Current and Potential Use of WhatsApp in Oral Health Care - A Narrative Review
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International Journal of Health Sciences and Research
www.ijhsr.org ISSN: 2249-9571
Review Article
Current and Potential Use of WhatsApp in Oral Health Care - A Narrative
Review
Dr. Shweta Somasundara Yale1, Dr. Santosh Kumar C2, Dr. Vasudha Sharma1
1
Reader, 2Senior Lecturer,
Department of Public Health Dentistry, Rajarajeswari Dental College and Hospital, No.14, Ramohalli Cross,
Mysore Road, Kumbalgodu, Bengaluru, Karnataka 560074
Corresponding Author: Dr. Shweta Somasundara Yale
ABSTRACT
Smartphones, internet and instant messaging applications have changed the telecommunication
scenario since their advent, with immense benefits for healthcare providers and recipients across the
globe. WhatsApp is one such instant messaging tool that has found favour with health care
professionals working in diverse settings. Although WhatsApp has been extensively used in health
care, the literature on its use in oral health care is sparse. This review explored the current and
potential use of WhatsApp in the field of oral health care. The PUBMED database was searched for
English language articles reporting the use of WhatsApp in dentistry, oral health care, dental
education. Snowballing to find additional relevant articles was done by also using Google Scholar and
grey literature. Tele-consultation, appointment booking, addressing queries from patients, treatment
planning, referral, obtaining second opinions, emergency help in dealing with maxillofacial trauma be
it in routine practice or sites of disasters and conflicts, oral health promotion, tobacco cessation,
facilitating dental education through innovative teaching approaches, online follow up of patients,
data collection for research are some of the possible uses of WhatsApp in oral health care. Addressing
the concerns of privacy issues, by appropriate usage of smartphones and WhatsApp, oral health care
professionals can expand the delivery of oral health care to remote and underserved areas as well as
improve the quality of oral health care.
Key words: WhatsApp, oral health care, dentistry, mouth, smartphone.
INTRODUCTION each other. The entire process of sending the
WhatsApp is reported to now have message/image is free. [2] Smartphones and
1.5 billion monthly active users (MAUs), WhatsApp are now being used by doctors in
with over 200 million monthly active users health care delivery, for telemedicine and
in India. [1] “WhatsApp Messenger” is a teledentistry services. [3] A comprehensive
cross-platform instant messaging systematic review of present literature on
application for smartphones. Cross platform the use of the WhatsApp Messenger app as
means that the software is available for iOS, an adjunctive health care tool for medical
Blackberry OS, Android, Symbian, Series doctors concluded that pooled data provided
40 and Windows Phone and allows seamless compelling evidence that the WhatsApp
communication between the various Messenger app is a promising system,
devices, be it a Windows phone, Blackberry whether used as a communication tool
phone, Android phone or apple phone. In between health care professionals, as a
addition to text messaging, users can send means of communication between health
images, video and audio media messages to care professionals and the general public, or
International Journal of Health Sciences & Research (www.ijhsr.org) 278
Vol.8; Issue: 6; June 2018Shweta Somasundara Yale. Use of WhatsApp in Oral Health Care
as a learning tool for providing health care oral health care including dental education,
information to professionals or to the oral health promotion/smoking cessation.
general population. [4]
The WhatsApp business app is now Literature search:
actively used by over 3 million people. It The PUBMED database was
was launched in January 2018 for Android searched using the term “WhatsApp”
users in six countries including India, yielding 156 articles; then a search for
Indonesia, Italy, Mexico, Britain and the English language articles reporting the use
US. Users can now download WhatsApp of WhatsApp in dentistry, oral health care,
Business app for free from Google Play dental education, using the search details:
store but the new app, is yet to come on WhatsApp [All Fields] AND
Apple App Store in India. [5] This tool can ("mouth"[MeSH Terms] OR "mouth"[All
potentially be used by dental practices to Fields] OR "oral"[All Fields]) was done and
communicate with patients regarding dental eleven articles were found. Snowballing to
procedures, treatment costs, and most find additional relevant articles was done by
importantly, getting appointments over also using Google Scholar and grey
WhatsApp; [6] basically, interact with literature.
