Mobile & Teledentistry- Is It Time To Take Them Seriously? Are They Right For Your Practice?

Chris Pistorius:
Hi, everyone. This is Chris Pistorius again with The Dental and Orthodontic Marketing Podcast. We have got a super cool guest with us today. We have Melissa Turner, who quite frankly, does a little bit of everything in dentistry, but she is known as a dental influencer, a dental consultant, and she’s also, I think this is really cool, the Co-Founder of The National Mobile & Teledentistry Conference. So Melissa, thanks so much for taking the time to be with us today.

Melissa Turner:
Chris, thank you so much. What is up, everybody? Honored to be here, so honored.

Chris Pistorius:
Yeah, I feel like I should be getting an autograph or something, because everywhere I look with dentistry, you seem to pop up. So you’re doing a great job in something I’m trying to learn from, so thanks again. Melissa, we’ve got quite a few clients around the country and we do marketing for them, and during the pandemic especially, and even a little bit before that, we started getting questions around mobile, teledentistry. “How could we use that? Is it possible to use that in a dental practice?” Can you just start us off by telling us all right, what is mobile, what is teledentistry? Fill us in on the latest on what’s going on with all of that?

Melissa Turner:
Chris, I would love to. So this is something now, we were talking before and I told you I’ve kind of been preaching the same message for about six years now, and the message is basic, the message is dentistry is changing, our patients are changing, the dental consumer is changing, and as an industry, we have to adapt to the changing times. And so, one of the things that’s super important is changing the way that we deliver our care. So, in the past, I’ve been a dental hygienist for going on almost 20 years now, and it’s one of these things where we’re so used to the patient walking through our front door, we’re so used to that mindset. You come to us. Sure, we’ll send you a mailer. Sure, we’ll be active on Facebook, and you can friend us and whatever, but you come to us. And especially since the pandemic, we’ve realized that the dental consumer, wants us as the dental professional, to come to them.

Melissa Turner:
So mobile delivery of dental care, virtual delivery of dental care, we lump that together, in everything that I do. We have a conference called The National Mobile & Teledentistry Conference, and we use those two terms because it’s healthcare delivery outside of the four walls of the dental practice, and you can have mobile dentistry without teledentistry, but they really do go hand in hand. They’re like peanut butter and jelly. The mobile clinician can go more mobile, and stay better connected using teledentistry. You can have fixed dental practices that just have a virtual arm into the patient’s phone, and that’s getting the care outside of the traditional brick and mortar, and that’s where we’re headed. So that’s the long and short, that’s the 60 second spiel of what mobile and telehealth is about right now.

Chris Pistorius:
Nice. That is exciting stuff, and it kind of changes the whole concept of this traditional dentistry as we think about it now. So, and I think certainly, people, I talk about this with our clients, look, not everybody wants to communicate with you by phone, right? And some people want to do a chat online, they want to text you, they want to do whatever, so why not open up your website and all of your other marketing assets to communicate in different ways with different people, based on how they prefer to communicate?

Chris Pistorius:
And we still get some of the traditional people that say, “Oh no, nobody wants to use that stuff. They just want to pick up the phone and call,” and I struggle with that, because I get frustrated sometimes and I’m like, “Look, it’s not about how you do things, it’s about how the rest of the world does things,” right? And I think that that’s where we are with some of our more traditional dentists now, and the thought of mobile and teledentistry, they’re just kind of like, “We do it this way, and that’s the way.” Are you seeing some of that? Is that pretty consistent where you are too?

Melissa Turner:
Mm-hmm (affirmative). Yeah. I mean, right now, we’re seeing adoption as either the practice owners are for it, completely or they’re not for it completely. Over the shutdown when dental practices were forced to close their doors and forced to find ways to find other touchpoints with the patients, they dabbled in virtual care. Many of them did it wrong, and got upset. Many of them did it right, and now it’s a regular part of their practice. And I’ll tell you two things, Chris, the first thing is when dental providers think about teledentistry and what that could mean, there’s so many times when they simply think that it means a live video chat like we’re doing right now. That’s what they think it is, and that’s well and that’s good, but the secret sauce is the asynchronous stuff, the stuff that doesn’t have to be live, the stuff that’s more flexible.

