Dental radiology is quickly becoming the standard of practice in veterinary medicine. It has been shown to be 1 of the best ways to improve quality of dental care in veterinary practice. As a result, practices are adding this technology on a daily basis. However, most veterinarians have received minimal to no training in school regarding obtaining and interpreting dental radiographs.
Dental teleradiology is a relatively new but invaluable service available to veterinarians that fills this gap. It is already of great value in human dentistry.1,2 Teleradiology has the potential to improve the quality of patient care and reduce the stress and frustration for practitioners learning to interpret this novel diagnostic format. Teleradiology can also be a profit center for practices that use it.
There are several reasons to use teleradiology, especially if dental radiology is new to your practice.
- The most obvious indication is to obtain expert interpretation on unknown, questionable, or novel abnormalities.
- Dental specialists can also help practitioners and their staff with the challenges of positioning and exposure.
- Finally, veterinary dental teleradiologists can be an invaluable aid when it comes to equipping your dental operatory.
Techniques & Equipment
Dental teleradiology can be used by any practitioner with a digital dental radiography system. The efficiency of the teleradiology experience will vary with the system. Some digital systems allow users to directly send images to a teleradiology service by using a DICOM (digital imaging and communication in medicine) protocol. In digital dental systems that support DICOM, sending full DICOM files is recommended.
An alternative method of sending images for review is to export the images as JPEG files and upload them to a teleradiology service. Sending JPEG images may be cumbersome; specialists will not be able to window and level images, and patient demographic data will not be included with the images. Nonetheless, sending JPEG images is a necessity for systems that do not use DICOM.
To get the most out of teleradiology, full-mouth radiographs should be submitted initially as a learning aid.
Improved Diagnosis of Abnormalities
The main advantage of dental teleradiology is that specialists often find more abnormalities than most general practitioners. This leads to superior patient care and ultimately should increase income for the practice (because of the increased number of necessary procedures performed).
Detailed Treatment Recommendations
Furthermore, teleradiology readings deliver an official report for the practitioner and client, with detailed treatment recommendations. Expert advice coming from a third-party specialist should go a long way toward improving client compliance with prescribed treatments. If the teleradiology service offers STAT readings, therapeutic procedures can be performed under the same anesthetic episode.
Comparison of Radiographs & Photographs
Most teleradiology services allow submission of digital photographs of the oral abnormality along with radiographic images. If the reader is a veterinary dentist, these additional images can help with diagnosis and treatment recommendations. In addition, photos of an oral abnormality with normal radiographic findings can be included for expert opinion.
Permanent Image Backup
Dental images are as much a part of the medical record as are whole-body films or patient progress notes. An additional advantage of teleradiology services is permanent backup of images. Practices often use laptops or dedicated desktops for dental radiographs. In many practices, these computers are not backed up, and laptops are notoriously unreliable.
Many teleradiology sites permanently back up all submitted images. This can save money and prevent potential liability issues for practices that use these services. Check with the teleradiology service for details on their backup system.
Official & Legal Interpretation
Finally, teleradiology provides the advantage of reports that can be used as an official, legal interpretation. This can be invaluable if there is ever a dispute about whether a procedure was performed correctly or was necessary. A radiology reading could even be performed after a complaint has occurred, which may quell the client’s concern early on and avoid any disputes over the procedure.
Lack of Dental Interpretation
Veterinary dental teleradiology has only a few minor disadvantages. The first is that most teleradiology services are staffed by radiologists rather than veterinary dentists. Although radiologists are qualified to read skull images, most are not trained in reading dental radiographs. A significant amount of subtle and unusual abnormalities are found on intraoral films, and dentists are significantly more knowledgeable in this area.