“The Missing Link” in Teledentistry – by Dr. Richard Simpson, DMD

“The Missing Link” in Teledentistry

by Dr. Richard Simpson, DMD

Originally published in NNOHA

In various fields of science, the search for a missing link goes on, and the questions are challenging. Is Australopithicus sediba the missing link in evolutionary theory? I don’t know that. I would refer you to the anthropologists and biologists if that is of interest to you. Will neutrinos finally be the answer to the unaccounted for mass in the universe? Will general relativity and quantum mechanics ever be unified? You’d have to ask Neil DeGrasse Tyson. Or for kicks, try Brian May. (Yes, the co-founder and lead guitarist for Queen has a PhD in Astrophysics!). I obviously am in no way equipped to broach these subjects with any credibility.

However, I would like to propose that there is, and has been, a lack of significant inquiry into what I believe is the “missing link” in a field in which I am more acquainted…Telehealth and Teledentistry. The questions, and the answer, are not so grand in scope or depth as in the aforementioned subjects, but they have very meaningful and practical implications in the everyday application of telehealth systems in oral health.

So, I ask…

Is there a missing link in Teledentistry? Yes.

What is it? The ability to easily and remotely illuminate the oral cavity, capture superior images and videos with a portable device, mark areas of concern and comment if indicated, send these images to providers securely without the necessity of wi-fi, receive these images for review and upload into a patient electronic health record regardless of the platform or software, and be able to do this at very low costs, from any location, thousands of times. More simply put, the missing link in teledentistry, and in the medical-dental remote assessment and management of patient oral health, is the capture and transmission of quality imaging of the entire mouth and oropharyngeal areas.

When will it (aka a solution) be found? My impression is that it is already available, and I will discuss this further after a brief review and a question I propose to the reader.

In a recent interview on “This Week in Health IT”, Dr Joe Kveder of Harvard University stated “…we’re now learning what it means to be in implementation mode versus proof-of-concept or experimentation mode” with regards to telehealth. I suggest this is more so the case in teledentistry, as prior to the COVID 19 crisis we were well behind medicine in the fielding of many of the concepts and grand potentials for telehealth utilization in all areas of oral health care. The pandemic crisis rapidly accelerated the acceptance and adoption of various methods for remote triage and emergency management of patients. Further, it brought to the forefront extensive discussions, studies, proposals and debates on the potential benefits of telehealth services for the future of oral health care. How best to utilize this new technology to implement the multitude of pre-COVID visions for medical-dental integrated and comprehensive care, while improving access to patient centered prevention and intervention in oral health that was evidence based?

Being somewhat familiar with NNOHA, my expectations regarding the readership of this article is that you represent many varied backgrounds and roles within our health care system, and you have a strong interest in oral health and an understanding of its inseparable role in overall health and well-being. Many of you are also likely familiar with some of the great work and publications by organizations such as The CareQuest Institute of Oral Health, the Primary Care Collaborative, NACHS, and NNOHA in addressing health disparities and the challenges and failures of our current care delivery models, particularly with regards to care gaps between medical and dental care and underserved populations. Many of you are also likely now experienced first-hand in the implementation of some form of telehealth services in your own clinics and facilities. That being said, I ask that you please consider the following scenarios. One or more of them you will likely be familiar with:

  • Co-located dental and medical facilities within a CHC or other facility, and an agreed upon desire amongst the staff to develop a more comprehensive approach to care with shared decision making between the services and the patient.
  • The embedding of oral health specialists, such as dental hygienists, in medical facilities with an ability to utilize telehealth to consult with a dentist.
  • Emergency Departments, hospitalists and nurses, urgent care centers, free
  • standing primary care facilities, retail health clinics, and school nurses consulting with a dentist for triage, diagnosis, prescription and care recommendations, and determination of disposition for follow up care.
  • Rural health centers and medical offices consulting with a dentist and hygienist through telehealth for oral cancer examinations or chronic disease management.
  • Outreach programs for oral health screenings and prevention education, and documentation of oral conditions for asynchronous review later.
  • Pre-surgical evaluations and post-surgical follow-ups for pediatric hospital cases, special needs patients, and oropharyngeal cancer or orthognathic surgery for patients that travel long distances.
  • Skilled nursing and assisted living facility staff members utilizing telehealth to consult with a dentist for a resident patient.
  • Dental and medical school faculty and students utilizing teledentistry for interprofessional training and collaboration in community outreach programs.
  • Public health teams performing school screenings or mission teams working with developing countries in oral health data collection and epidemiological assessments for targeted prevention and intervention strategy planning.

