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Lee J, Park JS, Feng B, Wang KN. The utilisation of teledentistry in Australia: A systematic review and meta-analysis. J Dent 2024; 149:105265. [PMID: 39059707 DOI: 10.1016/j.jdent.2024.105265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 07/17/2024] [Accepted: 07/23/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND Teledentistry is the usage of information-based technologies to deliver healthcare services remotely. It is used to deliver care in regional, rural and remote regions and was particularly useful to deliver care during the COVID-19 pandemic. OBJECTIVE This systematic review and meta-analysis aimed to determine teledentistry utilisation in Australia. METHODS The databases PubMed, Google Scholar, EMBASE and Web of Science were searched from inception to June-2024. The phrases "Dental" AND "Telehealth" AND "Australia" and "Teledentistry" AND "Australia" were used. Two authors completed the study selection and data extraction. The Joanna Briggs Institute Critical Appraisal Tools were used to assess quality and bias. RESULTS Eighteen articles met the inclusion criteria. There were six diagnostic tests, six cross-sectional studies, 4 economic evaluations, one qualitative study and one expert opinion. Teledentistry was accurate for screening caries (average sensitivity=69.7 %, average specificity=97.4 %). There also appeared to be a non-significant negative correlation between specificity and sensitivity (r = 0.432). Opinions regarding teledentistry were mixed from clinicians but positive from patients. Teledentistry may also lead to savings for patients and healthcare providers. CONCLUSION Teledentistry increases healthcare access especially for people in regional, rural and remote areas. It is an effective screening tool for caries. Whilst the opinions of clinicians were mixed, potential implementation barriers were identified which could improve opinions of clinicians and increase implementation. CLINICAL IMPORTANCE This study demonstrates teledentistry as a satisfactory tool for screening caries. This could be beneficial to those with difficulties visiting dentists in-person, particularly if they live in regional, rural or remote areas.
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Affiliation(s)
- Joshua Lee
- School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia; School of Allied Health, The University of Western Australia, Crawley, Western Australia, Australia; International Research Collaborative - Oral Health and Equity, The University of Western Australia, Western Australia, Crawley, Australia.
| | - Joon Soo Park
- International Research Collaborative - Oral Health and Equity, The University of Western Australia, Western Australia, Crawley, Australia; School of Engineering, Information Technology and Physical Sciences, Federation University Australia, Ballarat, Victoria, Australia; Institute for Sustainable Industries & Liveable Cities, Victoria University, Melbourne, Australia
| | - Boxi Feng
- School of Allied Health, The University of Western Australia, Crawley, Western Australia, Australia; International Research Collaborative - Oral Health and Equity, The University of Western Australia, Western Australia, Crawley, Australia
| | - Kate N Wang
- School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia; International Research Collaborative - Oral Health and Equity, The University of Western Australia, Western Australia, Crawley, Australia
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Ashtiani GH, Sabbagh S, Moradi S, Azimi S, Ravaghi V. Diagnostic accuracy of tele-dentistry in screening children for dental caries by community health workers in a lower-middle-income country. Int J Paediatr Dent 2024; 34:567-575. [PMID: 38196024 DOI: 10.1111/ipd.13157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 12/11/2023] [Accepted: 12/27/2023] [Indexed: 01/11/2024]
Abstract
BACKGROUND Tele-dentistry can be useful for dental caries screening of children, especially in lower-middle-income countries (LMICs). AIM To evaluate the diagnostic accuracy of mobile phone photographs taken by a community health worker (CHW) for caries detection in Iran. DESIGN Children aged 6-12 years were visually examined by a paediatric dentist. Following dental examinations, intraoral photographs were taken by a trained CHW. Two remote dentists assessed intraoral photographs for dental caries. Diagnostic accuracy of tele-dentistry for caries detection was evaluated. In addition, the questionnaire about oral health and parents' views towards tele-dentistry was prepared. RESULTS One hundred thirty-one children aged 8.74 ± 1.62 years participated. The caries prevalence was 30% for the whole dentition. Tele-dentistry demonstrated high accuracy, with a sensitivity exceeding 80% and specificity exceeding 90%. The inter-rater reliability for remote dentists' assessments to the gold standard dental examination ranged from substantial to almost perfect (kappa: 75%-93%). Additionally, 80% of parents whose children participated in this study had positive views towards tele-dentistry. CONCLUSION Tele-dentistry was shown to be an alternative approach to clinical examinations for caries detection among school children. Employing non-dental care professionals in tele-dentistry has been emerged as a reliable and cost-effective approach, especially in LMICs.
