Fall 2018

The Doctor Will See You Now…In the Conference Room

Teledentistry opens new possibilities for patients and practitioners.

By Helene Ragovin

Previous Next

Illustration: Roberto Cigna

Things you are likely to find at any tech start-up: free beverages, someone’s golden retriever, a beanbag chair. Not on this list: a dental chair.

Yet, on a Tuesday morning in a high-rise office in Boston’s Financial District, that’s exactly what’s occupying space under the white board in a conference room at LevelUp, a company that makes software products to engage restaurant customers. The space has become a pop-up exam room for the day, as employees file in for cleanings and X-rays. Write some code; take a bite-wing.

Behind the dental chair is a hygienist from Virtudent, a mobile dental practice that brings preventive dental care right to the workplace. By providing on-site services, booked online and covered by insurance, Virtudent seeks to eliminate one of the painful parts of a regular checkup for patients—the difficulty of squeezing a dental appointment into the workday. (And that’s good for employers, too. According to a Virtudent case study, the company treated 118 patients at Wayfair, the Boston e-commerce giant, and saved 354 work hours.)

Virtudent CEO and founder
Hitesh Tolani, DG13. Photo: Anna Miller

Millennials, particularly, want “convenience, technology, and on-demand service,” said Hitesh Tolani, DG13, founder of Virtudent, which is based in Newton, Massachusetts. “So how do we cater to them?” Virtudent’s answer is bringing a portable dental set-up to work sites, and uploading the diagnostic data to the cloud, where it can be retrieved by dentists for review and treatment planning. “Instead of a rigid brick-and-mortar practice, why not take the quality care to them?” Tolani asks.

Virtudent also personifies the possibilities inherent in what has become known as teledentistry. There are several models: dentists and patients communicating in real-time via live video; dentists monitoring patients through devices such as smartphones or tablets; or, as in the case of Virtudent, dentists expanding their practices through asynchronous interaction, known as the store-and-forward method.

In 2018, the American Dental Association adopted its first set of guidelines for teledentistry. The practice initially gained traction as a way to reach patients in remote locations, or those who can’t easily travel, such as the elderly or people with disabilities. Virtudent is one of the first attempts to use teledentistry to reach a segment of the population who have been neglecting dental visits the most in recent years—adults ages nineteen to sixty-four. According to the ADA’s Health Policy Institute, “among working-age adults, dental care use has been declining since 2003 for all income groups”—including those with higher incomes, and with private dental insurance, suggesting cost is not the primary obstacle. Virtudent calculated that the average time since a Wayfair employee had last seen the dentist was 3.8 years.

“Virtudent offers another access point that is more conducive to one’s workplace,” said Mark Nehring, the Delta Dental professor and chair of public health and community service at the School of Dental Medicine. “The teledentistry approach through Virtudent can reestablish a connection to oral health. Depending on the range of oral health treatment available following an initial encounter, a dental home can be reestablished as part of referral and follow-up.”

Virtudent’s model also addresses what the Health Policy Institute has termed the profession’s “busyness problem.” The percentage of dentists who report they are not busy enough and could see more patients has been rising for the past decade. Virtudent connects patients who need in-office follow-up care after their workplace visit with dentists who have openings.

Tolani sees it as a “spoke and hub” model, similar to the way hospitals have established community-based primary care outposts that can refer patients who need further treatment to major medical centers. “We’re getting people back into dentist chairs,” Tolani said. “And, for me, it’s a way of paying it forward.”

While at Tufts, Tolani served as chief resident and focused on special-needs patients. When he first hit on the idea for Virtudent, his goal was to provide access to care for underserved populations, motivated by his experience growing up in an immigrant family, and the example of the scholarship sponsor who made it possible for him to attend Wofford College in South Carolina. But economic realities made that difficult, and, after placing in several business competitions—including the Tufts $100K New Ventures Competition and the Harvard President’s Challenge—Tolani transitioned to a more sustainable model: “No money, no mission,” as a Harvard professor told him. The for-profit part of Virtudent now subsidizes its philanthropic efforts. Through a partnership with Northeast Delta Dental, Tolani said, his practice oversees care for 4,200 children in New Hampshire, including those with special needs.

Top Stories

The New Face of Dentistry

The School of Dental Medicine is leading the way into a bold, new future for implantology.

Heal the World

A group of committed dentists from the Alpha Omega professional fraternity is helping Holocaust survivors smile again.

Building a Better Binky

How a pediatric dentist and an engineer with the Tufts Gordon Institute are reinventing the pacifier.

The Acid Test

Can a tooth-mounted pH sensor curb an epidemic of tooth decay?

Sleep Apnea Signals

Researchers from the dental and medical schools work together to improve diagnosis and monitoring.

Editor's Picks

The Danger of Fluoride Doubt

A flood of misinformation is undermining a successful public health effort.

Compassion on Two Continents

In Africa, Sister Kay Lawlor, D68, fixed teeth, ran hospitals, and confronted health-care crises. In Massachusetts, she’s giving women who need help a new start.

O Pioneer!

After graduating from Tufts in 1966, Athena Papas passed on the dental school because she didn’t want to be the only woman in her class. She finally joined the school eight years later as an assistant professor, and in the four decades since has secured dozens of grants for groundbreaking research, helped launch countless life-changing medications and mentored generations of colleagues. Today, half of all dental students are women… and Papas seems to be just getting started.