Each of these scenarios are all in the earliest stages of “implementation mode” utilizing various telehealth modalities. There are several considerations and challenges currently, to include security, integration into multiple EHR platforms, workforce planning, and so on. However, there is one single “missing link” that is universally vital to the success of each and every one of these scenarios. Can you guess what it is? It is the ability to remotely illuminate and capture quality images of the entire oral cavity with minimal training, at low cost, from any location. If the images are incomplete or of poor quality, the program or system you are trying to implement is hindered. The camera on a laptop, tablet, or smartphone is inadequate for full access and lighting. Most health facilities do not have a dental intraoral camera, and if a “mobile” telehealth cart is available, it is cumbersome, requires a trained staff member to use it, and it is rarely equipped to provide quality intraoral images and video.

At the beginning of this article, I mentioned that a likely solution to this dilemma may already be available. The TelScope Telehealth System by Holland Healthcare, combined with the TelScope Telehealth System app, turns any mobile smart device into an all-in-one handheld intraoral light and camera. In my experience, the images are of exceptional quality, and the ability to zoom in and out, thoroughly illuminate and examine the throat and entire oral cavity, and capture and securely send the images, raises the bar and the capabilities for any oral health program you design or implement that would utilize telehealth capabilities. 

TelScope Telehealth System, by Holland Healthcare

Captured with TelScope Telehealth System, by Holland Healthcare

With every challenge comes opportunity, and although none of us would have ever foreseen such a challenge as the pandemic, health care has been given an accelerant to move forward to improve access and outcomes. The desire and ability to incorporate technological advances in telehealth to reduce disease burdens, address disparities, enhance value based care, and better integrate oral health into a comprehensive care model is genuine and increasingly accepted. The right tools to maximize the technology at a non-prohibitive cost are critical to implementing these new delivery models.

Download this case study here.

Dr. Richard Simpson, DMD, is a board certified pediatric dentist with over 25 years of experience in interprofessional collaboration and advocacy. He is experienced in cross-sector networking at the state and national level and is the Immediate Past Chair of the Oral Health Coalition of Alabama. Dr Simpson serves on the corporate advisory boards for Holland Healthcare and The Teledentists and is a Fellow in the American College of Dentists and the International College of Dentists. Dr Simpson is currently an MPH student with the Johns Hopkins Bloomberg School of Public Health.

Dr. Richard Gallagher to Speak at GPCE

Dr. Richard Gallagher, Sydney’s leading Head and Neck Surgeon from St. Vincent’s Hospital – Sydney, will be presenting his course, “HPV and Oropharyngeal Cancer: Connecting the Dots” LIVE at GPCE in Sydney this May.

GPCE is the General Practice Conference & Exhibition. 900 General Practitioners from across New South Wales, Australia, will attend the conference. The conference features “over 150 education sessions and practical workshops, all led by esteemed local speakers, providing practical and implementable education to bring straight back to the practice.”

Among these educational sessions and practical workshop will be Dr. Gallagher’s course, “HPV and Oropharyngeal Cancer: Connecting the Dots” on the early detection of head and neck cancer.

The course discusses he prevalence of oropharyngeal cancers associated with the human papillomavirus (HPV), which is on the rise in Australia. The course will provide updates on HPV-related oropharyngeal and other head and neck cancers, as well as examples of use-cases. The majority of the session will be dedicated to a step-by-step, hands-on guide to examining people for oropharyngeal cancer in general practice.

COURSE OBJECTIVE:

Learn how to take a systematic approach to diagnosis, investigation, referral and ongoing management of oral cavity and oropharyngeal cancers.

