Advancing Technology-Driven Care

The Department of Dental Hygiene at Idaho State University (ISU) has a rich history rooted in academic excellence and healthcare innovation. Celebrating its 60th anniversary, ISU is the only institution in Idaho offering a Bachelor of Science degree in dental hygiene.

The program has always prioritized integrating technology to provide patient-centered care and to train the next generation of healthcare providers, including incorporating tools like MouthWatch Intraoral Cameras and the TeleDent teledentistry platform. This technology integration has been instrumental in fostering collaboration between dental hygienists and nurses, thus bridging the gap between medicine and dentistry.

Focusing on Interdisciplinary Healthcare Partnerships

Since its first graduating class in 1963, ISU’s Department of Dental Hygiene mission is not only to develop and prepare professional leaders in oral healthcare but also to promote equitable access to healthcare through interprofessional partnerships. This vision aligns with ISU’s broader objective of improving individual and community health outcomes.

A crucial aspect of this mission is to cross-train healthcare professionals in the latest technologies. Updating the ISU dental hygiene curriculum with the introduction of MouthWatch intraoral cameras in 2021 and the more recent integration of the company’s TeleDent software for teledentistry in 2023 reflect the university’s commitment to staying ahead of the curve in healthcare education. By doing so, ISU aims to empower students to increase healthcare accessibility, particularly in underserved and rural areas.

The Introduction of Intraoral Cameras

The dental hygiene clinic integrated intraoral cameras for students at both junior and senior levels, enabling them to capture and share high-quality intraoral images. This allowed students to better educate their patients and communicate more effectively with other healthcare providers, particularly when making dental-medical referrals and vice versa.

One of the most significant benefits of the intraoral cameras has been their application in ISU’s restorative function program for hygienists. Students in this program are trained to place and finish restorations, both composite and amalgam, which both fall within the scope of hygiene practice in many neighboring states.

The intraoral cameras are used to document the restorative process by taking pre-operative images, capturing details during the preparation phase, and documenting the final restoration. This detailed visual record is not only useful for patient education but also provides students with an invaluable self-assessment tool.

Additionally, the intraoral cameras have been widely used for oral pathology education and patient counseling. Their introduction has proven to be an effective educational tool, giving students real-time visual feedback while providing patients with a clearer understanding of their oral health.

Expanding Access with Teledentistry

The summer of 2023 marked another significant milestone for ISU with the incorporation of teledentistry. Funded by a grant aimed at expanding oral healthcare access in Idaho’s dental health professional shortage areas, this technology was introduced to enable hygienists and other healthcare providers, such as nursing school faculty and students, to perform oral health screenings.

Teledentistry is especially impactful in rural and underserved areas of Idaho, where access to dental care is limited. The state’s health professional shortage area score can be found in Table 1.

Teledentistry is helping ISU improve Idaho’s HPSA score by extending its reach, conducting oral health screenings at community centers, senior homes, and food pantries.

These oral health services are provided to populations that often face barriers to care, such patients who may have difficulty finding a provider that accepts Medicaid.

By utilizing both the intraoral cameras and teledentistry, ISU has built a collaborative network where dental hygienists and nurses can work together to meet patients where they are, while simultaneously training students in interprofessional teamwork. This required implementing a formalized cross-training program.

Cross-Training Nurses and Hygienists

The decision to cross-train nursing students to use intraoral cameras and teledentistry platforms was largely inspired by similar initiatives in other states, such as Montana.

There, nursing students had successfully integrated oral health screenings into their community outreach work. Motivated by this model, ISU’s dental hygiene faculty applied for and received a grant to fund the cross-training of its nursing students.

The implementation of this program began with educating ISU’s dental hygiene faculty, who would in turn train the university’s nursing students. This cascading model ensured that the dental hygiene faculty could serve as resources for the nursing students, either accompanying them on patient visits or providing asynchronous (recorded) teledentistry support during their rotations.

Specifically, nursing students were trained to use intraoral cameras to capture images of both normal and abnormal oral exam findings. They were also trained in screening processes, prioritizing referrals, and applying treatments such as silver diamine fluoride (SDF) and fluoride varnish.

By the end of the training, nursing students were proficient in identifying common oral health issues and making appropriate and timely referrals to dental providers.

Despite the limited time for hands-on training and the complexity of coordinating schedules between dental and nursing faculties, the implementation process went smoothly.

The main hurdle was that the initial cohort of nursing students had just one day of hands-on training, and only two dental hygiene instructors were available to assist. However, the enthusiasm of the students and faculty alike helped overcome these obstacles, and the overall process was deemed successful by both the hygiene and nursing departments.

Bridging the Gap Between Dentistry and Medicine

One of the most exciting aspects of this program is its potential to bridge the long-standing gap between dentistry and medicine. Historically, these fields have been siloed, with little collaboration between medical and dental professionals. However, ISU’s cross-training program demonstrates how effective interprofessional collaboration can be in improving patient care.

Many nursing students initially expressed apprehension about working in the oral health field, as dental screenings were not part of their core medical training. However, after the training, most students adapted quickly and found the experience to be both rewarding and valuable. They recognized the importance of oral health as part of overall health, and their ability to educate patients on this connection was a critical outcome of the program.

The success of this cross-training program also underscores the potential for similar collaborations in the future. By training nurses to identify oral health issues and perform basic screenings, ISU is preparing the next generation of healthcare providers to work across disciplines. This model can be replicated in other states or institutions, further eroding the boundaries between medical and dental care.

The Impact on Patient Care

The integration of intraoral cameras and teledentistry has had a profound effect on the patient care that ISU provides. By conducting screenings in places patients already frequent, such as food pantries and senior centers, ISU has improved access to oral healthcare for populations that may have otherwise gone without it.

These efforts are particularly critical in Idaho, where there is a shortage of Medicaid providers, making it difficult for low-income patients to access routine dental care.

What’s more, the use of intraoral cameras enables nursing students to capture detailed images of the patient’s mouth, enabling accurate assessment and prioritization of care. These images, combined with teledentistry, allow for seamless referrals and better communication between patients, nurses, and dental providers. Today, ISU patients are not only made aware of their oral health status, but they are also given clear instructions on the next steps for seeking care.

By identifying oral health issues early, ISU hopes to reduce the number of emergency dental visits, which are often the result of neglected or untreated conditions. While the program is still gathering data, there is optimism that these screenings will ultimately lead to better long-term health outcomes for patients.

The Future of Collaborative Healthcare

The cross-training initiative at ISU is still in its early stages, but it holds immense potential for the future of healthcare. By integrating oral health into nursing education, ISU is helping to create a more holistic approach to patient care—one that acknowledges the important relationship between oral health and overall health.

The collaboration between nurses and dental hygienists represents a significant step toward closing the gap between medicine and dentistry, a gap that has long hindered comprehensive care.

As the program evolves, ISU is committed to expanding its reach and refining its training processes based on student feedback and patient outcomes. With the continued use of MouthWatch Intraoral Cameras and the TeleDent platform, ISU is paving the way for a future where interdisciplinary collaboration is the norm, not the exception, and where underserved populations have better access to the comprehensive care they need.

Crystal Kanderis Lane, RDH, BS, MS, is a tenured associate professor in her eighth year of higher education and a dedicated professional with over 20 years of experience in the dental hygiene field. In 2024, she was honored with the Teledentistry Educational Innovation Award, a national recognition of her forward-thinking efforts to bridge care gaps through technology-enhanced learning and service delivery. Her scholarly interests include teledentistry, interprofessional education, and curriculum innovation aimed at reducing health disparities.