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21st Century Dentists Make Internet Calls for Underserved Children

Michael McFadden
Dental hygienist with Finger Lakes Community Health, Marlene Allen, sends video images of 6-year old Jason Green's teeth for Dr. Sean McLaren, who watches from his office in Rochester.

Six-year old Jason Green is spending his afternoon at the dentist’s office, but his focus is on the many stickers he’s earning by behaving during the appointment. “Well, I have been really good,” he beams, holding a stack of adhesive monster truck drawings.

For his mom, Melissa Green, the exciting part of this appointment is that she’s able to have her son seen by a dentist without having to travel too far from her rural upstate New York community. Otherwise she would need a friend to drive her, her son and infant daughter an hour west to Rochester where the nearest dental hospital is located.

It could be dangerous for Jason to go without treatment for his dental health needs. Tooth decay is the number one most common chronic childhood disease. It can lead to bacterial infections, malnourishment, and a host of other dangerous outcomes. A parent who lives in a rural area, far from a dentist, might need to lose several days wages and travel long distances to get the treatment they need.

Credit Michael McFadden
Dr. Sean McLaren examines patients remotely from his office computer screen.

Melissa and Jason didn’t have to take the trip to Rochester for the kindergarten’s appointment. Jason squirms in a dental chair at a clinic run by Finger Lakes Community Health in the rural community of Sodus. So, mother and son were able to stay in Wayne County to consult with pediatric dentist Sean McLaren. The doctor is also close to his home. He views the six-year old’s teeth from Rochester on his computer screen.

Jason’s hygienist uses a camera shaped like an electric tooth brush to send images to Dr. McLaren at the Eastman Institute for Oral Health. A secure internet connection links doctor to patient letting them chat by video over long distances.

“Through this tele-dentistry program, what we’re trying to do is eliminate at least that initial visit to the dentist. That initial exam appointment. So, we do that over the internet with the live video connection and do the examination there. So that the first time that they’re coming in to see the dentist they’re going to have treatment done,” McLaren explains.

The treatments can be extensive. Patients referred to Dr. McLaren have dental health needs that require surgery and sedation. “The kids that we’re typically taking to the operating room probably have anywhere from 10 to 20 cavities on their baby teeth and for a four-year old to sit to have 10 fillings done is not that easy,” says McLaren.

More than a quarter of children between the ages of 2 and 5 have tooth decay. This is particularly a problem in communities that traditionally have less access to health care, like among migrant farm workers.  Alejandra Hernandez Morales, who works in Wayne County’s apple orchards, sought out care for her children. The mother of four brought two of her children for treatment with McLaren. Hernandez Morales says for the sake of her kids she would have found a way to get the work done even without tele-dentistry. But it would have been more difficult. After an initial tele-dentistry appointment, Dr. McLaren sedated her daughter Adela to cap two of her front teeth and removed four others.

Doctor McLaren says a big part of what makes the program work is the care coordinators like Patricia Hall, from Finger Lakes Community Health. Before clinics with tele-dental services added care coordinators to the mix, many of their patients didn’t follow through with treatment. Hall serves as a go-between with the patient, the doctors and the clinic, and helps link them to any of the services they require. She says when people have problems getting enough food or housing, making and keeping dental appointments are not their priority. She helps them problem solve.

After getting to know the patients, Hall says it’s easier to find them the assistance that will best address their needs, “then we find out, after we build a rapport with them, exactly what’s happening. So, sometimes, it may not be transportation or housing, it can be other personal things going on in their family.”

Tele-dentistry with support from care coordinators is ensuring more kids get their teeth fixed. Since 2010, McLaren has treated more than 400 children through the tele-dentistry program reaching kids in rural communities who wouldn’t get care otherwise.