LEARNING OUTCOMES:

  • Explain how the epidemiology of head and neck cancer is changing.
  • Recognise the traditional symptoms of oral cancer.
  • Explain why HPV-related oropharyngeal cancers represent a distinct disease entity.
  • Describe how to perform a thorough examination of the oral cavity and oropharynx, and the neck.
  • Plan what investigations should be initiated when a person presents with a persistent/suspicious neck lump and recognise when to refer to an otolaryngology-head and neck surgeon.

If you are attending GPCE Sydney, you can register for Dr. Gallagher’s free course on the GPCE website here.

About the Presenter

Dr. Richard Gallagher is a head and neck surgeon at St Vincent’s Private Hospital, St Vincent’s Public Hospital, and at The Kinghorn Cancer Centre since 1998. He finished surgical training in 1995 and following that did further training in head and neck cancer surgery. Currently his practice mainly looks after patients head and neck cancer and patients with complex airway problems and cancers due to HPV (human papillomavirus). He is also the Director of Cancer Services and I’m also the Director of the Head and Neck Cancer Service at St Vincent’s.

In 2011 he did further training at University of Pennsylvania in transoral robotic surgery, which is surgery used mainly for patients who have cancers at the back of the throat and oropharynx. It is particularly useful for patients who have cancers due to HPV. That’s a large number of patients at the present time.

 

 

 

 

 

Dr. Gallagher will be presenting the live workshop at GPCE Sydney and GPCE Melbourne later in 2021, as well. Learn more and sign up on the GPCE website.

Unable to attend GPCE?

No problem, you can enroll for the course for free at ThinkGP. Enroll here. This course offers accreditation for RACGP: 2pts | ACRRM: 1hr sent straight to your college.

Want to hear more about news and upcoming events from Holland Healthcare?

Sign up for our newsletter.

Telehealth Tuesday: Doing a Teledentistry Exam – with Dr. Richard Simpson, DMD

Dr. Richard Simpson, DMD, is a pediatric dentist in private practice.

Dr. Richard joined Holland Healthcare founder and medtech inventor of TelScope Telehealth System intraoral examination device and intraoral camera, Jennifer Holland, to discuss teledentistry and more.

The teledentistry team discussed

  • What is teledentistry?
  • Why is it important? What are its benefits?
  • Why is teledentistry especially important in today’s climate?
  • Plus a live demonstration of an at-home dental consultation via teledentistry using TelScope Telehealth System.

ABOUT THE HOSTS

Dr. Richard Simpson, DMD, is a board certified pediatric dentist in private practice.
His achievements include:
• Diplomate in the American Board of Pediatric Dentistry
• Fellow in the American College of Dentists
• Fellow in the International College of Dentists
• Fellow in the American Academy of Pediatric Dentistry
• Advisory Board Member of The TeleDentists
• Advisory Board Member of Holland Healthcare
Dr. Richard’s experience and active interests include telehealth, child advocacy, health disparities, policy, and advancing improved medical-dental access to care. Dr. Richard is also a veteran with 15 years of military service.

 

 

 

 

 

Jennifer Holland is the inventor of TelScope Telehealth System. She is the CEO and founder of Holland Healthcare, as well as the inventor of Holland Healthcare’s first product, Throat Scope illuminating oral examination device and tongue depressor.

TelScope Telehealth System is the oral examination device that also transforms any smart device into a high quality intraoral camera for telehealth and teledentistry.

Oral Lesion – by Dr. Richard Simpson, DMD

image captured with TelScope Telehealth System

image captured with TelScope Telehealth System

PROBLEM

A 12-year-old male complains of pain for three days. His mother is concerned that he has an “infection in his gums.” A clinical exam performed in the dental office was documented using a TelScope. The first image reveals two oral lesions above the teeth and gum tissue in the upper right quadrant, located in what is called unattached mucosa. The appearance of a white center surrounded by a red halo is similar to an aphthous ulcer (canker sore), but the shape of the larger lesion is not typical of a mouth ulcer, which is usually more ovoid.

Careful extra-oral examination reveals an area of contusion (bruising) of the upper lip near the sores. Directly behind this discolored area is the irregular, linear oral lesion measuring approximately 7.5mm. A smaller lesion is located more distal.

