Digital Dental Technologies and Aged CareSame But Different - QAS

Aim

The project seeks to utilise digital technologies for the impression of Copy or Reference Dentures within aged care facilities, thereby reducing transportation costs, minimizing clinical chair time, and enabling a consistent, evidence-based in-house solution (Kim, Lee, & Shin, 2023; Zhou, Li, Liu, Z)

Outcomes

• Enhance denture accessibility and convenience for aged care residents (Zhou & Liu, 2021).
• A one appointment treatment plan (Lee, Kim, & Shin, 2020).
• Traditional impression techniques caused anxiety and discomfort (Wang, Li, & Zhang, 2023).
• Follow-up appointments were frequently cancelled due to patient health issues disrupting continuity of care (Gillway & Doshi, 2023).
• Lengthy treatment timelines required multiple visits, adding burden to patients and providers (Zhou et al., 2021).
• Communication barriers led to misunderstandings and frequent remakes (Chen et al., 2022).
• Extended lab processing times forced patients to alter diets and social activities (Kim et al., 2023).

Background

The traditional methods of dental care presented numerous challenges for both patients and dental professionals, particularly the aged care residence. One of the primary issues was that many patients found it difficult to attend their scheduled appointments, which disrupted the continuity of care (Chen, Li, & Zhou, 2022). Additionally, the old impression techniques were often stressful for patients, causing anxiety and discomfort (Wang, Li, & Zhang, 2023). Many patients also struggle to fully comprehend clinical instructions, which led to misunderstandings and, on several occasions, required remakes of dental appliances (Kim, Lee, & Shin, 2023).

Follow-up appointments were commonly cancelled due to health-related issues, prolonging treatment timelines and increasing the overall burden on both patients and providers (Zhou et al., 2021). The process of fabricating copy dentures using traditional methods was particularly labour-intensive, requiring extensive manual work and laboratory hours (Lee, Kim, & Shin, 2020). In some instances, dentures remained in the lab for extended periods, compelling patients to temporarily modify their diets and social routines, thereby diminishing their quality of life (Zhou, Li, Liu, Zhao, & Zhao, 2021).

The need to innovate in dental care processes has become evident, particularly when addressing the challenge of providing copy dentures without requiring patients to visit the clinic (Gillway & Doshi, 2023). One potential solution could be leveraging digital technology to remotely capture the necessary digital impressions or scans, allowing patients to avoid the need for visiting the clinic (Chen et al., 2022). By using advanced scanning devices, clinicians could collect accurate data directly from patients, even in their homes or care facilities (Wang et al., 2023). This approach would not only improve patient convenience but also ensure a more streamlined process.

Implementing the use of oral scans could significantly enhance the delivery of dental care. Many elderly patients struggle to visit clinics regularly due to mobility issues, and oral scans could be performed on-site with minimal disruption (Kim et al., 2023). By equipping care facilities with the necessary technology, dental professionals could remotely assess and plan treatments, improving the overall accessibility of care for this population (Zhou & Liu, 2021).

Digitizing the entire denture workflow - from initial assessment to final fabrication - has the potential to drastically improve clinical and laboratory efficiency (Lee et al., 2020). By streamlining processes and reducing manual interventions, digital workflows enable faster turnaround times, enhanced accuracy (Zhou et al., 2021). Establishing standardized digital protocols further ensures seamless communication and integration across the care pathway (Gillway & Doshi, 2023).

Furthermore, limiting clinical chair time and laboratory working hours is essential for optimizing the patient experience and reducing operational costs (Chen et al., 2022). By adopting digital impressions, the need for multiple visits and labour-intensive processes in the lab can be significantly reduced (Wang et al., 2023)

Discussion

The project's success in clinical dental settings has been driven by several key environmental and contextual factors. Supportive leadership and a strong culture of innovation among dental teams laid the groundwork for adoption (Gillway & Doshi, 2023). Access to digital scanning technology, secure data transfer systems, and robust infrastructure enabled effective implementation (Zhou & Liu, 2021). Staff and clinician willingness to embrace new workflows allowed seamless integration into practice (Kim et al., 2023), while strong collaboration between clinics and laboratories enhanced efficiency (Lee et al., 2020).

Given these outcomes, the model shows strong potential for expansion into aged care settings, where timely dental care is limited and demand is high (Chen, Li, & Zhou, 2022). Several lessons emerged from the clinical rollout: digital technologies reduced treatment delays and improved outcomes when thoughtfully implemented (Wang et al., 2023). On-site care was particularly valuable for patients with mobility issues, demonstrating the benefit of delivering services directly (Zhou et al., 2021). Crucially, success required more than just new tools—training and proactive change management were essential (Gillway & Doshi, 2023).

Despite the benefits, limitations were identified. High initial costs for equipment and infrastructure can be a barrier, especially in resource-limited settings (Chen et al., 2022). Inconsistent internet connectivity also affected data transmission (Wang et al., 2023). Some resistance to change was encountered, underscoring the need for early engagement and education (Lee et al., 2020).

Evaluation highlighted significant strengths: improved efficiency and precision in denture fabrication, greater patient access, and reduced clinical and lab workloads (Kim et al., 2023). Weaknesses included reliance on stable digital infrastructure and the need for upfront investment (Zhou & Liu, 2021). Initial awareness among clinical teams was limited but improved with time (Zhou et al., 2021).

The model also presents broader opportunities beyond aged care, including mobile healthcare services like telehealth and portable radiography (Gillway & Doshi, 2023). It has potential for scalability across Queensland Health, particularly in rural and remote hospitals, Aboriginal and Torres Strait Islander health services, long-stay facilities, and clinics with extended waitlists (Zhou et al., 2021). Integration of AI-assisted design and predictive planning could further enhance impact (Wang et al., 2023).

For successful transfer to aged care, several refinements are recommended. Piloting the model at a single site will help identify early technical challenges (Zhou & Liu, 2021). Structured feedback loops and digital literacy assessments will support responsive adaptation and targeted training (Chen et al., 2022; Kim et al., 2023). A formal evaluation framework is essential to track key metrics such as turnaround times and patient satisfaction (Lee et al., 2020). Moving forward, priorities include developing standardised protocols, centralised support for digital workflows, securing funding, and expanding knowledge sharing across the health system (Wang et al., 2023).