Teledentistry as a Health Promotion Strategy: perspectives and challenges in dental practiceABSTRACT
Objective: This qualitative study explored the role of teledentistry as a strategy to promote oral health, identifying the perspectives and challenges perceived by dentists working in primary care and continuing care settings.
Methods: Semistructured interviews were conducted with 25 professionals from the region of Maringá (PR), whose reports were analyzed with the support of NVivo software through Bardin’s thematic content analysis.
Results: Four main categories emerged: (1) use of teledentistry to promote oral health; (2) access and digital inclusion in dentistry; (3) role of digital tools in communication and monitoring; and (4) impact of the pandemic on the adoption of teledentistry. These results indicate that teledentistry is recognized as an effective tool for educational and preventive actions and remote clinical follow-up. However, significant barriers related to digital literacy, technological limitations and ethical issues related to the privacy of patient data hinder its wide and continuous implementation. The COVID-19 pandemic was a catalyst for the rapid adoption of digital practices, but it also revealed the need for public strategies that ensure the sustainability of this modality of care.
Conclusion: Investments in technological infrastructure, professional training and actions aimed at digital inclusion are recommended to maximize the potential of teledentistry in promoting public health.
Indexing terms
Health Education; Health Promotion; Oral Health; Public Health; Teledentistry
RESUMO
Objetivo: Este estudo qualitativo explorou o papel da teleodontologia como estratégia de promoção da saúde bucal, identificando perspectivas e desafios percebidos por cirurgiões-dentistas atuantes na atenção primária e na atenção continuada.
Métodos: Foram conduzidas entrevistas semiestruturadas com 25 profissionais da região de Maringá (PR); os relatos foram analisados com suporte do software NVivo por meio da análise de conteúdo temática de Bardin.
Resultados: Emergiram quatro categorias principais: (1) uso da teleodontologia para promover a saúde bucal; (2) acesso e inclusão digital na odontologia; (3) papel das ferramentas digitais na comunicação e no monitoramento; e (4) impacto da pandemia na adoção da teleodontologia. Os resultados indicam que a teleodontologia é reconhecida como ferramenta eficaz para ações educativas e preventivas e para o acompanhamento clínico remoto. Entretanto, barreiras significativas relacionadas ao letramento digital, a limitações tecnológicas e a questões éticas vinculadas à privacidade dos dados dos pacientes dificultam sua implementação ampla e contínua. A pandemia de COVID-19 atuou como catalisador para a rápida adoção de práticas digitais, mas também evidenciou a necessidade de estratégias públicas que assegurem a sustentabilidade dessa modalidade de cuidado.
Conclusão: Recomenda-se investir em infraestrutura tecnológica, capacitação profissional e ações de inclusão digital para maximizar o potencial da teleodontologia na promoção da saúde pública.
Termos de indexação
Educação em saúde; Promoção da saúde; Saúde bucal; Saúde Pública; Teleodontologia
INTRODUCTION
Teledentistry has emerged as a transformative tool in the field of oral health, providing new forms of care and expanding access to dental services [1,2]. This technology, which is integrated into telehealth, uses digital resources to provide remote assistance, education, and monitoring [1,3]. During and after the Coronavirus Disease 2019 (COVID-19) pandemic, teledentistry demonstrated its potential by enabling remote consultations, preventive guidance, and continuous patient follow-up despite restrictions on face-to-face contact [4-8].
In the context of health promotion, teledentistry is aligned with the principles established by the Ottawa Charter, which defines health promotion as the process of enabling individuals and communities to improve their quality of life and gain greater control over the determinants of health [9]. Through remote consultations, digital awareness campaigns, and interactive platforms, teledentistry contributes to oral health education, prevention of oral diseases, and continuous patient monitoring [3,10]. Its potential is especially relevant for populations with limited access to traditional services, such as rural communities [11-13], institutionalized older adults [14-17], and patients with reduced mobility, by supporting more comprehensive and preventive oral health care.