Questioning the patient provided the answers to the mystery. Three to four days earlier, the patient was chewing on a small straw and he was bumped in the mouth by another child.

DIAGNOSIS

The lesions in question are “traumatic ulcerations” caused by the edge of an object (in this case a straw) scraping the soft tissue. Traumatic ulcerations can also occur elsewhere in the mouth from accidentally biting your lip or cheek, or from a toothbrush abrasion or other foreign object.
The typical appearance is a whitish-yellow central area surrounded by an inflammatory red (erythematous) halo, often on a rolled border. They are painful, and “sting” when exposed to high acid products such as ketchup, tomato based sauces, and citrous products. They typically heal in 10-14 days. Ibuprofen can help with pain if needed, and an over the counter oral paste can be used to cover the ulceration to improve comfort if desired. Your dentist can also prescribe an oral paste with a topical steroid.

COMMENTARY

This case is an excellent example of how TelScope could be utilized to pre-screen or triage a problem without having to initially make the physical trip to the dental office. If a parent, caregiver, school or a medical office (if the patient was taken there) had a TelScope, similar images could be taken and shared with the family dentist, or uploaded for an immediate consult with an on call dentist with The Teledentists. A diagnosis and recommended treatment could then be rendered, as well as any recommendations for follow up – all for lower costs, more convenience, and providing peace of mind for the patient and parent.
Dr. Richard will be LIVE on Facebook this Tuesday, February 23 at 9 p.m. EST to discuss teledentistry and perform a live teledentistry demonstration using TelScope Telehealth System with inventor Jennifer Holland. RSVP here.

About the Author: Dr. Richard Simpson, DMD

Dr. Richard is a board certified pediatric dentist in private practice.
His achievements include:
• Diplomate in the American Board of Pediatric Dentistry
• Fellow in the American College of Dentists
• Fellow in the International College of Dentists
• Fellow in the American Academy of Pediatric Dentistry
• Advisory Board Member of The TeleDentists
• Advisory Board Member of Holland Healthcare
Dr. Richard’s experience and active interests include telehealth, child advocacy, health disparities, policy, and advancing improved medical-dental access to care. Dr. Richard is also a veteran with 15 years of military service.
————
INFORMATION & CONTENT DISCLAIMER

This content is for information only. This content is not for advice, diagnosis, or
guarantee of outcome for patients. No patients should use the information,
resources, or tools contained within to self-diagnose or self-treat any health-related
conditions. 

Sign up for more content like this from Holland Healthcare:

Subscribe

* indicates required

Profession / Field

Which upcoming device(s) are you interested in?

Pink Tooth – by Dr. Richard Simpson, DMD

pink-tooth

image captured with TelScope Telehealth System

image captured with TelScope Telehealth System

PROBLEM

The mother of a 10 year old girl was concerned about a “pink tooth”. There was no report of pain or other concerns.

DIAGNOSIS

The first image, captured with TelScope Telehealth System, reveals an emerging upper left permanent tooth (first premolar), with the primary (“baby”) tooth still present. The primary molar has a pink color to it because it has resorbed internally as the permanent tooth moved into position, and the underlying gum tissue is showing through. This situation is not uncommon, but can be evaluated by a dentist through a teledentistry examination and appropriate questioning to determine if any treatment is indicated. In this case, the baby tooth was loose and can be allowed to be lost naturally if no other problems develop. The parent was informed that an extraction of the primary tooth may be required if it is still present in several weeks.

GINGIVITIS DUE TO POOR BRUSHING HABITS AROUND LOOSE TEETH

The second image, marked using the TelScope app, highlights the red gum margins of other teeth in this area. This inflammation is called gingivitis, and is commonly seen in children with a loose tooth because they are often hesitant to brush the area near that tooth. The child should be supervised when brushing and encouraged to gently but thoroughly brush at the gumline twice per day as normal. The gingivitis will heal with improved hygiene.

