Sir, current teledentistry uses will influence the post-epidemic burden of dental disease. We surveyed applications, clinician experiences and conditions presenting for teledentistry amongst 115 clinicians across the UK between 24 April-15 May 2020, during the lockdown restrictions.

Most were GDPs (60%) with dental core trainees (17%), foundation dentists and orthodontists (each 5%), oral surgeons (4%), OMFS consultants and speciality doctors (each 3%), dental specialist trainees, special care dentists, and oral and maxillofacial surgery (OMFS) registrars (each 1%). Of the respondents, 76% had no prior experience of teledentistry; 63% had no access to video consulting; 39% sometimesrequested photographs of the concerned area; 23% neversent patients further resources; 18% were not confident making diagnoses from telephone consultations alone; 17% couldn't request photographs as systems were unavailable in their workplace; 16% did notfeel confident making diagnoses using telephone consultations alongside clinical images and 11% were unsure if these systems were available. Overall, 52% thought teledentistry would remain following the epidemic whilst 21% did not; 27% were unable to commit to a decision.

The survey highlighted areas necessitating caution in teledentistry use. Remote consultations may reduce waiting lists and financial implications when patients attend in person.1 Conditions presenting for teledentistry, such as temporomandibular joint disorders (23%) and pericoronitis (63%), may be suitable for self-care measures, thus minimising patient-clinician contact. Yet, concerns have been raised surrounding antibiotic stewardship and the appropriateness of using teledentistry in isolation to manage patients.2 Facial swelling (77%) and pulpitis (65%) were frequently reported remote consultations. Such acute conditions traditionally require operative intervention and should continue to do so via Urgent Dental Care centres.3 Remote prescribing in emergencies is warranted but in the long term, could compromise care. Orthodontic problems (17%) or intra-oral swellings (60%) may result in adverse outcomes the longer operative treatment is delayed.

Diagnostic confidence was a highlighted concern. Clinical photographs can improve quality of assessment, however, in the absence of an examination, patients should be 'safety-netted' by providing information specific to the management of their condition should they deteriorate.4 This can be readily delivered through various forms of telecommunication.5 As we now witness reopening of 'normal' dental services, clinicians should consider developing systems to incorporate digital-consulting and improve patient resources to enhance teledentistry services.