The relevance of teledentistry in the Brazilian context is evident in light of the guidelines of the Política Nacional de Promoção da Saúde (PNPS) and the Política Nacional de Saúde Bucal (Brasil Sorridente, in Portuguese). By prioritizing intersectoral and equity-oriented actions, the PNPS recognizes the role of digital technologies as tools that can facilitate access to health services and reduce inequalities [18]. In this scenario, teledentistry has emerged as an important complement to traditional practices by enabling remote screening, guidance, and follow-up, optimizing care flows, and reducing pent-up demand in face-to-face services [19-21].
Despite these advances, there is still a relevant gap in the literature regarding teledentistry as a strategy for health promotion beyond its emergency use during the pandemic. Existing studies have mainly emphasized its technical and operational advantages, such as cost reduction, efficiency, and expanded access, whereas fewer studies have explored its use in continuous oral health promotion actions [1,2,4,8,10-13,17,22]. Thus, the following research question emerges: How has teledentistry been perceived and used as a strategy to promote oral health, especially in primary care and continuing care contexts? Given this scenario, the present study aims to analyze the role of teledentistry as a strategy to promote oral health.
METHODS
Design
This is a qualitative, exploratory and descriptive study guided by Bardin’s content analysis [23]. This study followed the recommendations of the Consolidated Criteria for Reporting Qualitative Research (COREQ) [24].
Participants and Sampling
Sampling was nonprobabilistic for convenience and snowballs [25]. A total of 25 dentists working in Maringá, Paraná, Brazil, and its metropolitan region were interviewed. The participants were selected through chain referrals, according to the snowball technique, starting with the researcher’s professional contacts. The inclusion criteria were (a) have more than 10 years of clinical dental experience, and (b) have worked before, during and after the COVID-19 pandemic.
Data collection
Semistructured interviews were conducted on the basis of a script built with a focus on perceptions, practices and experiences with teledentistry. Three pilot interviews were initially carried out to test the clarity, relevance, and sequencing of the questions in the semi-structured interview guide. After this preliminary stage, no substantial modifications were needed in the content, structure, or order of the questions. For this reason, these pilot interviews were incorporated into the final analytical corpus, since they were conducted under the same methodological conditions as the subsequent interviews, involved participants who met the established inclusion criteria, and generated data relevant to the research objectives. The interviews took place remotely via Google Meet, with an average duration of 40 minutes each, and were recorded with prior consent. The interview guide included questions such as (a) “How do you perceive the role of teledentistry in promoting oral health?”; (b) “What barriers do you face in implementing teledentistry in your practice?”; and (c) “In your opinion, how can teledentistry contribute to expanding access to oral health?”.
The study was conducted by a dentist, with training in qualitative research and health promotion. The researcher conducted all the interviews, establishing a relationship of trust with the participants through an initial presentation of the study, its objectives and the importance of the interviewees’ contributions. There was no previous relationship between the researcher and the interviewees, except in cases indicated by the snowball sampling method. Data collection was terminated when theoretical saturation was reached. Data saturation was discussed with the research team throughout the data collection and transcription process [26].
Data analysis
The analysis followed the steps of the thematic content analysis proposed by Bardin [23], which was supported by NVivo 15 software for encoding and categorization [27,28]. The process occurred in three phases (1) preanalysis: organization of the corpus on the basis of a cursory reading of the transcripts, identification of the main ideas and development of a coding plan; (2) exploration of the material: coding of the interviews on the basis of thematic units, building categories and subcategories. The word cloud and the word association cluster generated by NVivo helped in the identification of semantic recurrences; and (3) treatment of results and interpretation: The emerging categories were critically analyzed, seeking relationships with the research objectives and the theoretical framework.
Ethical Aspects
The study was approved by the Ethics in Research Committee at Universidade Cesumar (Unicesumar), opinion no. 7.025.738, according to Resolution 466/12 of the National Health Council.