About the Author: Dr. Richard Simpson, DMD

Dr. Richard is a board certified pediatric dentist in private practice.
His achievements include:
• Diplomate in the American Board of Pediatric Dentistry
• Fellow in the American College of Dentists
• Fellow in the International College of Dentists
• Fellow in the American Academy of Pediatric Dentistry
• Advisory Board Member of The TeleDentists
• Advisory Board Member of Holland Healthcare
Dr. Richard’s experience and active interests include telehealth, child advocacy, health disparities, policy, and advancing improved medical-dental access to care. Dr. Richard is also a veteran with 15 years of military service.
————
INFORMATION & CONTENT DISCLAIMER

This content is for information only. This content is not for advice, diagnosis, or
guarantee of outcome for patients. No patients should use the information,
resources, or tools contained within to self-diagnose or self-treat any health-related
conditions. 

Sign up for more content like this from Holland Healthcare:

Subscribe

* indicates required

Profession / Field

Which upcoming device(s) are you interested in?

Facial Swelling Caused by Dental Infection – by Dr. Richard Simpson, DMD

Dental Infection and Facial Cellulitis TelScope Teledentistry

image captured with TelScope Telehealth System

PROBLEM

A 5-year-old male was seen in a medical emergi-care center with a chief complaint from the parent of pain and “his face is swollen”. He was also febrile (showing symptoms of a fever). The patient was diagnosed with a rapidly developing facial cellulitis (infection spreading into the soft tissues of the face), of probable dental origin. The child was given a shot of Rocephin, and was prescribed an oral antibiotic and an over-the-counter pain medication. The patient was then given a dental referral for further evaluation and treatment.
Note: Untreated facial cellulitis from a dental infection can lead to multiple systemic health complications, blindness, difficulty breathing, and in rare cases, death.

DIAGNOSIS

Upon dental exam, the facial swelling had resolved in response to the antibiotics. This intraoral image reveals the swelling was now localized and associated with an upper left second primary (“baby”) molar that had a large cavity (dental caries) present. This presentation and diagnosis is considered urgent, and treatment should be rendered as soon as possible. The tooth will require extraction (removal). A discussion of the recommendation for a space maintainer should take place.

INTER-PROFESSIONAL COLLABORATION FOR IDEAL PATIENT CARE

This case is an excellent example of how healthcare providers, equipped with a TelScope in their facility, are able to triage a patient and obtain a teledentistry consult for an initial diagnosis and treatment plan, followed by a referral for appropriate treatment. This inter-professional collaboration through telehealth capabilities leads to effective and efficient health care, and can reduce appointment numbers, time, and exposure to others during these times of COVID-19.

About the Author: Dr. Richard Simpson, DMD

Dr. Richard is a board certified pediatric dentist in private practice.
His achievements include:
• Diplomate in the American Board of Pediatric Dentistry
• Fellow in the American College of Dentists
• Fellow in the International College of Dentists
• Fellow in the American Academy of Pediatric Dentistry
• Advisory Board Member of The TeleDentists
• Advisory Board Member of Holland Healthcare
Dr. Richard’s experience and active interests include telehealth, child advocacy, health disparities, policy, and advancing improved medical-dental access to care. Dr. Richard is also a veteran with 15 years of military service.
————
INFORMATION & CONTENT DISCLAIMER

This content is for information only. This content is not for advice, diagnosis, or
guarantee of outcome for patients. No patients should use the information,
resources, or tools contained within to self-diagnose or self-treat any health-related
conditions. 

Sign up for more content like this from Holland Healthcare:

Subscribe

* indicates required

Profession / Field

Which upcoming device(s) are you interested in?

Chipped Tooth as a Sign of a Cavity – by Dr. Richard Simpson, DMD

image captured with TelScope Telehealth System

image captured with TelScope Telehealth System

PROBLEM

A 6-year-old male reported to the dental office with his mother, who stated she noticed “a chipped tooth”. There was no current pain reported. However, after questioning, it was confirmed that the patient had experienced oral pain for “a few days” several weeks earlier, but it went away.