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Affiliation(s)
- Gelareh Haghi Ashtiani
- Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Sedigheh Sabbagh
- Dental Materials Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sara Moradi
- Department of Health Research Methods, McMaster University, Hamilton, Ontario, Canada
| | - Somayyeh Azimi
- School of Human Sciences, University of Western Australia, Crawley, Western Australia, Australia
| | - Vahid Ravaghi
- School of Dentistry, University of Birmingham, Birmingham, UK
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Kargozar S, Jadidfard MP. Teledentistry accuracy for caries diagnosis: a systematic review of in-vivo studies using extra-oral photography methods. BMC Oral Health 2024; 24:828. [PMID: 39039499 PMCID: PMC11265175 DOI: 10.1186/s12903-024-04564-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 07/03/2024] [Indexed: 07/24/2024] Open
Abstract
BACKGROUND Dental caries is a global public health concern, and early detection is essential. Traditional methods, particularly visual examination, face access and cost challenges. Teledentistry, as an emerging technology, offers the possibility to overcome such barriers, and it must be given high priority for assessment to optimize the performance of oral healthcare systems. The aim of this study was to systematically review the literature evaluating the diagnostic accuracy of teledentistry using photographs taken by Digital Single Lens Reflex (DSLR) and smartphone cameras against visual clinical examination in either primary or permanent dentition. METHODS The review followed PRISMA-DTA guidelines, and the PubMed, Scopus, and Embase databases were searched through December 2022. Original in-vivo studies comparing dental caries diagnosis via images taken by DSLR or smartphone cameras with clinical examination were included. The QUADAS-2 was used to assess the risk of bias and concerns regarding applicability. Meta-analysis was not performed due to heterogeneity among the studies. Therefore, the data were analyzed narratively by the research team. RESULTS In the 19 studies included, the sensitivity and specificity ranged from 48 to 98.3% and from 83 to 100%, respectively. The variability in performance was attributed to factors such as study design and diagnostic criteria. Specific tooth surfaces and lesion stages must be considered when interpreting outcomes. Using smartphones for dental photography was common due to the convenience and accessibility of these devices. The employment of mid-level dental providers for remote screening yielded comparable results to those of dentists. Potential bias in patient selection was indicated, suggesting a need for improvements in study design. CONCLUSION The diagnostic accuracy of teledentistry for caries detection is comparable to that of traditional clinical examination. The findings establish teledentistry's effectiveness, particularly in lower income settings or areas with access problems. While the results of this review is promising, conducting several more rigorous studies with well-designed methodologies can fully validate the diagnostic accuracy of teledentistry for dental caries to make oral health care provision more efficient and equitable. REGISTRATION This study was registered with PROSPERO (CRD42023417437).
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Affiliation(s)
- Sanaz Kargozar
- Department of Community Oral Health, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad-Pooyan Jadidfard
- Department of Community Oral Health, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
- Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Thirunavukkarasu A, Alaqidi SF. Early Childhood Caries-Prevalence, Associated Factors, and Severity: A Hospital-Based Study in Riyadh, Saudi Arabia. Healthcare (Basel) 2024; 12:1376. [PMID: 39057519 PMCID: PMC11276339 DOI: 10.3390/healthcare12141376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 06/21/2024] [Accepted: 07/08/2024] [Indexed: 07/28/2024] Open
Abstract
Early childhood caries (ECC) is not merely a problem of the tooth; rather, it has negative impacts on the child's growth and development and oral health-related quality of life. The prevalence of ECC varies widely, and more variance is observed between countries than continents, and it changes over time. The current cross-sectional study aimed to determine ECC's prevalence, associated factors, and severity. This study was conducted in the Dental Clinic Complex, North Riyadh, KSA. The study sample included 306 participants between 36 and 71 months of age. A questionnaire was developed to collect information from participants. The decaying and filled teeth (DMFT) index was used to estimate the prevalence of caries. The study results revealed the prevalence of ECC to be 76% among 36- to 71-month-old children in North Riyadh. ECC is influenced by socioeconomic factors like maternal occupation, education, oral hygiene habits, and dietary patterns. Also, it was found that exclusively breastfed children have lower ECC odds (68.1% vs. 83.6%, p = 0.001), while the intake of more than three between-meal sugar-containing snacks/beverages per day increases the likelihood of ECC (63.5% vs. 79.8%, p = 0.006). The researchers recommend encouraging breastfeeding as it correlates with lower ECC prevalence, in addition to establishing effective oral hygiene practices for preschool children.
