authors
Francis Clough, Nikki Patel Francis Clough BDS MJDF RCS (Eng)
Prim Dent J. 2018;7(2):28-29
Digital transformation
in dentistry: An
organisational view
The digital revolution has brought benefits to many
areas of healthcare, but dentistry still has a way
to go, write Francis Clough and Nikki Patel
D
igital technology is transforming
the way we live our lives; from
the way we shop, bank and
even watch TV. However, in
dentistry, it is still common for patients to
book their appointments via telephone,
while dentists communicate with other
healthcare professionals via letter.
Digital solutions in dentistry can deliver
great benefits to patients – improving
their experience, the quality of care
received and enhancing safety. In
addition, the dental workforce must
be appropriately trained to adopt new
digital ways of working and make the
most of the functionality. IT skills and
capabilities may not be inherent in the
wider dental workforce so concerted
efforts should be taken to support staff
in the acquisition of digital skills and to
enhance their digital literacy.
Technology has become inextricably
woven into nearly every aspect of our
daily lives. Consumer relationships with
retail, travel and media industries have
changed fundamentally over the past 15
years. Digitisation is changing consumer
and employee expectations.1 and the
most successful companies have changed
their business practices to engage
digitally with customers.2
In the NHS and private sectors, there is
a strong demand to use digital health
services across all demographics. While
there exists a generational divide, some
78% of 65-74 year olds have access to
internet at home and over half of over-
54s own a smartphone.3 People now
expect to be able to access convenient
and personalised services at the touch of
28
Clinical Fellow and Associate Dentist, Imperial
College Healthcare NHS Trust
Nikki Patel BDS MFDS RCPS PGDip
Dentist and Clinical Programme Lead, Digital
Development, NHS England
a button. With expensive and long-term
conditions on the rise and people living
longer, information and technology can
help meet the increasing demand.4
Digital healthcare
ecosystem
In the wider field of healthcare, there
are thousands of ‘digital healthcare
start-ups’ who are harnessing the power
of technology to provide patients with a
quick, efficient and convenient healthcare
service. This could be in the form of apps
for a multitude of conditions, or the ability
to have a consultation with a healthcare
professional via video chat.
In dentistry, there do not seem to be
many digital initiatives. ‘Brush DJ,’ the
only dental app approved by the NHS to
be included in the NHS Apps Library, has
proved popular with children, while apps
such as Zesty allow patients to book their
dental appointments online.
What do we mean by
‘digital’ in dentistry?
Digital dentistry encompasses a vast
array of different applications for
technology in the delivery of oral health
care. As part of the clinical workflow
it can relate to digital X-rays, intraoral
scanners, CAD-CAM restorations and
3D printing. Digitisation of administrative
functions might involve practice
management systems, remote follow-up
for patients and online patient surveys.
At the organisational level, it may mean
applications including electronic referrals,
p r i m a r y d e n ta l j o u r n a l
online clinical triage and electronic
prescribing. In dentistry, practices invest
in digital capabilities of their own
accord, resulting in a broad spectrum
of digital maturity across primary care.
Empowering the clinician
At an organisational level, some regions
have benefited more than others from
the early adoption of digital strategies
by their local professional networks,
commissioners and academic institutions.
More than 40% of the country’s dental
practices use locally-commissioned
electronic referral management systems
to handle at least some of their dental
referrals, which have proven effective
and well accepted.5 Increasingly, digital
events do not focus simply on clinical
technologies but also the digital aspects
of care models and digital programmes
on the horizon in the NHS; the ‘Digitally
Enabling Dentistry’ conference, now
in its second year, has proven to be a
rich environment to start conversations
between software companies and NHS
organisations.
Other examples of positive digital
movements being observed included
‘Dentistry24’ on 24 May 2018. Dentists
used Twitter to promote the good work of
the profession using a common hashtag
– #dentistry24 – which resulted in nearly
2.5 million Twitter impressions generated
and nearly 1,400 tweets in a 24-hour
period. Additionally, robust, quality-
assured digital networks such as Dentinal
Tubules are becoming well established
as places for dentists to interact and
learn online. Organisations like the
‘International Team for Implantology’ run
an online academy in parallel to study
clubs and events to support dentists in
the safe provision of implants.
are already empowering many people
to take control of their health; 14 million
people in the UK are now registered
for online services in their GP practice,
where they can book appointments
online, view their health records and
check results of tests. Additionally,
NHS 111 Online allows patients
access to online triage tools to check
their symptoms. It is anticipated that
dentistry will follow these trends towards
heightened patient empowerment.
Digital literacy
There are 11 million people in the UK
who lack the basic digital skills to be
able to access and use digital health
technology, and often they are the people
that need it most. Those that are ‘offline’ and contractual constraints faced. In
often are the ones that have multiple order to achieve a seamless digital
health problems, have the most complex journey for patients, engagement with
health and care needs and are the most patients and the profession is essential,
frequent users of NHS services.7 To help as is strong leadership nationally and
alleviate this, in 2013, the ‘Widening locally to champion positive change,
Digital Participation’ programme was and novel approaches to training for
established in the NHS to ensure that undergraduates and postgraduates
members of the public are not left behind and in the workplace.
in the digital health revolution.
Principals, associates and dental care
Digital literacy is a powerful enabler for professionals might work to enact
self-care, something that is particularly change on an individual basis: learning
important in the context of dentistry when new digital skills, using online training
dealing with preventable oral diseases. tools, investing in practice management
It offers opportunities for individuals to software, practice websites or social
access a wider range of support tools media expertise. The opportunity is
and health information to look after ripe to take these issues to Local Dental
themselves when appropriate. Committees, Education Committees,
Local Dental Networks and Managed
Challenges to digital Clinical Networks to highlight the need
adoption in dental practice for enhanced digital skills, the case for
There are significant challenges in investment in training and infrastructure
improving the digital literacy of the dental and to develop local networks to
team due to the nature of the dental share best practice in digital change
market and by virtue of the financial programmes.

Empowering the patient

Digital apps and products have
enormous potential to empower patients,
as well as clinicians, to take control
of their healthcare and improve the
services we can offer. One in 20 Google
searches in England now relates to
health, of which one in five are directed
to NHS Choices health content.
Investment in technology can increase
efficiency, improve outcomes for patients
and enhance the patient experience.6
Digital services and tools in the NHS
references
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Are Service expectations really
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4 NHS England. Next Steps on
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5 Goldthorpe J, Walsh T, Tickle
M, Birch S, Hill H, Sanders
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