DIAGNOSIS

Clinical exam and an x-ray confirmed the patient had a large cavity (dental caries) in the lower right first primary molar. The second photograph, marked using the TelScope App, shows a fistula that developed as a result of a previous tooth abscess. This allowed the infection to eventually drain, which resolved the patient’s original pain. The nerve of the tooth is no longer vital (alive). This is a non-urgent diagnosis, but treatment is indicated. The treatment consists of extraction of the primary tooth, as well as a recommendation for a space maintainer to be placed on the second molar to hold eruption space for the replacement tooth, which usually emerges at age ten to eleven. Failure to remove the tooth could lead to multiple complications to include further fracturing of the tooth, space loss, shifting of teeth, recurrence of the infection, or damage to the underlying permanent tooth.

INTERESTING FACT

Tooth decay can be categorized by the type of tooth surface and the location on the tooth in which it develops. This cavity developed between the teeth and was originally much smaller. An x-ray taken at a routine dental exam can identify this type of cavity before it is visible in the mouth. Early diagnosis is important, because dental decay in primary teeth (“baby teeth”) typically increases in size four to six times faster than in permanent teeth.

About the Author: Dr. Richard Simpson, DMD

Dr. Richard is a board certified pediatric dentist in private practice.
His achievements include:
• Diplomate in the American Board of Pediatric Dentistry
• Fellow in the American College of Dentists
• Fellow in the International College of Dentists
• Fellow in the American Academy of Pediatric Dentistry
• Advisory Board Member of The TeleDentists
• Advisory Board Member of Holland Healthcare
Dr. Richard’s experience and active interests include telehealth, child advocacy, health disparities, policy, and advancing improved medical-dental access to care. Dr. Richard is also a veteran with 15 years of military service.
————
INFORMATION & CONTENT DISCLAIMER

This content is for information only. This content is not for advice, diagnosis, or
guarantee of outcome for patients. No patients should use the information,
resources, or tools contained within to self-diagnose or self-treat any health-related
conditions. 

Sign up for more content like this from Holland Healthcare:

Subscribe

* indicates required

Profession / Field

Which upcoming device(s) are you interested in?

Identifying an Oral Lesion – by Dr. Richard Simpson, DMD

image captured with TelScope Telehealth System

image captured with TelScope Telehealth System

PROBLEM

A 6-year-old female patient was seen for a routine Well Child exam by her pediatrician. The doctor noted a “swelling” on her lower lip, and the mother reported that it had been present for 4 weeks. The physician recommended a teledentistry evaluation with a dentist and referred her.

DIAGNOSIS

The “swelling” in question appeared as a raised, 4mm x 3mm soft tissue lesion with a broad base and normal color. It is located in the midline of the lower lip inside of the wet-dry line. The lesion did not change in size since it first appeared, and was not painful.
The diagnosis is a mucocele. A mucocele is a harmless fluid-filled retention “cyst” that most commonly results from the rupture of a minor salivary gland. Hundreds of salivary glands are located under the surface of the lip and other areas of the oral mucosa to maintain moisture. If a mucocele does not disappear after 4-6 weeks, it should be removed by a dentist or an oral surgeon, as it can interfere with normal function and often lead to the development of chronic biting or sucking habits and scar tissue, especially in children.
This is an excellent example of how an oral lesion or area of concern could be pre-screened by a healthcare provider, photographed using the TelScope Telehealth System, and transmitted to a dentist for a teledentistry consult prior to scheduling an appointment.

About the Author: Dr. Richard Simpson, DMD

Dr. Richard is a board certified pediatric dentist in private practice.
His achievements include:
• Diplomate in the American Board of Pediatric Dentistry
• Fellow in the American College of Dentists
• Fellow in the International College of Dentists
• Fellow in the American Academy of Pediatric Dentistry
• Advisory Board Member of The TeleDentists
• Advisory Board Member of Holland Healthcare
Dr. Richard’s experience and active interests include telehealth, child advocacy, health disparities, policy, and advancing improved medical-dental access to care. Dr. Richard is also a veteran with 15 years of military service.
————
INFORMATION & CONTENT DISCLAIMER

This content is for information only. This content is not for advice, diagnosis, or
guarantee of outcome for patients. No patients should use the information,
resources, or tools contained within to self-diagnose or self-treat any health-related
conditions. 

