title: Interstate Practice of Dental Teleradiology in the United States: The Effect of Licensing Requirements on Oral and Maxillofacial Radiologists' Practice Patterns.
abstract: In the United States, each state has independent licensing standards. Dentists wishing to practice in more than one state must apply to each individually. The goal of this study was to assess whether board-certified oral and maxillofacial radiologists interpreted images taken outside the states in which they were licensed and whether coverage provided by the malpractice insurance plans to which they subscribed affected their behavior.
  
  
  
  An electronic survey was sent to all current members of the American Board of Oral and Maxillofacial Radiology, with a response rate of 74%. Descriptive statistics were calculated.
  
  
  
  The majority of respondents (54.6%) indicated they write reports for patients in states for which they do not have a dental license. An even larger majority (80.0%) do not know whether their malpractice insurance protects them in these cases. Qualitative responses indicate that there is confusion among practitioners as to what is legally permitted pertaining to teledentistry of this nature.
  
  
  
  Much of the work in which oral and maxillofacial radiologists engage may be considered teledentistry. In other settings, teledentistry has been proposed as a means to improve access to care for vulnerable populations, yet current licensure laws may make this more difficult to implement. Based on the results of our survey, many oral and maxillofacial radiologists in practice may be considered to be practicing without a license. Portability of diagnostic images may make it more difficult to enforce geographic practice boundaries. A national licensure system would be easier to enforce while maintaining high levels of patient safety.
authors.affiliation: 1 Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine , Boston, Massachusetts.
authors.forename: Lisa
authors.initials: L
authors.lastname: Simon
authors.affiliation: 2 Department of Oral Medicine Infection & Immunity, Harvard School of Dental Medicine , Boston, Massachusetts.
authors.forename: Bernard
authors.initials: B
authors.lastname: Friedland
mesh_terms: D003430:Cross-Sectional Studies; D006801:Humans; D007571:Jaw Diseases / Q000000981:diagnostic imaging*; D008004:Licensure / Q000331:legislation & jurisprudence; D008318:Malpractice / Q000331:legislation & jurisprudence; D009059:Mouth Diseases / Q000000981:diagnostic imaging*; D019112:Teleradiology / Q000331:legislation & jurisprudence* / Q000592:standards; D014481:United States
keywords: e-health; policy; teledentistry; teleradiology