Rural Americans are more likely to experience tooth decay and twice as likely to lose their adult teeth as their urban counterparts. Access to dental care is one of the most common reasons cited for the disparity in oral health in rural communities. Poor oral health contributes to diabetes, obesity and heart disease, makes it more difficult to eat and speak, furthers social isolation, increases the difficulty to find or retain employment, and reduces quality of life.
Teledentistry—offering oral health services remotely—is one strategy states are using to connect rural patients to oral health providers. Teledentistry services often include face-to-face consultations between oral health providers and patients via video conference (i.e., synchronous) and sharing images and records among providers (i.e., asynchronous or store-and forward). Dental providers can also use teledentistry to conduct live consultations or electronically share dental records for consultation purposes.
Some states establish teledentistry through legislation by incorporating it into general telehealth or scope of practice legislation or authorizing pilot programs to explore teledentistry. In recent legislative sessions, some states specifically defined teledentistry in their statutes instead of only including the practice in broader legislation (e.g., including dentists as eligible telehealth providers).
As of May 2020, at least 20 states have adopted reimbursement policies related to teledentistry in their Medicaid programs and/or private payer policies. Medicaid typically requires reimbursement for live video interactions. Additionally, private payer policies typically require coverage and/or reimbursement for teledentistry that is comparable to what is covered and/or reimbursed for an in-person visit (i.e., payment parity).
NCSL tracks trends and policies around teledentistry on its Scope of Practice Policy website (www.scopeofpracticepolicy.org)—a resource for state policymakers to learn more about scope of practice policies for various providers, including dental hygienists and dental therapists.