Melissa Turner:
So I know a practice owner who, over the shutdown, his hygiene department was backed up. They were just trying to get as many hygiene patients in and in as fast as possible, they had so many to get in, and what ended up happening was he was getting so tired, because during his crown prep, he’d have to get up four different times to go check hygiene patients. Well, that’s just a really inefficient business model anyway. So what he did was he started to use the asynchronous teledentistry aspect of his practice management software, and the hygienists would collect all the data, they’d do a scan, they’d do video and photos of the mouth, and the dentist at the end of the day, would just zoom through all the hygiene checks asynchronously without the patient in the chair, and he was able to catch up, and that’s efficiency.

Melissa Turner:
That’s something that not many dentists are thinking about right now. They’re thinking, “Oh, I got to go do the hygiene check,” they want to connect with that patient, but what if that patient doesn’t care about connecting with the dentist, right, that’s kind of where we are. They get that connection with the dental hygienists anyway. Yeah, and then there was a second thing, but I don’t really remember what the second thing was.

Chris Pistorius:
That’s all right. You’re like me, it’ll pop up in a few minutes.

Melissa Turner:
It’ll come back, yeah.

Chris Pistorius:
No problem. Yeah. Well, cool. So let’s talk about that a little bit, because I told you off air, we’ve kind of played with teledentistry with our marketing campaigns, and I think that there’s a lot to learn there, based on what you just said, and we going into it, kind of thought that way too, we’re like, “Okay, so we’re going to do a Zoom, a HIPAA secured Zoom with new patients,” and that’s some of the feedback that we got and they were kind of like, “You know what? Yeah, you can put it on the website, but I don’t think it’s going to work.”

Chris Pistorius:
And we had a lot of kind of, I don’t want to say pushback, but a lot of doubts. I mean, they’d say, “Yeah, we could see how that could work for a regular doctor to prescribe medication or look at something basic, but we could never do this. We could never make this work in a dental practice, but you can try it if you want.” So can you talk about that a little bit? And I know you touched on part of it, but what would you say to somebody telling you that?

Melissa Turner:
Mm-hmm (affirmative). I would say take a look at health . Dentistry has it easy, because we are typically about 10 years behind healthcare, and telehealth, they’re in a telehealth boom right now. And it’s one of these things where in dentistry, we’re still in the early adopter phases, we’re still in the pioneering phases of finding the right technology, putting together all the right pieces of technology to really make virtual care take off. But I’ll tell you this, if a dental practice owner starts to use virtual care and does it correctly, they’re going to find their schedule is open now, they can bring in those full day cases, they can bring in traveling specialists, and house their referrals under one roof.

Melissa Turner:
Their time just starts to open up, and it’s one of these things where… So the easy answer is, okay, so if you have an emergency, you can triage them via live FaceTime, or Zoom, or whatever platform, HIPAA compliant platform you use. You can do a post-op procedure, which opens up your clinical chair time. You can do a [inaudible 00:09:10] exam. You can do all these live things, but there’s also tons of not live things, asynchronous things that you can do in the background, and that’s where it’s a learning curve right now for dental practice owners and their team. They don’t understand that maybe there is a better way to do this. Intraoral scanners are really entering both the mobile and the telehealth market right now.

Melissa Turner:
What we’re finding is dentists, let’s say we have a hygienist who’s offsite at a patient’s house, providing a cleaning and an exam. That hygienist really could do a scan, if they’re in a mobile unit, and they could do a video of intraoral photos of the mouth, and even just that data alone is mostly enough to create a diagnosis or a prediagnosis, let alone having the radiographs, let alone having the perio charts, let alone having the salivary testing. Down the road, we have remote patient monitoring, we have mHealth, mobile health. We’ve got all these apps that are coming down the road that we see in healthcare, that are now being applied in dentistry.

Melissa Turner:
There’s a great one for bruxism, and you wear a strap around your head and it measures the temporalis muscle. This is the patient is doing this, right? And so, then the patient on their app, they get to see their clenching and grinding that happens during the day, but then that information also gets sent to the doctor or the hygienist on the other side of the app, on the clinical part of the app, and that right there is virtual care, right? But we’re not thinking like that yet. We’re not thinking like that, but we are, it’s a learning curve, and we have to adopt it industry-wide. But we’re there, COVID-19, the shutdown really accelerated the way we think.