RESULTS AND DISCUSSION
A total of 25 dental surgeons participated in the study. Participants were aged between 30 and 69 years, with a mean age of 48,2 years, and had professional experience ranging from 10 to 45 years, with a mean of 23.1 years. Regarding sex, 68% (n=17) were female and 32% (n=8) were male. In relation to professional practice, all participants worked in private practice at the time of the interview, but some of them have worked before in the public sector as well. This profile allowed the inclusion of professionals with different backgrounds and experiences related to the use and perception of teledentistry in oral health care (table 1).
The content analysis of the interviews revealed four main thematic categories related to the use of teledentistry in health promotion: (1) use of teledentistry in the promotion of oral health; (2) digital access and inclusion in dentistry; (3) the role of digital tools in communication and monitoring; and (4) the impact of the pandemic on the adoption of teledentistry. These categories reflect both the potential and the challenges of integrating digital technologies into dental care. The coding tree, subcategories, and illustrative quotations are presented in chart 1.
Use of Teledentistry in the Promotion of Oral Health
The participants recognized teledentistry as a relevant strategy for oral health promotion, particularly for preventive actions, health education, and follow-up support [2,21,29]. They reinforced that specific virtual actions, especially in health education, allowed for an expansion of educational campaigns, strengthening self-care and prevention of oral diseases [10,30]. According to the interviewees, teledentistry can also facilitate the engagement and active participation of patients in preventive and educational actions, although they point out limitations for this participation in the long term.
Professionals perceived that patients, although they value the convenience of digital technologies, still have significant resistance to the complete replacement of face-to-face consultations with virtual sessions. In this context, the interviewees emphasized the importance of viewing teledentistry as a complement to traditional care and not as a direct replacement for face-to-face clinical practices [31-33].
Another relevant aspect highlighted by the participants was the lack of knowledge and insecurity about teledentistry on the part of the professionals themselves [6,34-36]. Many dentists interviewed did not have prior experience or specific training on how to effectively apply digital tools in daily clinical life before the COVID-19 pandemic. The lack of adequate technical knowledge was identified as a significant barrier, indicating the need for qualifications and continuous training to expand the adoption of this practice in clinical practice.
Finally, the analysis revealed that, despite the limitations and challenges, there is a trend of consensus on the potential of teledentistry to expand the coverage of dental care, especially with respect to health education and oral health promotion [2]. The respondents expressed an interest in using teledentistry in the future, recognizing that the integration of this practice can improve access to dental services, reduce health inequalities and enhance the results of preventive treatments, especially in populations in situations of socioeconomic and geographical vulnerability.
From a health promotion perspective, these findings suggest that teledentistry may strengthen autonomy and empowerment by expanding access to information, encouraging self-care, and supporting greater patient participation in preventive practices.
Digital Access and Inclusion in Dentistry
The category related to digital access highlighted both the opportunities and the limits of teledentistry, especially with regard to digital inclusion [20,37-39]. Participants reported that younger generations and patients with greater familiarity with digital technologies tended to show greater ease and faster acceptance of virtual consultations. In contrast, older adults and socially vulnerable groups, particularly those with low income, were perceived as facing greater barriers to accessing these services [40-42].
The interviews showed that the benefits of teledentistry are unevenly distributed. According to the respondents, difficulties related to digital literacy, internet connectivity, and access to appropriate technological devices directly interfere with the feasibility of remote care [38,39,41-44]. In this sense, the findings suggest that access to the internet alone is insufficient, since the effective use of teledentistry also depends on the availability of affordable devices and on the users’ ability to handle digital tools properly [43,44].
Another relevant aspect identified by the participants was the need for public investment aimed at strengthening digital inclusion, especially in rural areas and economically vulnerable communities [43,45-47]. The professionals emphasized that the expansion of teledentistry requires not only technological infrastructure, but also educational and institutional support strategies capable of increasing patients’ familiarity with digital resources and improving adherence to this modality of care.
