4/23/20

This petition originated on April 1st after it was posted and stated on the TSBDE website that dentists were not allowed to use teledentistry due to no laws permitting it and board rule 108.8(c)(2)(C). The use of telehealth technology has not only been shown to increase access to care, but currently as social distancing continues, telehealth is a tool that can be used to eliminate possible exposure to Covid 19 by live video consults, triaging, and advanced communications with patients.  As I have been hearing from dentists both on and off this petition, I have become more aware of their concerns currently and how they have used or would be using telehealth technology.  Dentists have expressed concerns of contracting the virus, and are diligently implementing new protocols for infection control and PPE to protect patients and employees. In addition, some TX dentists have  concerns that, due to current law, they are not being compensated for their time or knowledge in numerous telephonic or screening consults. Others, such as a pediatric dentist have stated “telehealth makes individual and risk based preventive interventions easier, faster, and more effective. Telehealth integrates nicely with the dental home concept and the Texas first dental home initiative.”  Still other cosmetic and orthodontists have supported using telehealth technology to monitor and track Invisalign and orthodontic patients respectively.

We are seeking Governor Abbotts waiver to expand telehealth options to TX dentists and dental specialists with allowance of compensation and/or insurance reimbursement.

Thank you

April 1st, 2020

Dear Governor Abbott,                   

During the current crisis and mandates many dental offices have had to close entirely or limit their office locations and/or times for emergency services only. For those dentists who are still serving patients, the risk of exposure to Covid 19 is real for them and the patients as well as over burdening the resources of fewer amount of offices and PPE. For some patients who are immunocompromised, the risk for them may be too great to visit a dental office with an urgent dental concern.

There is also a concern that patients with a NTDC (Non Traumatic Dental Condition) may present to an ED, thereby further taxing a system and possibly exposing themselves and others to Covid 19. As research has shown, please see below, the large majority of patients who present to an ED with a dental urgency are stabilized with a prescription(s) and sent home. 
With today’s technology, there are highly reputable platforms available for telehealth, both secure and HIPPA compliant, even some used by NASA, GE Healthcare, and Cleveland Clinic. With these platforms, dentists would be able to video screen and triage patients, who either need to present for treatment or can be stabilized with a prescription, if necessary, and scheduled for a next possible date. In addition, several major dental insurance companies are allowing the codes D0140 (limited screening problem focused) and D0170 (problem focused established patient) to be covered with telehealth. This would help in prioritizing patients who absolutely need to be seen in office and also allow patients with a dental concern to remain in their home and given an Rx, if necessary, especially forthose with an immunodeficiency. 
Thank you,

Leanne Tessandori, DDS

Emergency Department Referral Programs for Non-Traumatic Dental Conditions, 2015, astdd 

National Hospital Ambulatory Medical Care Survey 2009-2010

National Emergency Department 2006