Chris Pistorius:
Yeah, yeah.

Melissa Turner:
Yeah, yeah.

Chris Pistorius:
I agree. I totally agree, and like I told you, we’d tested some of this before the pandemic, and then the pandemic hits and we’re like, “Uh-oh, we might need to think about this a little further.” So, and I guarantee there’s a lot of dentists out there that thought that same way. So that’s awesome. So what does all of this look like five years from now, in your opinion?

Melissa Turner:
Mm-hmm (affirmative). Yeah, that’s when I really start to get excited, because I think when a dental practice owner hears the word “mobile dentistry,” they’re either going to be like, “Yay!” or “Nay.” We’re so used to hearing mobile dentistry, mobile delivery as a public health thing, something that our patients don’t really want, but that is changing, and starting to implement virtual care teledentistry in a dental practice, is the first step. It’s kind of the gateway drug to thinking outside of the practice.

Melissa Turner:
So I know some dental practice owners who started implementing virtual care and now they’re like, “Well, why don’t I just send my associate out to the workplace down the street that has a hundred employees? Why don’t I go to them? Why don’t I drag portable units? Why don’t I buy a van?” You can get these great Mercedes Sprinter vans, low cost, low overhead. We’re seeing dental students coming out of dental school not wanting to purchase a practice, not wanting to be an associate. They can purchase these vans, they can pimp out a pod, a trailer for much lower overhead than a fixed practice. And the thing is, the patients want this, they want us to come to them. If I could have a dentist come to my house right now and see my two kids, me, my life partner, I’m like, “I will love you forever,” right?

Melissa Turner:
And so, that’s the thing, once a dental practice starts to implement virtual care, they start to think beyond the four walls of their fixed practice, and then the next step is to start sending their providers out. And then I can’t tell you how much chair time you’ll have for the more lucrative procedures, for the referrals that you don’t want to send to somebody else, you want to keep in house so you can keep on brand, so that you can retain that patient relationship.

Chris Pistorius:
Yeah. So I have probably a dumb question here, but when you talk about mobile dentistry, are you seeing doctors do mobile only, or are you seeing them have a brick and mortar and they kind of have a mobile unit, if you will, or could you do it both ways?

Melissa Turner:
Mm-hmm (affirmative). So I’ll tell you what I see right now, and then I’ll tell you what I see down the road, and that’s what’s exciting. So right now, I call them the sexy mobile dental companies. So for years, mobile dentistry has been known to go into nursing homes, school, and public health, giving away free dentistry. And whether that’s a dental RV on wheels, whether that’s portable units you drag in somewhere in a suitcase, that’s what it’s known for.

Melissa Turner:
About four or five years ago, we started seeing outside funding, VC funding, angel investors coming in. We started seeing non-dental business owners become interested in providing mobile dentistry. So right now, there’s this whole slew of companies of sexy mobile dentistry companies who are only mobile, and they take care into workplaces like Amazon Headquarters, Nike. We’ve got Floss Bar, Jet Dental, Onsite Dental, HENRY The Dentist, Studio Dental. I mean, the list goes on and on, and they rely on big time marketing, they rely on great branding to get them where they need to go, and they scale fast, they scale fast. They start on one end and before you know it, they’re all across the country.

Melissa Turner:
So that’s what we’re seeing now, and that’s kind of a phenomenon. That’s kind of a separate subgroup of business models. But what I see in five to 10 years, Chris, is the traditional fixed dental practice will have the virtual arm into the community, and then it will have the mobile arm. And whether it’s simply a provider carrying in dental units in a suitcase, the portable dental units, there’s a time and place for that, but then there’s also a time and place to pimp out an RV, and to make it look sexy and good, and start doing Invisalign, or Candid, or any of the aligners on there, and start doing sleep dentistry on there. And so, we’re seeing it, we’re seeing some companies, they get architects to design the inside of these RVs, and they look sleek, and they look good, and then they stay at a corporate facility for like a month, and they build a deck, and they build it into the area, and then they move on the next month, and it’s really working well, and it’s what the consumer wants right now.

Chris Pistorius:
Yeah, that’s amazing. You mentioned earlier, “If they do teledentistry correctly,” right? And I wrote that down, because what does that mean? What is correct? What’s the correct way to use teledentistry?

