Teledentistry: Addressing oral health and pediatric HIV a world away

Telemedicine in dentistry (teledentistry) is the use of electronic information and telecommunications technologies to support long-distance dental health care, patient and professional education, public health, and health administration. The emerging technology includes wand-like intraoral cameras, videoconferencing, store-and-forward imaging, and streaming media. The initial adoption of such technology by state governments has helped address oral health disparities in underserved regions of the United States that are designated health professional shortage areas.

Researchers at Columbia University College of Dental Medicine (CDM) recently extended the use of teledentistry to remote parts of the world, serving the most vulnerable populations—AIDS orphans in Africa. With a planning grant award from the President’s Global Innovation Fund, which supports faculty teaching and research activities at Columbia’s Global Centers, the Children’s Global Oral Health Initiative launched the first teledentistry project in Kenya (and the first such international initiative by a U.S. dental school).

Dr. Shantanu Lal, associate professor of dental medicine and principal investigator, along with faculty from Nairobi Dental School, established proof of concept as they transmitted secure, store-and-forward clinical imaging from an AIDS orphanage and Maasai Mara community clinics. Children at the AIDS orphanage will benefit from periodic digital monitoring, by a local and/or international specialist, of dental and opportunistic oral infections that can serve as a marker for HIV progression, especially in the absence of affordable conventional testing.

“Using a $70 intraoral camera (smaller and lighter than an electric toothbrush) and a refurbished tablet or laptop, it is now possible for anyone with minimal training to stick a camera in the mouth and receive a dental checkup from a world away,” said Dr.Lal.

The CDM model is being expanded to include remote early cancer detection and training of local personnel in collaboration with all four health-care professions at Columbia University Medical Center. Programs such as these provide an enriching educational experience for the students. Ultimately, they foster capacity building in host nations, while advancing Columbia University’s mission of excellence in research and education in an increasingly globalized world.