I remember when the upcoming start to school was dreaded by nearly everyone I knew, not because it meant giving up the freedom of summer but because it meant shots and seeing the dentist. Growing up in mostly rural places, we’d often see the doctor and the dentist a couple of weeks before school so that our shot records would be current and our dental needs were cared for so as not to interrupt any days of school in the upcoming year.
School was not to be interrupted in my era, and to miss it you really had to have things go terribly wrong. I never gave it much thought until later as an adult while working on eliminating rural health care disparities. We often drove over an hour for our care, and it was planned weeks in advance because access to care was pretty limited. I was proud when Texas Tech University Health Sciences Center El Paso received the key funding to start West Texas’s first-ever dental school, the first built in Texas in over 50 years. It has long been known that students going to the dental schools located along I-35 and eastward typically locate their practices mostly near where they were trained. This leads to shortages out west. It’s a great opportunity for students in this new school, endowed by the Hunt family and named for Woody L. Hunt, to be exposed to West Texas and to better understand the kind of oral care needed in this rural part of the state.
Just as in most of the rest of contemporary life, technology in dentistry and oral health care is rapidly improving. I was very proud of my state senator, Charles Perry (R) of District 28, who carried Senate Bill 792 in the 86th Legislature Regular Session. This bill was about teledentistry, but the body adjourned sine die and it died. But did it really? Bills often take many tries, and the associated processes of consensus building among stakeholders generally lead to a better finished product. So, while it didn’t make it this time, I think it is likely to have another chance later.
When I think of ways to extend care and provide better access, I think of the successes of telemedicine. If we can produce dentists that understand and practice in West Texas, and if we include education in the use of teledentistry technology in their education, then I think there will be novel ways found to extend oral health care to people in places that may not have the best access now. There will be opportunities to harness telecommunications technology for patient education, for digital diagnostic imaging services, and for spanning distances in miles to remote rural areas. Even dental education can build on digital networking, sharing dental information through virtual practice communities, obtaining specialty consultations, and many more advances. And yes, we will have challenges with the legal and ethical issues, but we will have precedents that can guide a wise use of the technology, which brings me back to Senator Perry’s bill that laid out a path for much of how teledentistry could be implemented.
What we must remember is that we must use all the tools in our toolbox to bring about better access to care, and we must be concerned with quality. What we should avoid is the fear that sometimes comes with change. I hope that we approach this with a pragmatism that I know to be common in West Texas. If we do that, then real innovations and advancements will follow.