Melissa Turner:
Yeah. So if the word for 2020 was “pivot,” everybody was saying that, the word for 2021 is “flexibility,” having a business model that’s flexible. So teledentistry, if somebody implements teledentistry, it makes them more flexible, it makes their business more flexible, but not necessarily the live video chat. And this is kind of circling back to what we talked about earlier, because if I am a dentist and I have to be on live video chat all day long, how is that creating flexibility? How is that really any different than just having the patient in my chair? Except it opens up an op, which is different. But so, the flexible part of it is thinking, “What can I do? How can I use virtual care to expand my practice model, to reach new patients without me, the dentist, having to stare in front of a computer screen and spend time with the patient?” And that is the asynchronous, the store and forward teledentistry component. And honestly, if a dental practice has a practice management system that’s cloud-based, a lot of that can be done through that. Mm-hmm (affirmative). Mm-hmm (affirmative).

Chris Pistorius:
Right. That’s amazing. Do you have any stats or statistics, and if you don’t have them now, maybe you could send them to me later and I can include them with this, but about mobile and teledentistry, how many people are adopting it? You talked a lot about that’s what people want, I totally agree. Do you have any stats or numbers on that? Are we to a point yet where we’re even tracking that kind of stuff?

Melissa Turner:
We are tracking and we are collecting data at this point, The American Mobile & Teledentistry Alliance is working hard on that. What I can say, as far as teledentistry during the shutdown, there were numbers of up to 80% of dental practices who were using it at some points, and that would fluctuate down to 30, up to 80, back and forth, back and forth. So stats, we’re not there yet, but the easy answer is to look at the telehealth community, look at the stats in the telehealth community and see their adoption, because while we are more in-person clinical than many of our healthcare colleagues, it is still possible to do a lot virtually with our patients. Mm-hmm (affirmative).

Chris Pistorius:
Right. Are there any insurance implications here? I mean, does anything change as far as dental coverage with your insurance to use these types of services?

Melissa Turner:
Mm-hmm (affirmative). So what we’re seeing, well, to get into the weeds, there are regulations that you have to work around. And so, if someone is interested in potentially using telehealth in their dental practice, or even mobile delivery, you have to take a look at your state practice act, you have to take a look at what definitions they use, even the definition of a comprehensive evaluation. Do they say it has to be tactile? Do they say you have to be in-person? The practice acts are a little bit behind the times, but then the third-party payers also place their own restrictions on, and some of them have none, and some of them will only perhaps cover part of a live video chat.

Melissa Turner:
So these things, we saw a lot of movement in the last year, and even with the CDT codes, procedure codes for dentistry, we’ve seen a lot of movement with that to more teledental codes and virtual care codes going into those as well. So things are moving, but yes, definitely check with your third-party payer, check with your state practice act. State boards won’t even be able to give you an answer, so I’m happy if somebody needs me [inaudible 00:20:12].

Chris Pistorius:
Yeah, yeah. Awesome. So I want to hit you up on, what about HIPAA? Did anything really change there? I mean, you just got to lock down your systems if they’re mobile, and I’m assuming all the rules still kind of apply the same way, right?

Melissa Turner:
Yeah, if not, they’re stricter because of technology, and as technology advances, we’re seeing new rules and new things come that way. We’re going to have some pretty good education coming up at the conference in March at The National Mobile & Teledentistry Conference in March, regarding HIPAA and what to look for, and because there’s platforms out there that say they’re HIPAA compliant, but you will have to do your due diligence, and double and triple check that.

Chris Pistorius:
Don’t take their word for it-

Melissa Turner:
No.

Chris Pistorius:
… because that can be a problem, we’ve seen it.

Melissa Turner:
Mm-hmm (affirmative).

Chris Pistorius:
Let’s talk about this conference, it sounds exciting, all I heard was Vegas. So, but maybe you can talk to us about the conference coming up in March, and where it is, and the details, and all that stuff, please.