Finally, the interviewees indicated that these barriers compromise continuity of care, particularly in long-term follow-up processes [40-42]. Although teledentistry was recognized as a promising strategy for expanding access and facilitating communication, many participants still emphasized that its incorporation should occur as a complementary modality rather than a substitute for face-to-face care. Taken together, these findings indicate that the implementation of teledentistry must be accompanied by equity-oriented actions; otherwise, digital strategies may reproduce preexisting inequalities in access to oral health care.
Role of Digital Tools in Communication and Monitoring
Respondents often reported that they use messaging applications as channels of direct communication with their patients. For them, WhatsApp has become an almost indispensable resource, especially because of the ease and speed of exchanging information, sending reminders about treatments, scheduling and rescheduling appointments, and the dissemination of educational content related to oral health [7,44,48-50]. This aspect was mentioned by the professionals, indicating that such tools contribute directly to increasing treatment adherence and reducing patient evasion.
In addition to media and social networks, interviewees stressed the importance of videoconferencing, particularly during the COVID-19 pandemic, when face-to-face meetings had to be reduced [5-7,21]. Many professionals have started to use platforms such as Google Meet and Zoom to conduct initial consultations, follow up on treatments and answer questions that previously required face-to-face meetings. This change generated significant benefits, such as greater convenience for the patient and greater efficiency for the professional, reducing unnecessary travel.
However, despite these advantages, important issues related to the security and privacy of digitally transmitted information have been highlighted [43,51]. The respondents expressed concern about the absence of clear guidelines for sharing clinical information through unconventional digital means, such as instant messaging applications. Many reported uncertainties regarding legal certainty in cases of sharing images and sensitive patient information.
Owing to these challenges, some participants suggested the urgent need for specific regulation and adequate training to ensure the safe and ethical use of digital tools in dentistry [43,51,52]. There was a consensus among the professionals interviewed that regulation can help mitigate the risks associated with patient privacy and increase confidence in the adoption of these technologies. Although these tools were valued for improving communication and monitoring [29,40], participants emphasized that their safe and sustainable use depends on clearer regulation, privacy safeguards, and professional training.
Impact of the pandemic on the adoption of teledentistry
The COVID-19 pandemic was unanimously identified as a decisive factor for the rapid implementation of teledentistry [4–7,20]. The professionals interviewed reported that, during the period of social distancing, remote consultations became an essential alternative to care for patients with dental emergencies, offer preventive guidance and perform triage [7,15,53]. Many participants who had not adopted digital practices before the pandemic reported that the health crisis forced them to seek training and adapt their routines to the virtual environment [35,53].
In addition to the immediate impact, the interviewees described a cultural change, with greater acceptance of teledentistry by both professionals and patients [54]. The experience during the pandemic showed that teledentistry not only reduces geographical barriers but also optimizes the time of professionals and patients. However, with the resumption of face-to-face consultations, many professionals observed a marked reduction in the demand for remote consultations, suggesting that teledentistry is still more often perceived as an emergency tool than as a continuous complementary practice.
The respondents highlighted that the definitive incorporation of teledentistry into the health system requires public policies that encourage its continued use, even in post-pandemic periods [29,41]. Initiatives such as the inclusion of remote consultations in dental health plans, training for professionals and awareness campaigns on the benefits of teledentistry were suggested [7,55,56]. According to the interviewees, the pandemic not only revealed the potential of teledentistry but also highlighted the importance of definitively integrating it into the health system, especially for health promotion and prevention of damage to oral health.
Many professionals reported that before the pandemic, they had no experience with digital service platforms and did not consider the digital environment as a real possibility for dental practice [35,53]. According to some interviewees, the incorporation of these tools provided efficiency gains, reduced travel-related costs and facilitated the maintenance of preventive guidelines for patients.
