Sir, the pandemic has brought to light the extent of the digital divide in the UK with 11.9 million (22%) adults lacking basic digital skills.1Data published by the Office for National Statistics show that 4% of households do not have internet access; this is most prevalent in households comprising of a single adult aged 65 or older.2 Furthermore, only 20% of people aged 65 and over had used an electronic device for making telephone or video calls over the internet.3
Arguably, patients over the age of 65 who live alone are some of the most vulnerable patients; furthermore, it is important to also consider patients from social or religious backgrounds where the use of technology may be limited, one example being the Orthodox Jewish community, but there are many other categories of vulnerable patients to be considered, each with their own circumstances.
The approach taken should be tailored to what is known of the individual's circumstances. This may involve giving priority for face-to-face appointments over remote assessments for patients identified to be high-risk or with reduced digital access. For patients who have reduced access due to religious or cultural reasons it may be helpful to liaise with community or religious leaders regarding the provision of webcam-enabled devices.
As virtual dentistry becomes a more commonplace part of the dental assessment, new approaches should be introduced to ensure that vulnerable patients are not disadvantaged and are able to access the services they need.
References
Lloyds Bank. UK Consumer Digital Index 2019. p 4. Available at: https://www.lloydsbank.com/assets/media/pdfs/banking_with_us/whats-happening/lb-consumer-digital-index-2019-report.pdf (accessed March 2021).
Office for National Statistics. Internet access - households and individuals, Great Britain: 2020. 7 August 2020. Available at: https://www.ons.gov.uk/peoplepopulationandcommunity/householdcharacteristics/homeinternetandsocialmediausage/bulletins/internetaccesshouseholdsandindividuals/2020 (accessed 7 January 2021).
Office for National Statistics. Internet access - households and individuals, Great Britain: 2017. 7 August 2018. Available at: https://www.ons.gov.uk/peoplepopulationandcommunity/householdcharacteristics/homeinternetandsocialmediausage/bulletins/internetaccesshouseholdsandindividuals/2017 (accessed 14 March 2021).
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Muhsin, H. Reduced digital access. Br Dent J 230, 326–327 (2021). https://doi.org/10.1038/s41415-021-2863-9
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DOI: https://doi.org/10.1038/s41415-021-2863-9