Melissa Turner:
Sure. So on March 3rd through the 5th of 2022, we will have our third annual conference, and it is a great time. So it’s two full days of courses, and then on Thursday, the day before we have a teledentistry workshop, so that day is completely devoted to teledentistry, getting as hands on as possible. We have the mobile dental RVs, we have the portable units that come, you can tour them, you can get hands on. We’re going to have some rooftop action this year, which is going to be amazing. And then the final night, we close out the conference with a separate event, but it’s an amazing event, it’s called The Denobi Awards, and The Denobi Awards is an awards program for all of dentistry, not just mobile and teledentistry, but the gala takes place on the closing night, and it’s like the dental Oscars. So it’s a time to celebrate everyone in dentistry. Nominations are happening now, and then people get shortlisted, and then the final list is announced, the final 10 winners are announced that night.

Chris Pistorius:
Wow, that’s awesome. That sounds like a really cool event. If people are interested, how can they find out more and get signed up, that kind of stuff?

Melissa Turner:
Yeah. So we’ll start with The Denobi Awards, it’s D-E-N-O-B-I, denobiawards.com. You can go there, you can purchase a ticket. If you attend the Mobile Conference, then your admission to The Denobi Awards is free. So the Mobile Conference, the website is www.N-M, D as in David, nmdconference.com. We’ve got early bird tickets happening until June 30th, and we do have exhibitor and sponsor opportunities too, which is really great, and we usually sell out. And the conference itself, it’s been hybrid all three years, so we always have a virtual component if you can’t make it there to Vegas in person, but who wouldn’t want to, right?

Chris Pistorius:
Right.

Melissa Turner:
Yeah.

Chris Pistorius:
What kind of numbers are we talking here? How many people? I mean, I know it’s going to be weird coming out of COVID, but what traditionally have you seen?

Melissa Turner:
So, you know what? So it’s all a story. So the first conference, we were happy if there were two people in the room, right? This was pre-COVID, we were like, “We’re just going to get this started, because it’s necessary,” and it ended up, we had 300 people for our first conference, and then another hundred or so online. And that was right before COVID, we came home, and the world shut down. And then we had a full year to plan for the second conference and we said, “We’re okay if there’s two people in the room again.” We were like, “You know what? It just needs to happen.” And so, we ended up having another in-person and virtual conference just in March, and we had probably another two or 300 in person, and then we had about 500 online.

Chris Pistorius:
Wow.

Melissa Turner:
So who the heck knows what we’re going to get into this next year?

Chris Pistorius:
That’s cool. Nice.

Melissa Turner:
Yeah. But what we know is that large conferences are kind of going by the wayside. We’re talking like thousands and thousands of people. And so, our perfect conference would be somewhere around 500 people, where you can still literally talk to everybody in the room if you want to, where the vendors get to know the people intimately, and where it’s a conversation, and not a show. Although we do have some fun things going on too.

Chris Pistorius:
Oh yeah, for sure.

Melissa Turner:
Yeah.

Chris Pistorius:
Well, Melissa, thank you so much. This has been a lot of great information, and I got to tell you, usually when I do these interviews, I already know quite a bit about the subject matter, but I’ve learned a ton in this short amount of time. So, and this is something that I think is going to continue changing, and probably change pretty quickly. Would it be okay if we checked in with you in a few months and just get a litmus test to what’s going on and what we’re seeing in the industry?

Melissa Turner:
Absolutely. And up until the shutdown, the pioneers were talking about mobile dentistry, about teledentistry, and then everyone was forced to talk about it. And so, what we’re seeing now are intentional conversations coming from it, from the third-party payers, from the DSOs, from the big brands, they’re talking about these things, and this is where it starts to get fun.

Chris Pistorius:
Yeah, yup.

Melissa Turner:
So yes, we’d be happy to come back and give an update.

Chris Pistorius:
Yeah, once you get those guys starting to talk about things, that’s when change happens pretty quickly, right?

Melissa Turner:
That’s right, that’s absolutely right.

Chris Pistorius:
So that’s awesome, and it kind of gets me excited too, because I think that’s probably going to be an arm off of us as well. How do we get involved with this and make sure that our clients stay on the top of that curve?

Melissa Turner:
Yeah.

Chris Pistorius:
So, great information, Melissa. Thanks again so much for joining us. I wish you the best of luck for the conference, and I have every intention of being there and being as much of a participant as possible, so thank you for that too.

Melissa Turner:
Thank you, Chris.

Chris Pistorius:
Okay. Well, thanks everybody else for tuning in this week. We’ll have another great guest next week.