Dentaltown September 2017 - 102

Store-and-forward (asynchronous):
Transmission of recorded health
information such as radiographs,
photographs, video, digital impressions and photomicrographs through
a secure electronic communications
system to a practitioner, who uses the
information to evaluate a patient's
condition or render a service outside
of a real-time or live interaction.13
Two of the four-synchronous and
asynchronous modalities-were granted
CDT 2018 codes. An ADA Ad Hoc workgroup is developing a guide for the use of
these new teledentistry codes as they did
for D4346 in 2016.14
Intraoral cameras are proven tools
for boosting patient awareness and case
acceptance. An oral digital tour has become
common practice for many professionals.
There are a wide variety of systems available
but not all are ready for the changing world
of teledentistry. Barriers in the form of cost,
design, portability and HIPAA compliance
still exist.
The type of technology chosen and the
solutions provider selected are paramount.
Not all collaboration technology is equal; it
needs to provide seamless communication
in real time while being easy to use. Poor
connections, confusing technology or inferior technology can render teledentistry
inefficient.
Systems designed with an eye for
teledentistry are emerging on the market.
They include video conferencing services
like Vidyo, VSGi and more. Virtual Dental
Care and Planet DDS offer asynchronous
cloud-platforms teledentistry solutions.
Another teledentistry option is TeleDent
by MouthWatch.
*

Robotic learned behaviors
The challenge is integrating and
implementing current science, new ideas,

philosophies, technologies and codes into
our established systems. Once our school
days are over, ongoing training can become
inconsistent. Coding education and training
is absent, erratic, hand-me-down and tradition-based. Once patterns are established,
they seem rock solid and difficult to break.
It's somewhat like downhill skiing. On
the first run, the powdery snow creates
an amazing and enjoyable ride. The skier
takes the run again and again and again.
Over and over the pattern continues. Why?
Because that skier gets comfortable with the
run. Over time this snow becomes packed,
weather changes and there is some melting
and refreezing. What was a wonderful run can
become a deep rut with icy sides. Attempts
to scale up the sides of the rut can often lead
to slipping right back into the rut.
It can feel daunting when there is also
the perception of someone on the top of the
rut kicking you back down. This describes
the perception that many dental professionals
have of dental benefit carriers. Strategic
thinking, step-by-step planning and small
daily choices can help break patterns and
melt the icy sides.

Daily choices make
the difference
New codes are not more numbers that
become the responsibility of the practice business professionals to implement.
These codes are game-changers that create
opportunity for radical growth, change
and profitability. In addition, these codes
can help significantly move the needle to
improve interdisciplinary health care and
collaboration and ultimately patient health.
The question becomes: Where do you
start? As the old saying about eating an
elephant goes, you can only do it one bite
at a time. It would be foolhardy to try to
change everything at one time. Strategic
planning is the key. Though common in

many businesses, trade associations and more,
the process is not frequently considered or
implemented in dental practices.
It's easy to look back and see how big
decisions have changed your life. What's
harder to do is look back and realize how
all those small everyday decisions have
impacted you. In life, it's the daily small
choices that make the most difference.
There's a great quote by Wayne Dyer that
goes, "Our lives are the sum total of the
choices we have made." So, what kind of
life are your everyday decisions making?
Why does it take new codes for dentistry to
change our deeply held behavior patterns?
Codes are just numbers. Codes can provide
opportunity. n
References
1.
Burger, D. "Code Maintenance Committee OKs teledentistry,
HbA1c codes.'" ADA News. March 14, 2017.
2.

More than 29 million Americans have diabetes; 1 in 4 doesn't
know. 6/10/15 Centers for Disease Control. Accessed 6/13/17.

3.

Guray, A. The association of periodontitis and metabolic
syndrome. Dent Res J (Isfahan) v.11(1); Jan-Feb 2014
PMC3955301. Accessed 6/13/17.

4.

Barasch A, Safford MM, Qvist V, Palmore R, Gesko D,
Gilbert GH; Dental Practice-Based Research Network
Collaborative Group. Random blood glucose testing in dental
practice: a community-based feasibility study from The
Dental Practice-Based Research Network. J Am Dent Assoc.
2012.

5.

Borrell LN, Kunzel C, Lamster I, Lalla E. Diabetes in
the dental office: using NHANES III to estimate the
probability of undiagnosed disease. J Periodontal Res. 2007
Dec;42(6):559-65. Accessed 6/13/17.

6.

Herman WH, Taylor GW, Jacobson JJ, Burke R, Brown MB.
Screening for prediabetes and type 2 diabetes in dental offices.
J Public Health Dent. 2015 Summer;75(3):175-82 Epub
2015 Feb 6. Accessed 6/13/17.

7.

DiGangi, P. More than Pocket Change. April 2013.
Self-published.

8.

Nath SG, Raveendran R. Microbial dysbiosis in periodontitis
J Indian Soc Periodontol. 2013 Jul;17(4):543-5. doi:
10.4103/0972-124X.118334. Accessed 6/13/17.

9.

Gilliam, K. The Critical Role of Oral-Systemic Link in
Clinical Practice. December 2015. PennWell Publications.
Accessed 5/30/17

10.

DiGangi, P. CDT 2017 Shifts. December 2016.
Self-published. Accessed 6/13/17

11.

House passes guidelines on teledentistry. ADA News.
December 15.

12.

DiGangi, P. Chapter 12: D9000 - D9999: Adjunctive
General Services CDT 2018 Companion. American Dental
Association. August 2017.

13.

A Guide to Reporting D4346. American Dental Association.
May 5, 2016. Accessed 6/13/17.

14.

Introducing Teledent by MouthWatch. Accessed 6/13/17

Listen to Patti and Howard crack the code
Patti DiGangi demystifies dental coding on Dentistry Uncensored with Howard Farran.
Get a crash course in dental coding from someone who literally wrote a book on it!
To listen, visit dentaltown.com and search "570 Dental Codeology."

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