The Middlesex College Teledentistry Program: One Year Later

In the past year, Middlesex College has made great strides with the incorporation of teledentistry into our dental hygiene curriculum. We have proudly graduated one class of teledentistry-trained hygienists in 2023 and will graduate our second class this year. They are the first to benefit from the implementation of teledentistry in our hygiene curriculum program. The classes consist of approximately 53 students well versed in virtual care made possible by the use of teledentistry.

We are proud to be pioneers in including teledentistry into our hygiene curriculum and are advocates for seeing more hygiene and dental schools take our lead—especially those in New Jersey.

For example, the New Jersey State Board of Dentistry authorizes health care providers to engage in telemedicine and telehealth. This includes licensed dental hygienists.

Adding More Hygienists to Teledentistry
All New Jersey dental hygiene programs have a responsibility for implementing teledentistry. The challenge is to do so in a way that is seamless and does not require additional hours.

However, with our successful model as an established guide, I do foresee many more hygiene schools implementing teledentistry into their curricula. I also foresee the Commission on Dental Accreditation placing emphasis on this in the future.

As part of our advocacy for including teledentistry in the curricula of all New Jersey hygiene schools, in October 2025 Middlesex College will be presenting at the New Jersey Dental Hygienists’ Association meeting and discussing teledentistry during an educators’ workshop. I am confident that this will have a positive impact on the future of dental hygiene education in New Jersey and hopefully other states as well.

Taking Teledentistry From the Classroom and Into the Wild
Since we introduced teledentistry into our curriculum, we have been taking it from the classroom to the community. We began by conducting simple screenings, but today we are engaging in external community outreach rotations by utilizing asynchronous (store and forward) teledentistry. This form of teledentistry involves recording a patient’s clinical information and transferring the data to another dental professional at a separate location.

One example of our community outreach efforts occurs at the onset of each fall and spring semester, when faculty members, students, and clinic dentists collaborate to perform screenings for more than 200 children in the Educational Services Commission of New Jersey (ESCNJ).

Following these screenings, a faculty member and 2 students are selected to rotate to ESCNJ locations (Piscataway, New Jersey, in the fall and Sayreville, New Jersey, in the spring) to administer preventive dental care.

During these rotations, MouthWatch intraoral photos and radiographs using a NOMAD handheld x-ray system are taken and shared asynchronously (stored and forwarded) via MouthWatch TeleDent software with our clinic dentists for review. Manufacturer MouthWatch is headquartered in the neighboring town of Metuchen, New Jersey. Subsequently, our clinic dentists formulate treatment referrals, which are then forwarded to ESCNJ and provided to the respective parents or guardians.

Since we have expanded community outreach rotations, we now have 8 MouthWatch intraoral cameras and maintain 60 MouthWatch TeleDent software licenses. This investment has been very effective in providing more children with oral health screenings and clinical care.

In a 1-year span, we have been able to increase the number of children screened from 66 to over 200 and the number of children who receive preventive dental care to 70. (We did not provide clinical care in the past academic year. This is the first year we tracked it.)

Hygienists Bridging the Medical-Dental Gap
Teledentistry’s impact on the nation’s oral and systemic health can play a vital role in expanding access to preventive oral health care to underserved communities. It also will help bridge the gap between dentistry and medicine.

Currently, our hygiene students have multiple interactions with members of other health professions via participating in the Students’ Perceptions of Interprofessional Clinical Education interprofessional collaboration session with Rutgers School of Dental Medicine. During these sessions, they work with students from Rutgers medical, dental, nursing, pharmacology, nutrition, and social work schools. Together, they review a case and discuss it with the assistance of a faculty facilitator.

One of the main things we have learned during the past year is that we always need to evaluate our process and look for room to improve it. We need input from all who participate to help us make these improvements.

The Middlesex College Hygiene program’s teledentistry program will always be a work in progress. The possibilities of teledentistry are endless and we are thankful for the support we receive from the college, faculty, external sites, and MouthWatch.