Teledentistry

No person shall engage in the practice of dentistry, either in person or remotely using information transmitted electronically or through other means, on a patient within the state of Tennessee unless duly licensed by the Board in accordance with the provisions of the current statutes and rules. Teledentistry shall not alter or amend the supervision requirements or procedures that are authorized for licensed dental hygienists or registered dental assistants as stated by T.C.A § 63-5-115, 0460-03-.09 and 0460-04-.08. (1) Treatment and the Practice of Teledentistry (a) A teledentistry encounter entails the rendering of a documented dental opinion concerning evaluation, diagnosis, and/or treatment of a patient whether the dentist is physically present in the same room or in a remote location within the state or across state lines. (b) Teledentistry as practiced under T.C.A § 63-5-108(b)(16) is not an audio-only telephone conversation, email/instant messaging conversation or fax. At a minimum it shall include the application of secure video conferencing or store-and-forward technology to provide or support dental care delivery by replicating the interaction of a traditional encounter between a provider and a patient. (c) If the information transmitted through electronic or other means as part of a patient’s encounter is not of sufficient quality or does not contain adequate information for the dentist to form an opinion, the dentist must declare they cannot form an opinion to make an adequate diagnosis and must request direct referral for inspection and actual physical examination, request additional data or recommend the patient be evaluated by the patient’s primary dentist or other local oral health care provider. GENERAL RULES CHAPTER 0460-01 (d) No patient seeking care via teledentistry who is under the age of eighteen (18) years of age can be treated unless there is a parent or guardian present, except as otherwise authorized by law. (2) Dental Records and Informed Consent when Practicing Teledentistry (a) For patient encounters conducted by teledentistry, the dentist shall have appropriate patient records or be able to obtain the patient’s prior treatment information during the teledentistry encounter. (b) Secure electronic records of the patient are to be kept at all locations where the patient is seen physically and at the location where the dentist is if the dentist is not present at the time of the visit. Dental records established for the purposes of teledentistry must contain the same information as required by Rule 0460-02-.12. (c) Store-and-forward technology as used in (1)(b) above is the use of asynchronous electronic communications between a patient and dentist at a distant site for the purpose of diagnostic and therapeutic assistance in the care of patients, including the transferring of dental data from one site to another through the use of a device that records or stores images that are sent or forwarded via electronic communication to another site for consultation. (d) The dentist engaging in teledentistry is responsible for ensuring that the dental record contains all pertinent data and information gleaned from the encounter. Any dentist conducting a patient encounter via teledentistry must so document by an informed consent form which shall be added in the patient record and must state the technology used. (e) Informed consent forms shall be signed by the patient or parent/guardian describing the information to be transmitted and/or shared with a dentist who is at a different geographical location. (f) A dentist who provides information regarding healthcare services on an internet website that is directly controlled or administered by the dentist or the dentist’s agent, shall prominently display on the internet website the dentist full name and type of license. (3) Supervision (a) Patient encounter with hygienist - Any licensed dental hygienist who assists the dentist in providing dental health services or care using teledentistry is only authorized to perform those services that the dental hygienist is authorized to perform during an in- person patient encounter under general supervision as defined by T.C.A § 63-5-108 (c)(5).