customers, patients, and dental labs easily
by using tools to automate, sort, and quickly Reported uses of WhatsApp in oral
respond to messages. [7] health care
With improved encryption in the Use of WhatsApp in oral medicine and
current version of WhatsApp, its use in the radiology
health sector is expected to grow. [3] For WhatsApp has been reported to be
general communication, or for sending de- used for submitting clinical images and
identified protected health information diagnostic questions by general dentists,
(PHI), WhatsApp could be safely used by dental hygienists, patients and physicians
healthcare professionals. [8] In the USA, the for telemedicine consultation reducing the
Health Insurance Portability and geographic barriers to preliminary
Accountability Act, commonly referred to consultations. Telemedicine impression via
as HIPAA, sets national standards for the WhatsApp agreed with the clinicopathologic
confidentiality, security, and transmissibility impression in 82% of the cases in a study
of personal health information. Healthcare from Italy. [11] Another study carried out
providers are required, under the HIPAA among Oral medicine and radiology (OMR)
Privacy Rule, to protect and keep specialists across India, reported that
confidential any personal health WhatsApp was the most frequently used
information. [9] In order for WhatsApp to be application for m-Teledentistry (mobile-
HIPAA compliant, there would have to be a Teledentistry) practice. Telediagnosis and
significant number of security mechanisms treatment planning using patient images,
added to the software. [10] Till then, videos and radiographs, accessibility of the
additional security controls may be installed specialists to rural areas, was positively
on a smartphone to authenticate users before considered. Many OMR specialists agreed
the device can be accessed, [8] and app locks that sharing patient information over
may have to be used so that health WhatsApp may lead to breach of patient
information downloaded on the phone confidentiality; however, many concurred
remains confidential. that they discussed diagnosis and treatment
Despite these concerns WhatsApp is planning in WhatsApp chat rooms. The
being increasingly used in oral health care. study reported that CBCT image quality
This review explores the current and transmitted over WhatsApp may be less.
potential use of WhatsApp in the field of Most respondents felt that WhatsApp would
be useful in improving dental practice,
International Journal of Health Sciences & Research (www.ijhsr.org) 279
Vol.8; Issue: 6; June 2018Shweta Somasundara Yale. Use of WhatsApp in Oral Health Care
patient management and patient satisfaction. have reported using Smartphones having a
[12]
high definition camera, and WhatsApp as an
image and video transfer program to send
Use of WhatsApp in oral pathology Computerised Tomography (CT) sequences.
Smartphones allow pathologists and Views of CT images from a computer
other image dependent disciplines in low screen were sent as images and serial
resource areas to transmit consultations to images were recorded as videos and sent
experts anywhere in the world. [13] Second through WhatsApp. [15] WhatsApp can also
opinion diagnosis of 34 different oral be used by surgically active dentists in
pathologies that had been captured as structurally weak areas to seek guidance
photomicrographs, using smartphones from experienced maxillofacial surgeons or
through compound microscopes has been emergency doctors to treat potentially life-
reported to be effectively and conveniently threatening conditions, utilizing the real
accomplished by oral pathologists in India time video communication feature of
using WhatsApp to transfer the WhatsApp. [16]
photomicrographs to 20 different oral
pathologists. Considering that a second Use of WhatsApp in Orthodontics
opinion diagnosis was obtained in nearly A study that tested mobile
three hours, diagnostic delays can be applications for patient to orthodontist
minimised leading to better patient contact, compared WhatsApp and Telegram,
management. [14] WhatsApp can be used at found that: the majority of patients (75%)
the time of community surveys on oral preferred WhatsApp; it enabled them to
cancer detection, wherein second opinion send pictures, and the most frequently
can be sought for suspicious cases of oral reported messages were pertaining to
cancer. Faster second opinion will aid in bracket failures esp. of second molars, pain
early detection of oral cancer. [14] due to moving wires at the end, additional
information on oral hygiene and using
Use of WhatsApp in Oral and elastics, which prompted the adoption of
maxillofacial surgery protocols to improve the same, thereby
A study from South India has increasing patient contact with the
reported that they have greatly eliminated orthodontic practice and increasing patient
the communication gap, reducing the compliance. [17] Another study that
possibility of arbitrary evaluated the influence of a WhatsApp-
misdiagnosis/mismanagement in their Oral based approach in a protocol for domestic
and maxillofacial unit, by using a oral hygiene maintenance in a group of
WhatsApp protocol that is followed for adolescent patients wearing fixed
communication between post graduate multibracket appliances, instructed the
trainees and teaching faculty, junior and patients who were enrolled in a WhatsApp
