In May, Texas Governor Greg Abbott signed into law HB 2056 related to dentistry and the provision of teledentistry services. The bill created a definition of teledentistry, authorized its use, and directed the Texas State Board of Dental Examiners (TSBDE) to create regulations to ensure that patients using teledentistry dental services receive appropriate, quality care.
Over the past year, the AAO worked with its local lobbyist and other stakeholders to enact legislation that would authorize teledentistry. During the COVID-19 shutdown, dentists were one of the only healthcare providers that could not utilize teledentistry to treat their existing patients in Texas. It is important that orthodontists have the authority to safely use telehealth to continue to monitor and check in with their existing patients, who have already had an appropriate physical exam, especially in the case of any future circumstances that lead to a shutdown of offices again.
At an April 2020 virtual meeting of the TSBDE, current past-president, Dr. Matthew Ng, shared a statement on behalf of the Texas Association of Orthodontists (TAO) that emphasized the need for teledentistry in Texas.
“Our patients in active treatment have all received an in-person consultation, as well as documentation of our findings with a written diagnosis and treatment plan,” Dr. Ng explained. He added that, “Many of our appliances are continually active and without regular supervision and observation, can lead to detrimental harm to our patients.”
After the April 2020 Board meeting, stakeholders began discussing teledentistry legislation, and four different bills were introduced to address the issue. The AAO and TAO were supportive of many elements of the lead bill, but it lacked any language to ensure that the standard of care is maintained when using teledentistry, including the need for an in-person exam prior to beginning treatment.
In March 2021, Drs. Chris Cramer, Matthew Ng, Basma Fallah, Michael Delgado, Doug Shaw and AAO Trustee, Dr. Stephen Robirds, met with their state representative, who was sponsoring the teledentistry bill, to explain the need for legislation that not only authorizes teledentistry but also includes provisions that provide opportunities to utilize technology in a positive way and expands access to care while maintaining the standard of care that protects the health and safety of Texas patients. Additionally, a companion bill proposed a specific provision to allow digital scans outside the dentist’s office and to exclude scans taken outside of a dentist’s office from needing to comply with existing Texas statute requiring the practitioner to provide to the patient’s regular dentist and to the patient a record or report containing the treatment provided and the practitioner ’s evaluation, analysis, or diagnosis of the patient ’s condition. The AAO and TAO worked to oppose this provision because it created different standards of care based on how a patient started orthodontic treatment and which licensed dentist or orthodontist the patient visited.
Thanks to the efforts of the AAO, TAO, and several other stakeholders, including the Texas Dental Association, the concerning provision was removed from the bill. The AAO and TAO are appreciative of the Texas legislature for hearing the concerns of the dental community and establishing teledentistry to be used in a safe and productive manner. The final legislation mandated that the TSBDE create regulations to, among other things, ensure that patients using teledentistry dental services receive appropriate, quality care. The AAO and TAO will continue to advocate for the AAO’s Teledentistry Parameters, including the requirement of an in-person exam prior to beginning orthodontic treatment, at an upcoming stakeholder meeting hosted by the TSBDE on August 11th. Texas members are encouraged to participate by submitting written comments or attending the meeting in-person or virtually. If you are a Texas member and did not receive information about the meeting, please contact Gianna Nawrocki at [email protected].
Please also note that every orthodontist (as a citizen of and licensed dental provider in his or her state) and every patient has the right, independently and individually, to express his or her opinion on any dental issue to his or her state dental board, the federal Food and Drug Administration (FDA), and elected state officials (e.g. Attorney General, Governor, state representative, etc.). If you feel so compelled, you can look up and contact the appropriate entity.