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Affiliation(s)
- Ashokkumar Thirunavukkarasu
- Department of Family and Community Medicine, College of Medicine, Jouf University, Sakaka 72388, Saudi Arabia;
| | - Sultan Fadel Alaqidi
- Department of Family and Community Medicine, College of Medicine, Jouf University, Sakaka 72388, Saudi Arabia;
- Department of General Dental Services, Dental Clinic Complex, North Riyadh 123216, Saudi Arabia
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Huang B, Estai M, Pungchanchaikul P, Quick K, Ranjitkar S, Fashingbauer E, Askar A, Wang J, Diefalla F, Shenouda M, Seyffer D, Louie JP. Mobile Health Assessment of Traumatic Dental Injuries Using Smartphone-Acquired Photographs: A Multicenter Diagnostic Accuracy Study. Telemed J E Health 2024. [PMID: 38946689 DOI: 10.1089/tmj.2024.0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/02/2024] Open
Abstract
Background: Mobile health (mHealth) has an emerging potential for remote assessment of traumatic dental injuries (TDI) and support of emergency care. This study aimed to determine the diagnostic accuracy of TDI detection from smartphone-acquired photographs. Methods: The upper and lower anterior teeth of 153 individuals aged ≥ 6 years were photographed using a smartphone camera app. The photos of 148 eligible participants were reviewed independently by a dental specialist, two general dentists, and two dental therapists, using predetermined TDI classification and criteria. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value, and inter-rater reliability were estimated to evaluate the diagnostic performance of the photographic method relative to the reference standard established by the dental specialist. Results: Of the 1,870 teeth screened, one-third showed TDI; and one-seventh of the participants had primary or mixed dentitions. Compared between the specialist's reference standard and four dental professionals' reviews, the diagnostic sensitivity and specificity for TDI versus non-TDI were 59-95% and 47-93%, respectively, with better performance for urgent types of TDI (78-89% and 99-100%, separately). The diagnostic consistency was also better for the primary/mixed dentitions than the permanent dentition. Conclusion: This study suggested a valid mHealth practice for remote assessment of TDI. A better diagnostic performance in the detection of urgent types of TDI and examination of the primary/mixed dentition was also reported. Future directions include professional development activities involving dental photography and photographic assessment, incorporation of a machine learning technology to aid photographic reviews, and randomized controlled trials in multiple clinical settings.
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Affiliation(s)
- Boyen Huang
- University of Minnesota School of Dentistry, Minneapolis, Minnesota, USA
| | - Mohamed Estai
- School of Human Sciences, The University of Western Australia, Perth, Australia
| | | | - Karin Quick
- University of Minnesota School of Dentistry, Minneapolis, Minnesota, USA
| | - Sarbin Ranjitkar
- Adelaide Dental School, University of Adelaide, Adelaide, Australia
| | - Emily Fashingbauer
- University of Minnesota School of Dentistry, Minneapolis, Minnesota, USA
- College of Allied Health and Nursing, Minnesota State University, Mankato, Minnesota, USA
| | - Abdirahim Askar
- University of Minnesota School of Dentistry, Minneapolis, Minnesota, USA
| | - Josiah Wang
- University of Minnesota School of Dentistry, Minneapolis, Minnesota, USA
| | - Fatma Diefalla
- University of Minnesota School of Dentistry, Minneapolis, Minnesota, USA
| | - Margaret Shenouda
- University of Minnesota College of Liberal Arts, Minneapolis, Minnesota, USA
| | - Danae Seyffer
- University of Minnesota School of Dentistry, Minneapolis, Minnesota, USA
| | - Jeffrey P Louie
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota, USA
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Qari AH, Almashhadani SS, Balbaid MA, Alharthi YD, Alzahrani AA, Morad MH, Hassan SS. Perceptions of Schoolteachers About Teledentistry Use in Makkah City. Cureus 2024; 16:e51927. [PMID: 38333450 PMCID: PMC10851029 DOI: 10.7759/cureus.51927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2024] [Indexed: 02/10/2024] Open
Abstract
