Teledentistry companies historically focus on routine dental procedures. Now, a few combine their direct-to-patient reach with referrals to local dentists to ease the path for people with sleep apnea.

By Lindsey Nolen

Direct-to-consumer marketing has a controversial history in dental sleep medicine, sparking debate among professionals about the best ways to reach and treat patients. But several startups hope to leverage virtual platforms with in-person referrals into hybrid models designed to be the best of both worlds. 

An example of this approach is seen in a partnership facilitated by In Hand Dental, which connects sleep physicians with “affiliate” dentists who take on referrals. The platform assigns patients geographically or by practice. “For instance, we have a manufacturer that offers a sleep device for airway obstruction at night for children and is offered through social media to mom groups. It is a B2C [business-to-consumer] model. We created a branded app for them with their logo and color schemes to use for lead-generation purposes,” says Matt Quinn, chief revenue officer at In Hand Dental. 

“In Hand Dental is very unique in this respect because we can do either a B2B [business-to-business] or B2C model. Our application has the ability to set up an affiliate doctor who can peer into a practice that is assigned to them and the patients within that practice who they have been assigned.”

The affiliate dentist decides how they want to manage the treatment plan (remotely versus in-person follow-ups). In most cases, the patient will visit a dental office to receive the oral appliance and make sure it is fit appropriately. After that, patients are typically managed remotely. “The key to the whole process is to reduce the number of in-person visits that are unnecessary,” Quinn says.

Dental sleep medicine lends itself well to virtual consultation, monitoring, and care coordination, Quinn adds. Platforms like In Hand Dental enable in-person dental practices to compete through customizable apps, providing convenience without sacrificing continuity of care, according to Quinn. Expanded rural access and interdisciplinary referrals also enhance the capacity of sleep medicine services.

Quinn says In Hand Dental’s convenience and flexibility increase treatment plan close rates by 20%. When prospects download the branded app by scanning a manufacturer or practice’s QR code, they become registered as leads on the company’s dashboard, facilitating communication via text through the app.

In Hand Dental provides a software-as-a-service platform that allows providers, labs, and manufacturers to remotely monitor and manage patients undergoing obstructive sleep apnea (OSA) treatment. According to Quinn, the platform tracks patient compliance, enables photo/video uploads, and facilitates virtual calls. 

The HIPAA-compliant teledentistry platform connects dentists and orthodontists with their patients. It has treatment templates for invisible aligners, wired braces, temporomandibular joint disorders, whitening, myofunctional therapy, as well as OSA. So any OSA treatment plan can be pulled from the platform’s existing libraries or customized.

Most In Hand Dental clients utilize remote monitoring features like patient compliance scorecards more often than live teledentistry, according to Quinn.

“They only need to use virtual visits if they are offering a free consultation or to give a nudge to a patient who is being non-compliant. Most of the time the pictures, videos, and questions that are answered by the patient are sufficient,” he says.

Another hybrid in-person/virtual company interested in expanding access to sleep medicine is Dentulu Inc, which offers nationwide telescreening, teledentistry, and telemonitoring services.

“Dentulu’s program…provides a standardized workflow and nationwide billing capabilities that are very attractive to physicians, durable medical equipment companies, and other referring entities that send patients to Dentulu for OSA therapy,” says Arash Hakhamian, DDS, CEO at Dentulu. “We do not take on all cases, and we never treat patients without licensed practitioner supervision.”

Dentulu can benefit other physician providers by generating referrals and standardizing care processes, Hakhamian says. By referring patients to in-person dental practices and facilitating in-person care, hygiene, and maintenance, Dentulu helps increase patient flow to dental offices, according to Hakhamian.

“We have both price transparency and require patients to actively seek in-person treatment,” Hakhamian says. “Most of our patients would never seek in-person care and only do so because we promote and demand it of them, which equates to more patients for dental offices.”

There are concerns regarding the regulation, quality of care, and collaboration with physicians across teledentistry. For example, Hakhamian acknowledges the limitations of virtual-only platforms and says hybrid models incorporating in-person care may be more viable long term. He also highlights the need for quality-control measures, like audits.

“Standardizing the process and treatment provides our patients with access to unparalleled convenience and quality that still remains inconsistent on a national level with in-person solo dental offices,” Hakhamian says. “Dentulu has been providing these services under the care of experienced, licensed dentists and physicians and constantly goes through audits and quality-of-care assessments that ensure the effectiveness of our treatments.”

The team includes Darren Ramsey, DDS, director of sleep apnea, and Pedro Cuartas, DDS, clinical educator; Ramsey has expertise in oral appliances for OSA, while Cuartas specializes in training virtual and in-office dental sleep medicine practitioners.

Ultimately, Hakhamian argues that expanding teledentistry access, if done responsibly, can improve outcomes. He says startups like Dentulu may be positioned to help lead the charge due to understanding responsible regulation and future collaboration with providers are integral to the scope of its impact.

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