Sign up for more content like this from Holland Healthcare:

Subscribe

* indicates required

Profession / Field

Which upcoming device(s) are you interested in?


Eruption of a Permanent Tooth – by Dr. Richard Simpson, DMD

image captured with TelScope Telehealth System

image captured with TelScope Telehealth System

PROBLEM

10-year-old female patient says, “I feel something in the top of my mouth”. No pain reported.

DIAGNOSIS

A clinical exam, documented here with a TelScope image, confirms an over retained primary (baby) tooth with a stainless steel crown present.

It’s replacement permanent tooth is emerging (erupting) in the palate. The primary tooth was not mobile because a portion of the roots failed to resorb. Although this is not an urgent situation, the removal of the primary tooth by a dentist is indicated to allow the permanent tooth to fully erupt. The permanent tooth will likely drift back toward a more ideal position if the baby tooth is removed soon.

INTERESTING FACT

This is not an uncommon problem, and is an excellent example of a situation that can be pre-screened by a dentist through a teledentistry consultation with a clear photograph such as this that can easily be taken with a TelScope Telehealth System.

About the Author: Dr. Richard Simpson, DMD

Dr. Richard is a board certified pediatric dentist in private practice.
His achievements include:
• Diplomate in the American Board of Pediatric Dentistry
• Fellow in the American College of Dentists
• Fellow in the International College of Dentists
• Fellow in the American Academy of Pediatric Dentistry
• Advisory Board Member of The TeleDentists
• Advisory Board Member of Holland Healthcare
Dr. Richard’s experience and active interests include telehealth, child advocacy, health disparities, policy, and advancing improved medical-dental access to care. Dr. Richard is also a veteran with 15 years of military service.
————
INFORMATION & CONTENT DISCLAIMER

This content is for information only. This content is not for advice, diagnosis, or guarantee of outcome for patients. No patients should use the information, resources, or tools contained within to self-diagnose or self-treat any health-related conditions. 

Sign up for more content like this from Holland Healthcare:

Subscribe

* indicates required

Profession / Field

Which upcoming device(s) are you interested in?


Dental Growing Pains – by Dr. Richard Simpson, DMD

PROBLEM

An 11-year-old female patient is complaining of occasional pain in the lower right quadrant of her mouth in the evenings and at night for two weeks now.  The patient’s mother is concerned about possible “swelling”. This teledentistry photo taken with TelScope Telehealth System shows there is a permanent second molar emerging (“erupting”) in a normal position.

DIAGNOSIS

The tissue over the back of the tooth will recede with time as the tooth erupts into the mouth further. There is no inflammation or infection, and no treatment is indicated. The patient’s mother was instructed that the patient should brush the emerging tooth as normal. She could give her child an over the counter pain medication like acetaminophen or ibuprofen if needed.

INTERESTING FACT

Children grow, and teeth move, in the evenings and nighttime, as their growth hormone increases during this time. It is not uncommon to occasionally have discomfort from tooth movement that may come and go with no other symptoms – dental “growing pains”.

However, other more significant oral health issues can also cause night time pain. A photograph and a teledentistry consult with a dentist can help determine if an in-office examination is indicated.

About the Author: Dr. Richard Simpson, DMD

Dr. Richard is a board certified pediatric dentist in private practice.
His achievements include:
• Diplomate in the American Board of Pediatric Dentistry
• Fellow in the American College of Dentists
• Fellow in the International College of Dentists
• Fellow in the American Academy of Pediatric Dentistry
• Advisory Board Member of The TeleDentists
• Advisory Board Member of Holland Healthcare
Dr. Richard’s experience and active interests include telehealth, child advocacy, health disparities, policy, and advancing improved medical-dental access to care. Dr. Richard is also a veteran with 15 years of military service.
————
INFORMATION & CONTENT DISCLAIMER

This content is for information only. This content is not for advice, diagnosis, or
guarantee of outcome for patients. No patients should use the information,
resources, or tools contained within to self-diagnose or self-treat any health-related
conditions. 

Sign up for more content like this from Holland Healthcare:

Subscribe

* indicates required

Profession / Field

Which upcoming device(s) are you interested in?