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Online first visit consults high among private dental clinics in Japan, study shows

New research has looked into the number of dental institutions around Japan that conducted telemedicine for first and follow-up visits last year.

The study, which was recently published in the Journal of Dental Sciences, ultimately found that there were “fewer” dental centres across the country’s 47 prefectures that provided online consultations for first visits than for follow-up visits.

FINDINGS

While private dental clinics (36) conducted the most number of first visit consultations over the phone or online, general hospitals (217) performed the most remote consultations for follow-up visits. 

According to the study, it was difficult for the latter to conduct remote consultations for first visits without the needed referral documents, which include patient information. The same was the case for university hospitals where a fee is also being charged for first visit consultations without referral documents.

The study said it can be presumed that telephone consultation was the primary telemedicine method for both first and follow-up visits in the dental field, citing data from recent research by the Ministry of Health, Labour, and Welfare (MHLW). 

Based on the study, there were fewer dental institutions delivering remote consultations for first visits than follow-up visits because of the challenges in providing accurate diagnosis via telemedicine, especially with the lack of visual information and patient’s medical history, systemic diseases and profile. 

By prefectures, Ishikawa had the highest number of dental institutions (18) conducting dental telemedicine for first visits. According to the study’s authors, this was probably due to cluster outbreaks of COVID-19 infections in the prefecture last year.

Among the eight Japanese regions, Chubu had the most number of dental institutions performing online or over the phone consultations, including the most number of first visit remote consultations conducted.

By speciality groups, the dentistry cluster made the most teleconsultations for first visits, while the oral surgery group conducted the most for follow-up visits.

WHY IT MATTERS

The MHLW issued on 10 April last year a notice permitting telemedicine across medical and dental institutions for the first and follow-up visits, overriding a previous rule that did not allow remote consultations for first visits, albeit until the pandemic ends. The move was in part of the government’s effort to stem the spread of COVID-19 infections.

The study concluded that “many dental institutions in Japan made efforts to provide dental services via dental telemedicine using the telephone or online with video” to help prevent the spread of the disease.

THE LARGER TREND

Even before the pandemic, healthcare providers have forayed into telemedicine to provide patients with further access to dental care. For instance, in 2019, New Zealand’s Northland District Health Board tried out an oral telehealth service for children and adolescents. It used the Zoom video conference platform and a specialised intraoral camera to enable dentists at the Whangarei Hospital to perform remote examinations and consultations on children. 

Most recently in June, Texas signed into a law a measure formally permitting teledentistry. This move followed a lawsuit filed by the libertarian legal organisation Pacific Legal Foundation against the Texas State Board of Dental Examiners for its ban on all forms of teledentistry. In March last year, the examiners issued guidance prohibiting the practice of teledentistry as it cannot possibly conduct tactile exams, which is one of its requirements for practitioners.

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