Dentistry, e-health and digitalisation: A critical narrative review of the dental literature on digital technologies with insights from health and technology studies.

OBJECTIVE: To overview current developments in e-health and digitalisation in dentistry and identify gaps in the dental literature on this topic; Basic research design: a critical narrative review of published articles and relevant online materials; Results: Four themes are identified as characterising the current dental literature on e-health and digitalisation: 1) the impact of digitalisation on dental surgeries, 2) digital technology and practice management, 3) digitalisation beyond the dental surgery and in dentist-patient communication, and 4) digital technology and education. However, gaps remain in our understanding of the impact of digital technology on dental practice, particularly in relation to its ethical considerations. Following the example of the wider medical literature, the review introduces the field of critical digital health studies and identifies areas for future investigation and exploration based on its four characteristics: devices and software, data materialisation, data practices and data mobilities; Conclusion and Clinical significance: Digital technology is changing clinical practice and patient care. Dentistry needs to expand its understanding of how dental apps, digital workflow models and digital health information are transforming and disrupting dental practice in order to anticipate how this digital shift will impact on dentistry. The emerging field of critical digital health studies can signpost ways to improve research and practice on the topic in the future.

Is Dichotomization into Regular versus Irregular Dental Attenders Valid? A Qualitative Analysis.

AIMS: To discover whether dental visiting behavior can be understood as a dichotomy of planned versus problem based, or whether there were a range of different types of understanding and patient behavior, recognizable as patterns of dental visiting behavior. METHODS: Secondary analysis drawing on 2 qualitative studies of patients' accounts of dental attendance and oral health, with 1) opportunistic interviews with people attending urgent dental care services (n = 43; including 19 with follow-up) and 2) home-based, in-depth interviews with people attending a dental practice with a mixture of improved or deteriorated/poor periodontal health (n = 25). RESULTS: Four distinguishable patterns of dental visiting were identified in patients' accounts: Accepting and Active Monitoring, as well as Ambivalent and Active Problem-based dental visiting behavior. Individuals' patterns were relatively stable over time but could shift at turning points. Accepting Monitors were characterized as accepting dentists' recommendations and dental practice policies relating to oral health and visits, whereas Active Monitors were more independent in judging how often to attend for preventive appointments, while still valuing anticipatory care. Ambivalent Problem-based visitors placed a relatively low value on anticipatory care for oral health maintenance and drifted into lapsed attendance, in part because of service-related factors. This contrasted with Active Problem-based visitors, for whom using services only in an emergency was a conscious decision, with low value placed on anticipatory care. CONCLUSION: This article demonstrates the dynamic nature of patterns of dental visiting where the dental system itself is partly instrumental in shaping patterns of utilization in an ecological way. Thus, service-related factors tend to combine with patients' behavior in expanding inequalities. This illuminates the reasons why risk-based recalls are challenging to implement as a dental policy. KNOWLEDGE TRANSFER STATEMENT: The results of this analysis can be used by clinicians and policymakers to inform policy around supporting uptake of preventive health care visits, contributing in particular to understanding how risk-based preventive visiting policies may be better adapted to patients' understanding of the purpose of visits, taking into account that this is in part shaped by service-related factors in an ecological way, arising from patients' and dental teams' expectations.

Dental practitioners and a digital future: an initial exploration of barriers and incentives to adopting digital technologies.

BACKGROUND: Digital technologies are proliferating into dental practices. While their technical attributes have often been studied, it remains unclear why some dentists adopt and use these technologies more than others. AIM To explore the incentives for and barriers against accepting and using digital dental technologies. METHOD: Eleven semi-structured qualitative interviews were conducted with experts in dentistry, dental technology and dental education in the Netherlands. RESULTS: Dentists' acceptance and use of digital technologies are to varying degrees driven by the perceived advantages over analogue methods, perceived influence on treatment quality, dentists' personal and professional orientation, and social influence from peers and external groups. These effects are complemented by personal and dental-practice characteristics. CONCLUSIONS: The findings suggest that there are large differences in motivation to adopt and use digital technologies between early adopters, late adopters and non-adopters, which should be examined in greater detail. We recommend that educators, dentists, and representatives of the dental industry who deal with the diffusion of these technologies take account of dentists' widely different attitudes to digitalisation.