Digital therapeutics and dentistry
As our society continues to evolve and innovate, digital solutions to our problems are becoming more commonplace. After all, with the vast majority of individuals now owning a smartphone in the UK (55.5 million people)[i] it makes sense that companies are looking at ways to harness this technology in inventive ways, including revolutionising how we look at healthcare.
One particularly interesting development that has emerged in recent times is the concept of digital therapeutics. Effectively, digital therapeutics is the use of apps to help manage certain conditions, for example insomnia and depression. The goal of these technologies is to help people put control of these conditions in their own hands, allowing self-management and reducing the chance of condition-related hospital visits. These apps go through the same rigorous testing as medicines, including randomised clinical trials.
There are a number of these apps that have already seen great results. For example, there is a programme named Sleepio that has been specifically developed to help people improve their sleep if they suffer from insomnia or usually have to rely on sleeping pills and other methods to get the rest they need. Through a combination of setting sleep goals and filling out an in-depth questionnaire about their habits, the app assesses peoples’ needs and then generates a tailored programme for them to follow, which is supplemented with weekly lessons with a virtual “sleep expert”. Once people follow this regime, their sleep should start to improve, and the app has plenty of evidence to support it, with a respectable 76% of users achieving clinical improvement in their insomnia after 5 weeks.[ii]
Another app that has seen some great response is Daylight. Designed to help people manage anxiety and full of techniques and tips to encourage individuals to “get out of their head”, this app is advertised as an adjunct to usual medical care. Much like Sleepio, Daylight has seen impressive results, with 71% of users improving their anxiety issues.[iii]
So, with evidence supporting digital therapeutics, could we reasonably expect this technology to be able to help with dentistry?
Dental apps, as you’re probably aware, are nothing new. There are plenty of software programmes out there that are designed to encourage children to clean their teeth, learn oral health facts and address other issues. However, to my knowledge, there are currently no approved digital therapeutic apps that have been designed especially for dental needs. This may be a case of the technology not being there yet – and the fact that dentistry is much more about preventive care than management these days. But what if an app could be developed to help people who are at higher risk of caries or who have previously suffered from periodontitis?
The core aim of the app could be to monitor certain aspects and directly send this information to dentists – potentially helping us to keep a closer eye on high-risk patients and allowing them to feel more involved in the oral healthcare journey.
I think the main hurdle that would need to be overcome is that, unlike conditions such as insomnia and anxiety, dental problems would likely need photo monitoring to assess the condition of the dentition as part of the process. There are further limitations too – even if a phone camera could capture extraordinary detail and be viably harnessed by users to take photos, as dentists we know that not all problems are visible and a physical examination is often paramount to truly understanding the extent of any issues.
In light of this, I believe that if digital therapeutics were to be adapted to have a dental focus, current technological limitations would mean they would have to be utilised as behavioural adjuncts for general oral health. However, as technology is evolving so fast, who knows what the future has in store? Looking at the data supporting dental therapeutics in other areas, it’s clear that there are opportunities here to be grasped once the technology makes it possible.
In the end, even if our smartphones are able to perform extraordinary functions, I believe that in the case of dentistry, these apps will always be secondary to proper in person examination. Much like teledentistry, there are definitely situations where this sort of care could be introduced and even potentially help minimise the pressure on dental services. We just need to wait for technology to catch up and someone to design an app that can make a difference on a clinical level – a goal that is likely to be met in the near future.
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[i] Cybercrew. How Many People Own A Smartphone in the UK? Link: Water Regulations Advisory Scheme [Last accessed March 22].
[ii] Sleepio. Clinical Evidence. Link: https://www.bighealth.com/research/ [Last accessed March 22].
[iii] Big Health. Daylight. Link: https://www.bighealth.com/daylight/ [Last accessed March 22].
