Teledentistry session
A teledentistry session. Courtesy University of Rochester

By Marc Ackerman

Quality dental and orthodontic care is out of reach for many Californians.

Health care costs are on the rise across the board, and many residents have decided to simply go without care, particularly when it comes to dental health. Californians have gone so far as to take care of dental issues on their own, even resorting to pulling their own teeth.

For many, not having access to dental care is a barrier to leading a quality life. Simply put, bad teeth often keeps people from securing good jobs. In fact, a study conducted by the American Dental Association found that 31 percent of low-income Californians feel that the appearance of their mouth and teeth affects their ability to even interview for a job.

However, recent technological breakthroughs have brought access to high-quality dental and orthodontic care into the homes of Californians through the growing industry of teledentistry. Teledentistry uses electronic information, photos, videos, and communication technologies to provide dental care, including the diagnoses, education and treatment of patients.

A 2018 study entitled “Advancement of Teledentistry at the University of Rochester’s Eastman Institute for Oral Health” found that teledentistry has the “untapped potential to reach underserved populations.” It further found that it reduces costs and barriers to accessing oral health care and improves oral health outcomes for underserved children.

Marc Ackerman

Because of the advancements in teledentistry, consumers seeking teeth straightening solutions are able to access treatment at a fraction of the price of traditional orthodontia. One such treatment is remote clear aligner therapy. To date, more than 100,000 Californians have accessed clear aligner therapy via teledentistry to straighten crooked, crowded or gapped teeth, which studies have found can be a serious social impediment that impacts confidence and their daily lives.

Unfortunately, traditional dentistry, led by the California Dental Association, is threatened by the success of this growing new industry, and they have used their insider legislative connections to build obstacles to maintain their monopoly and to keep Californians from accessing affordable orthodontic care. Rather than embracing innovations that have increased access to care and lowered costs without sacrifice in quality and safety, they are more concerned with padding their bottom line.

During the most recent legislative session, a California sunset bill for the reauthorization of the Dental Board of California underwent unprecedented last-minute amending that added anti-competitive language supported by the CDA. The Governor, having no choice but to sign the bill or leave California without a dental board, even stated in his signing message, that while he was signing the bill for the “stability of the dental industry” by allowing “the dental board [to] continue to operate,” the amendments should have been “considered in separate legislation and evaluated accordingly.”

The adopted amendments to the bill create unnecessary barriers for consumers. The bill calls for dentists to review x-rays or other bone imaging suitable for orthodontia that are not needed prior to prescribing clear aligners for mild to moderate cases of crooked, crowded or gapped teeth, which are the type of low-risk cases that teledentistry addresses.

In fact, there is no clinical basis for requiring x-rays or other bone imaging in these types of cases, and according to the American Association of Orthodontists, as well as ADA and FDA guidelines, x-rays could come at a risk to patients and should never be considered “routine.”

While the bill does not stop Californians from accessing affordable clear aligner therapy through teledentistry in their state, the actions will only create disincentives, require unneeded x-rays or other bone imaging, pose risks to patients associated with radiology, and increase costs for patients seeking affordable care.

At a time when many Californians cannot access dental care due to cost, limited time and limited access to a doctor’s office, we should not allow powerful Sacramento interests to stunt cost-effective innovation at Californians’ expense. We must increase, not decrease, teledentistry options to offer better opportunities for Californians wanting a better quality of life.

Marc Ackerman is executive director of the American Teledentistry Association and a licensed dentist in California.

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