Telemedicine began in 1924, with the concept of a physician seeing his patient over the radio using a television screen [11]. The initial concept of teledentistry developed as part of the blueprint for dental informatics, which was drafted at a 1989 conference funded by the Westinghouse Electronics Systems Group in Baltimore [12]. The birthplace of teledentistry as a subspecialist field of telemedicine can be linked to a 1994 military project of the United States Army Total Dental Access Project aiming to improve patient care, dental education, and effectuation of the communication between dentists and dental laboratories [3, 11–13]. Teledentistry was put into practice by the U.S. Army by doing consultations on persons located more than 100 miles apart [11]. Since that time, various public health facilities, remote rural clinics, and organizations have practiced teledentistry with various degrees of success. The variation in the levels of acceptance and use of dental EHRs throughout the profession has been determined by the mode of communication preferred, type of software and hardware used, and the type of internet connection.

To practice dentistry within the realm of telehealth, a desktop or laptop computer with a microphone and substantial hard drive memory are needed. In addition, a significant amount of RAM with a speedy processor; a digital camera, video camera and intraoral camera for the capture of pictures [11, 12]; and a portable x-ray unit (NOMAD^®) (see Fig. 6.3) are essential. A comprehensive software capable of image acquisition and storage, and transmission of the gathered information and software capable of coding and decoding audio and video is desirable [11]. A fax machine, scanner, and a printer may also be required in some cases [12]. There is great variation in levels of speeds to connectivity to the internet and broadband technology, increasingly widespread and available, offers a selection of cutting-edge alternatives well suited to meet the needs of the telehealth professional and his or her staff [11]. There are many advantages as well as disadvantages to using telehealth technology.

Teledentistry provides a unique way to help overcome the barriers or geography and travel time to deliver long-distance clinical training, continuing education, and hands-on training for the dentist/dental hygienist at remote clinics [11, 15]. Its application is of utmost importance and great value in rural and urban underserved areas where there is unavailability of specialist consultation which reduces the costs of service and improves quality of care [12–14]. The results of telehealth usage increase inter-professional communications which will improve dentistry’s integration into the larger health care delivery system [13]. Second opinions, pre-authorizations and other insurance requirements will be met almost instantaneously online, with the use of real images of dental problems, thereby making traditional dental care more efficient [14, 15]. In addition, it will facilitate the greater use of nondentist providers (such as dental hygienists or mid-level providers) and improve early diagnosis and treatment of oral disease [15]. For dental and dental hygiene schools, interactive video-conferencing allows for the evaluation of patient information (with or without the patient’s presence), which allows for the interaction and feedback between the educator and the students [14]. Telehealth can serve as a tool to compliment and expand the capacity of school child care centers to meet the children’s dental care needs by using technology to connect to the health providers at another location [14]. For dental facilities, there is long term cost effectiveness due to savings generated from not purchasing equipment and materials to develop traditional dental radiographs. Although Telehealth is being used nationally and internationally by educational institutions and public health facilities, still many legal, financial, and ethical concerns exist (Table 6.1).