Remote patient monitoring has been in wide use in the medical field for decades—think pacemakers and implanted defibrillators. The health data collected allows health care providers to not only monitor patients remotely, but to act on the information received.
In the dental field, the technology needed to provide patients with remote monitoring is much more pervasive and much less invasive. With a smartphone and the Dental Monitoring™ (DM) app, an orthodontic patient’s treatment can be monitored remotely via photos and video taken by the patient and sent to the orthodontic practice. Using artificial intelligence, DM assesses over 130 intraoral situations, including three-dimensional tooth movement, archwire passivity, and aligner fit. At first glance, the appeal of a product like DM may be the reduction in patient visits—especially for those patients who have to travel far for what may only be a 10-minute appointment; but there are a whole host of benefits DM can bring to an orthodontic case. For Australian orthodontist Grant Duncan, BDS, MSc, MRACDS, FICD, those benefits include aligner change frequency built around the compliance and biology of the patient and improved tracking; early detection of lost attachments, poor hygiene, and developing gingival recessions; and a marked reduction in the number of appointments and treatment times.
“So better, shorter treatments combined with respecting a patient’s valuable time by reducing the number of appointments. What’s not to like?” asks Duncan.
Orthodontic Products asked a number of Dental Monitoring users to share their tips for getting the most out of the app.
1. Staff Buy-in
As with anything new, get the whole team on board and provide in-office training before rolling it out to patients. DM offers training covering implementation and day-to-day use. Incorporating DM is a big change in the way you practice. This means the team needs to understand how it works, their role, and the benefits to the patients and to the practice. Beyond that, both C. William Dabney, DDS, of Midlothian, Va, and Wayne Hickory, DMD, MDS, of Washington, DC, say it’s important to assign one staff member to be the DM coordinator. The DM coordinator is responsible for updating staff and the doctor and coordinating patient communication.
2. Train Patients
Spend time with patients explaining the benefits and training them on how to take the pictures with their smartphones. Illinois-based orthodontist Terry Sellke, DDS, MS, advises specifically training patients to effectively use the app for oral scans. These scans should take no more than 2 minutes and, once learned, can be done anywhere the patient may be—ie, at college or on vacation. And point out that this app in many ways gives patients more, not less, access to you.
3. Identify Your Implementation Strategy
Some orthodontists opt to go all in with DM from the start; others start by offering it to patients who have the greatest potential for non-tracking and to those for whom office visits are inconvenient. Sandra Selnick, DDS, MS, who is in practice with Hickory in Ellicott City and Clarksville, Md, opted to start off only offering it to new patients. Both Duncan and Sellke opted to launch DM with their aligner patients. “The benefits are so compelling, you can’t not use DM on all aligner cases. Imagine no unseats, finishing cases in less time, and less than 50% of the total number of appointments,” says Sellke, who currently uses DM in over 1,000 cases. That’s not to say that DM can’t be used with bracket cases. “Bracket cases have so many more areas that require monitoring,” Sellke says. Currently, Duncan, who fully committed to using DM last year, is looking to incorporate DM into the bracket side of his practice, and, down the road, plans to integrate its use with early treatment and retention.
4. Adjust Aligner Appointment Intervals
If you use DM with aligner patients, it is going to change appointment intervals for the better. As Hickory says, “With aligner treatment, progress visits are often mostly checking aligner fit. While aligner fit is critically important, it’s hard to justify the inconvenience of an in-office visit for something that can be done remotely. Therefore, we deliver all the aligners at the first treatment visit and check periodically, with 3 months or more between [office] visits.” For Selnick, aligner checks become “as needed appointments” because she and her staff are already on the lookout for problems. “It’s fantastic to have people come in as needed because you’re not bringing people in just to say, ‘Hey, you’re doing great!’” she says.
5. Think About Potential Revenue Opportunities
While many practices opt not to pass on the cost of DM to their patients during treatment, Sellke is considering charging a fee when he introduces the use of DM for retention monitoring. “Imagine the possibility of a new revenue source for the practice charging a nominal fee to monitor retention…forever!” he says.
6. Treat Your DM Time as a Normal Appointment
While the patient isn’t physically there; they are virtually there. So, treat the time you spend checking DM as you would a normal appointment. Selnick and her staff sit down together to look at what’s going on with the patient. The staff members chart Selnick’s instructions for the patient and send that on to the patient via the app. OP