TELEMEDICINE FOR SYMPTOMS MANAGEMENT IN ORAL MEDICINE

OBJECTIVES: The recent coronavirus disease 2019 pandemic has caused a significant drop in visits to dental and medical practices. Following the shelter‐in‐place orders across the United States, we have implemented tele (oral) medicine for the diagnosis and management of oral medicine conditions. We aimed to (1) characterize a cohort of oral medicine patients seen via telemedicine and (2) assess the effectiveness of telemedicine visits in terms of pain control in patients affected by oral diseases. STUDY DESIGN: A retrospective chart review for patients seen via telemedicine was conducted between March 2020 and December 2020. Sociodemographic information, home ZIP code, referring doctor and type of insurance, and clinical diagnosis were collected and entered into an electronic database. The pain score was recorded at each visit using a 0 to 10 scale. Descriptive statistics were used to calculate median and range. Differences in oral pain were evaluated using the Wilcoxon signed-rank test. RESULTS: A total of 137 new patients were included (57% female), with a median age of 56 years (range, 3-89). If seen in person, patients would have traveled a median distance of 65 miles (range, 0.9-100). More than half of the patients (n = 82; 59.8%) were referred by physicians, with the greatest proportion coming from primary care physicians (n = 47; 34.3%) and otolaryngologists (n = 17; 12%). The most common oral conditions seen were reactive/inflammatory lesions (n = 70; 51%), orofacial pain disorders (n = 18; 13.1%), and immune-mediated conditions (n = 17; 12.4%). One third of patients (n = 51; 37%) required an oral biopsy. Imaging and laboratory studies were ordered in 9.4% and 2.1% patients, respectively. Most patients (n = 92; 67.1%) had their visit covered by private medical insurance, 9 by dental insurance (6.5%), and 31 by Medicare (22.6%%), and 5 were self-pay (3.6%). When pain was considered, there was a 3-point median pain reduction from the first video visit to the first follow-up (P < .05) and a self-reported 65% (range, 0%-100%) median improvement of oral symptoms. CONCLUSIONS: Tele (oral) medicine was an effective method for the diagnosis and treatment of oral medicine conditions. Tele (oral) medicine may be used in the future for an initial screening of oral mucosal conditions and to improve access to care.