OBJECTIVES Teledentistry is a combination of communication technology and dentistry. Teledentistry is an alternative and useful way to remotely provide advisory, preventive, and emergency services in places with poor access to dental care. Few studies in Saudi have investigated the implementation of teledentistry at schools or assessed the perceptions of school personnel. This research aimed to evaluate teachers' perceptions about the use of teledentistry to examine schoolchildren in Makkah city. METHODS The study was conducted on 20 intermediate schools randomly selected from different regions of Makkah city using a multistage cluster sampling method. Two data collectors visited the schools to administer the study questionnaire, exploring teachers' perceptions of teledentistry. The questionnaire was adapted from a validated survey based on the technology acceptance model (TAM). Descriptive statistics, analysis of variance, Mann-Whitney U test, and the Kruskal-Wallis tests were conducted to compare the mean differences in participants' perceptions of teledentistry based on their demographics. RESULTS A total of 241 teachers completed the survey, 131 of whom were females (54.4%), and the mean age of participants was 42.5±7 years. Over 80% of participants taught ≥16 classes a week, and their experience ranged from less than a year to more than 31 years. Sixty participants (25%) knew teledentistry before watching the study video. The results revealed a significant difference between male and female teachers regarding perceptions of teledentistry. Female participants had higher scores in TAM dimensions than males. CONCLUSION This survey revealed a generally favorable attitude toward teledentistry utilization in schools. Including non-dental employees, such as teachers to provide such a service will assist in alleviating the shortage or unavailability of dentists at schools. This goes in line with the government's plans to promote telehealth as part of the Saudi Vision 2030.
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Affiliation(s)
| | | | | | | | | | | | - Sherif S Hassan
- Basic and Clinical Oral Sciences, Umm Al-Qura University, Makkah, SAU
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Qari AH, Hadi M, Alaidarous A, Aboalreesh A, Alqahtani M, Bamaga IK, Patel J, Estai M. The accuracy of asynchronous tele-screening for detecting dental caries in patient-captured mobile photos: A pilot study. Saudi Dent J 2024; 36:105-111. [PMID: 38375381 PMCID: PMC10874790 DOI: 10.1016/j.sdentj.2023.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 10/02/2023] [Accepted: 10/09/2023] [Indexed: 02/21/2024] Open
Abstract
Objectives Unaided visual inspection is a primary dental screening technique. Given the uneven distribution of dental services and prolonged waiting periods, an alternative screening approach is required to increase access to dental care. The purpose of this study was to evaluate the accuracy and reliability of tele-screening for detecting dental caries using mobile intra-oral photos taken by participants. Methods Dental care seekers attending Umm Al-Qura University Teaching Dental Hospital in 2022 were invited to participate in this study. The participants were initially examined by dental interns at the hospital under the supervision of faculty dentists (reference standard) before intra-oral photos were acquired by a trained sixth-year dental student using a Samsung S10 camera. Following an introduction to the photography guide, the same participants then took intra-oral photos of their teeth at home using their mobile devices, which were all uploaded to WhatsApp for later review. Two trained dental reviewers (sixth-year dental students) independently reviewed the intra-oral photos. Sensitivity, specificity, and Kappa scores were estimated to assess the performance of the tele-screening approach relative to the reference unaided dental examination. Results Twenty-three participants, with a mean age of 30 ± 12 years, were enrolled. The mean decayed, missing, and filled teeth (DMFT) was 13.43 ± 5.48. Patient-delivered tele-screening demonstrated a sensitivity, specificity, and inter-rater reliability kappa of 94 %, 90 %, and 0.81, respectively, when compared to unaided dental examination. Dentist-delivered tele-screening approach demonstrated a sensitivity of 88-89 %, specificity of 88-91 %, and kappa score of 0.75-0.79 relative to unaided dental examination. Conclusions This study demonstrated that the tele-screening approach based on reviewing intra-oral photos taken by participants can be a valid and reliable alternative to unaided dental examination. This is important for ensuring sustainable access to dental care.