senior colleagues. WhatsApp is used to chat room-based competition to share
share patient photographs, radiographs monthly, with the other participants two
between the first on-call post graduate self-photographs (selfies) showing their oral
trainee and all other seniors in the group; the hygiene status. Improved oral health status
theatre list along with the pre-operative and during orthodontic multibracket treatment
post- operative photos and radiographs, was observed by significantly lower values
treatment plans and outcomes, are also of both plaque index, and gingival index,
reviewed, thereby keeping all members of and a lower incidence of new white spot
the unit informed and also a creating a lesions and caries, as compared with the
digital archive for future reference. [2] For control group. [18] Studies using messaging
night time consultations on maxillofacial apps have reported their effectiveness in
traumas, in Turkey, emergency services reducing the treatment duration and bracket
International Journal of Health Sciences & Research (www.ijhsr.org) 280
Vol.8; Issue: 6; June 2018Shweta Somasundara Yale. Use of WhatsApp in Oral Health Care
bond failure and improving the attendance that group discussion and reminders via
in orthodontic patients besides being useful WhatsApp social group were effective to
for outpatient education and management. reduce smoking relapse. [23]
[19]
Therefore WhatsApp can be made use of Another study from Saudi Arabia
similarly in the Indian scenario. reported that Twitter and WhatsApp users
found it easier to quit smoking than those
Use of WhatsApp in dental education who did not take part in these social media
A study reported that WhatsApp was groups. Social media provides a good
the most used instant messaging (IM) app platform to discuss smoking cessation
among dental students of a university in treatment, and thus reduce smoking
U.K because of its popular features such as relapses. [24] WhatsApp can be a more
being able to check if recipients have read effective tool for providing dental education
and received messages and group work. on tobacco and oral cancer as compared to
WhatsApp was used a lot to undertake conventional audio-visual aids. [25] Social
group work and share files for their dental media can play an important role in
studies. [20] strengthening the health care system to
WhatsApp was introduced as a provide valuable information, educational
teaching tool in an Oral Radiology course. programs and interventions to promote
Undergraduate dental students at the healthy life styles among the people. [26]
University of Brasília were provided with
weekly quizzes via a WhatsApp discussion Potential uses of WhatsApp
group over a 14-week period. The quizzes Teleconsultation using WhatsApp
consisted of a tomographic or radiographic can potentially be used in the dental setting
image from a real clinical case and a to seek specialist opinions in rural areas,
multiple-choice question. Students war torn areas, underserved areas, disaster
reportedly had a positive attitude towards sites and for various purposes such as:
the use of WhatsApp and considered it had diagnosis and treatment planning for
helped them to learn about Oral Radiology patients requiring prosthetic or oral
although participation decreased over time. rehabilitation treatment, video-consultation
So, WhatsApp can facilitate participatory in dentistry; remote diagnosis of children’s
learning among dental students and further dental problems based on non-invasive
research can be carried out in this direction. photographs, identifying root canal orifices
[21]
based on images of endodontically accessed
Insufficient weekly hours to cover teeth, diagnosis of periapical lesions of the
the extensive curricula of English for Dental front teeth, reducing the costs associated
Purposes (EDP) courses in Iran, led to the with distant visits and making urgent help
use of a WhatsApp based approach that the available; The general dentist can send all
dental students believed enhanced their the pertinent information (radiograph of the
learning of English for Dental Purposes; this area, an intraoral photograph, all charting
research showed that WhatsApp mobile and health history information) of a patient
language learning activities carry benefits via the internet to a periodontist/other
for university students’ achievement and specialists who would then evaluate and
attitudes towards blended learning and suggest the appropriate treatment plan. [27]
teaching. [22] Oral teleconsultation could also
improve the quality of oral care in prisons.
[28]
Use of WhatsApp in oral health Other unique uses of WhatsApp in
promotion healthcare which can be applicable in the
A pilot cluster randomized oral health care scenario are suggested by
controlled trial in Hong Kong developed the experience of a Brazilian study that used
and provided the first preliminary evidence WhatsApp for online follow up of patients
International Journal of Health Sciences & Research (www.ijhsr.org) 281
Vol.8; Issue: 6; June 2018Shweta Somasundara Yale. Use of WhatsApp in Oral Health Care
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How to cite this article: Yale SS, Santosh KC, Sharma V. current and potential use of WhatsApp
in oral health care -a narrative review. Int J Health Sci Res. 2018; 8(6):278-284.
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