Experts say the digital solution could improve access to care while prioritizing urgent cases.

Tartu University Hospital has been using e-consultations since last fall, and according to orthodontics professor at Tartu University Hospital, Triin Jagomägi, these can help determine which children are not yet ready for orthodontic treatment due to poor oral hygiene or existing dental issues.

Jagomägi said: "In orthodontics, it is crucial that we do not start treatment or place appliances in the mouth of a child who cannot maintain proper oral hygiene, as this could harm their teeth."

"One of the biggest challenges in orthodontic treatment is that teenagers do not brush their teeth properly. You cannot imagine how quickly white spots and cavities develop when braces are in place but oral hygiene is neglected," she went on.

Meanwhile, Katrin Metstak, head of the Estonian Dental Association (Hambaarstide Liit), said: "Dentists can initiate an e-consultation with an orthodontist, who will then decide whether the case needs immediate attention or if it can wait. The orthodontist makes the final decision."

Katri Herman, president of the Estonian Orthodontic Society (Ortodontide Selts), said: "We won't turn anyone away, and I believe this is a great way to get faster consultations or alleviate concerns through e-consultations."

"The e-consultation is not a major source of income for dentists; in fact, it requires more work than the Health Insurance Fund compensates for. But at least the option is there. It is my hope this will not be the only way for dentists and orthodontists to communicate about children's treatment and that digital referrals will also remain available," Metstak added.

Since January, dentists in Estonia have been able to offer orthodontic e-consultations, which means that rather than automatically being placed on a long waiting list, some cases may be resolved remotely, helping to prioritize urgent needs.

Although the legal framework for this service was established a few years ago, developers have only now advanced to the point where e-consultations are available in all Estonian dental software systems.

In addition to describing the issue, the referring dentist must include photos of the child's teeth as part of the e-consultation.

However, according to Metstak, not all clinics have the necessary equipment to take these photos, so this could limit the use of the service somewhat.

In any case, patients will still have the option to join the regular orthodontic waiting list after an e-consultation, dentists say.

For children, the Health Insurance Fund (Haigekassa) covers the cost of e-consultations.

Dentists and clinics can adopt the system at their own pace. If successful, it could, proponents say, serve as a model for other areas of digital healthcare in Estonia, improving access to specialized care.

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