Another relevant aspect noted by professionals was the positive perception regarding the optimization of the time that teledentistry provided during the pandemic [10,37,57]. Patients who previously had to travel long distances, especially those residing in rural or isolated areas, were able to access dental care without leaving home. The respondents emphasized that teleconsultation allowed greater flexibility and agility in care, especially in situations where face-to-face care was unfeasible or unnecessary, such as for clarification of doubts or initial triage.
However, after the gradual return of face-to-face activities and the relaxation of restrictions, there was a notable reduction in the demand for remote consultations [8,58]. The pandemic experience also opened space for discussing and expanding the role of teledentistry. beyond emergency situations, highlighting its potential in promoting oral health and disease prevention, as well as in health education [2,32]. The respondents reported that remote consultations allowed for more efficient triage and proper referral of patients to specific face-to-face appointments. This optimized organization of dental care can reduce queues, save resources, and improve the quality of care, especially in regions where access to face-to-face dental services is limited.
CONCLUSION
Overall, the findings of this study indicate that teledentistry has relevant potential as a strategy for oral health promotion, particularly by expanding access to information, strengthening preventive actions, and supporting continuity of care beyond the traditional clinical setting. Based on the perceptions of the interviewed dentists, teledentistry may also contribute to greater patient participation, autonomy, and empowerment, especially when used to facilitate communication, follow-up, and educational practices that reinforce self-care and adherence to treatment. At the same time, the results show that these benefits are not distributed equally, since barriers related to digital literacy, internet access, technological infrastructure, and professional preparedness may limit the reach and effectiveness of this modality, especially in socially and geographically vulnerable contexts. In this sense, the incorporation of teledentistry into oral health care should be guided not only by technological feasibility, but also by equity-oriented policies, professional training, regulatory support, and strategies aimed at digital inclusion.
This study has some limitations that should be considered when interpreting the findings. First, the geographic scope was concentrated in Maringá and its metropolitan region, which may limit the transferability of the results to other Brazilian contexts with different social, technological, and organizational conditions. Second, the participants had a specific professional profile, since all were dental surgeons with extensive clinical experience and were working in private practice at the time of the interviews, although some had previous experience in the public sector. In addition, the use of nonprobabilistic convenience and snowball sampling may have favored the inclusion of professionals with closer professional networks and similar experiences. Another aspect to be considered is that all interviews were conducted remotely, which may have influenced interactional dynamics and the depth of some reports. Even so, the findings offer relevant contributions to public health planning and to the organization of oral health services, particularly in primary health care.
In the context of Primary Health Care and the Sistema Único de Saúde (SUS, Brazilian Unified Health System), the findings suggest that the sustainable incorporation of teledentistry depends on the development of clear protocols for its use, permanent professional training, appropriate regulatory frameworks, and robust measures for data protection and patient privacy. In addition, strategies aimed at digital inclusion are essential to ensure that the potential benefits of teledentistry are not restricted to socially advantaged groups. When integrated into care networks in an organized and equitable way, teledentistry may strengthen oral health promotion, improve continuity of care, and support more accessible and preventive dental services.
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Article aligned with the Good Health and well-being goal of the Sustainable Development Goals (SDGs).
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Artigo elaborado a partir da dissertação de Mestrado de GC PUPIO, intitulada “Percepções e Práticas de Cirurgiões-Dentistas em Relação ao uso da Teleodontologia na Promoção da Saúde e no Cuidado Odontológico”. Universidade Cesumar; 2025.
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How to cite this article
Pupio GC, Aranha ERM, Ivantes Rodrigues S, de Oliveira LP, Garcia LF. Teledentistry as a Health Promotion Strategy: perspectives and challenges in dental practice. RGO, Rev Gaúch Odontol. 2026;74:e20260032. http://dx.doi.org/10.1590/1981-86372026003220250101
Data Availability
The research data are available from the corresponding author upon reasonable request.
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Assistant editor
Luciana Butini Oliveira
