Bringing the examination to the resident: nurse-facilitated teledentistry in Estonian care homes

Care-home residents have considerable oral health needs yet face some of the greatest barriers to visiting a dental practice. Using Estonia as a case study, this Perspective examines what a health system needs for nurse-facilitated remote oral examination to become routine. In Estonia, a trained care-home nurse films the resident's mouth with an intraoral camera under the guidance of a hospital dentist by live video and enters the findings into the electronic health record. National claims data from January 2024 to July 2026 show that two public hospitals performed 550 teledentistry examinations for 537 residents. Because residents did not need to be transported to a dental clinic, each examination saved an estimated mean round trip of 132 km, equivalent to 2.5–5.4 hours of care-staff time and 22–34 kg of carbon dioxide equivalent. Tariff parity with in-person care, public provision and record integration enabled routine operation but did not create demand: activity remained around five examinations a month until one care-home operator requested examinations across all its homes. Scaling the model in Estonia therefore depends on policy rather than technology. We propose linking existing oral health assessment guidance for care homes to the teleconsultation pathway, informing care-home managers about the service, allowing trained care workers as well as nurses to facilitate examinations, and expanding provider capacity. Remote examination can also guide mobile dental units to care homes with documented unmet treatment need.