Advantage Dental philosophy known as Preventistry®, which is an all-in approach of meeting the patient where they are, reducing barriers to care and trying to identify and treating disease early. This helps to avoid the drill, fill, and bill approach, which is common within the traditional fee-for-service industry.

In other words, Preventistry paired with teledentistry improves the access to care. By using the technology, we can address different situations such as:

  • addressing basic patient concerns which don’t necessarily need to be handled in person;
  • performing post op checks in certain situations;
  • evaluating emergent concerns to determine next steps and intervening earlier in the evaluation of potential oral problems before they progress.

All these examples are ways MouthWatch and teledentistry can enhance access to care, and potentially decrease the numbers of visits for the patient as they navigate any obstacles that might impact their access to care. What’s more, virtual consultations enable us to encourage more patients to be co-participants in their preventive care and potentially spend less time in the chair for treatment.

Building Teledentistry Awareness

Achieving critical mass for teledentistry may take some time as certain patients (typically younger), will understand the value of teledentistry more readily and accept it more easily, and you will also have folks (mostly older) who believe “I have to go to the dentist,” or “I can’t hold the phone up to my mouth and show you my problem!” So in effect, the younger generation who don’t necessarily want to come to the office for every encounter, may be freeing up chair time for the older generation to whom still believe they need to visit the dental office. In any event, this makes scheduling more efficient and more in tune with patient expectations.

I believe this “generational adoption gap” will change over time and with the repetition of pro-teledentistry messaging. In consumer advertising, when you see the same commercial over and over, pretty soon you recognize the product. It’s the same thing for teledentistry.

Therefore, it makes perfect sense to promote your teledentistry options to your patients through various touchpoints such as your website, front desk conversations, office posters, social media, etc.

Don’t underestimate value of word-of-mouth advertising. If two friends are talking and one says, “My dentist offers virtual visits, so I don’t have to take time off from work for a consultation.” The other friend might say, “Maybe I should switch dentists!

Moving Beyond Traditional Dentistry

I believe teledentistry adoption will grow based on Advantage Dental’s overall success in reaching our 2022 goal of shifting 5% of appointments to teledentistry encounters and then surpassing that goal. Moreover, our cost for treating patients with teledentistry as part of their care was 70% lower on a per appointment basis, when comparing an in-office visit to a virtual visit.

Teledentistry is ideal for our patients who have extremely low disease states and could probably just be seen once a year. During a virtual check-in, a provider could have virtual discussions with a patient and ask questions such as “How are things going? Do You have any concerns? What’s going on with your diet that we talked about last time?” These types of wellness-oriented conversations can help bridge the gap between achieving optimal oral and overall health which is the ultimate goal of the Advantage Dental Preventistry care model.

Dr. Coryell joined Advantage Dental+ in March of 2019. He brings over 30 years of oral health care experience including over 17 years of private practice followed by more than 12 years leading the dental division at MAHEC (Mountain Area Health Education Center), a large multispecialty ambulatory healthcare organization. During his time at MAHEC, his leadership in the dental division encompassed both clinical and operational responsibilities, which included overseeing the dental residency training program. Additionally, he worked across disciplines to help develop organization-wide committees on peer review, credentialing, and safety. He set up quality assurance programs for the dental division and provided support in drafting policies across the organization.