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Affiliation(s)
- Alaa Husni Qari
- College of Dental Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Moayad Hadi
- College of Dental Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Alawi Alaidarous
- College of Dental Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | | | - Majed Alqahtani
- College of Dental Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Ibraheem K. Bamaga
- College of Dental Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Jilen Patel
- UWA Dental School, University of Western Australia, Perth, Australia
| | - Mohamed Estai
- School of Human Sciences, University of Western Australia, Perth, Australia
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Azimi S, Fernando C, Estai M, Patel J, Silva D, Tennant M. Experience of primary caregivers in utilising an mHealth application for remote dental screening in preschool children. AUST HEALTH REV 2023; 47:545-552. [PMID: 37580061 DOI: 10.1071/ah23110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 07/28/2023] [Indexed: 08/16/2023]
Abstract
Objectives This study aimed to address the acceptance of mHealth applications for a dental screening app that facilitates patient information entry and captures dental photos remotely to assist in caries diagnosis in preschool children in Australia. Methods All participants were recruited through the ORIGINS Project, a community-based interventional birth cohort study in Western Australia. Forty-two primary caregivers, who were the users of a teledental screening app, were given a questionnaire with 17 questions; these were constructed based on the theme of the Technology Acceptance Model: perceived ease of use (PE), perceived usefulness (PU), behavioural intention to adopt (BI), anxiety (ANX), attitude toward a behaviour (ATB), and self-efficacy (SE). Cronbach's alpha was estimated to determine internal consistency. Path analysis was employed to quantify the relationship between each theme. Results The mean values for most themes indicated high satisfaction with the intervention among caregivers (scores out of 5): PE (4.54 ± 0.55), PU (4.65 ± 0.49), BI (4.40 ± 0.65), ATB (4.23 ± 0.70), SE (4.36 ± 0.64). Results indicated high consistency in response in the PE, PU, ATB, and SE (α = 0.74-0.84) and moderate consistency was observed in ANX and BI (α = 0.50-0.62). The overall intention of using the dental screening app was significantly related to both PU and ATB (P Conclusion The perceived usefulness and attitude toward behaviours influenced the overall behavioural intention of the participants to use the telehealth model in dental screening. Recognising these relationships indicates community readiness for implementing the telehealth application in the dental program and enables identification of areas for improving its diffusion.
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Affiliation(s)
- Somayyeh Azimi
- School of Human Sciences, University of Western Australia, Crawley, 35 Stirling Highway, Crawley, WA 6009, Australia
| | - Chrishan Fernando
- School of Nursing and Midwifery, Curtin University, Building 405, Bentley, WA 6102, Australia
| | - Mohamed Estai
- School of Human Sciences, University of Western Australia, Crawley, 35 Stirling Highway, Crawley, WA 6009, Australia; and The Australian e-Health Research Centre, CSIRO, Kensington, WA, Australia
| | - Jilen Patel
- Dental School, University of Western Australia, Nedlands, WA, Australia
| | - Desiree Silva
- Telethon Kids Institute, University of Western Australia, Nedlands, WA, Australia; and Joondalup Health Campus, Joondalup, WA, Australia; and Medical School, The University of Western Australia, Perth, Australia
| | - Marc Tennant
- School of Human Sciences, University of Western Australia, Crawley, 35 Stirling Highway, Crawley, WA 6009, Australia; and School of Allied Health, University of Western Australia, Crawley, 35 Stirling Highway, Crawley, WA 6009, Australia
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Valizadeh-Haghi H, Valizadeh-Haghi S, Naslseraji N, Zandian H. Smartphone Photography as a Teledentistry Method to Evaluate Anterior Composite Restorations. Int J Dent 2023; 2023:3171140. [PMID: 37469491 PMCID: PMC10353899 DOI: 10.1155/2023/3171140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 06/14/2023] [Accepted: 06/27/2023] [Indexed: 07/21/2023] Open
Abstract
Objective Today, teledentistry have gain more attention than past due to the advances in technology. The aim of this study was to compare the use of smartphone photography as a method in teledentistry with the face-to-face examination in the evaluation of anterior composite restorations. Materials and Methods In this study, photographs of 24 composite restorations in patients attended to the clinic of Ardabil Dental School were obtained using a smartphone without any additional equipment and sent by email to 10 remote observers. As a gold standard method, these restorations were evaluated by an experienced expert in restorative dentistry a face-to-face examination. In both methods FDI criteria were used to evaluate the restorations and classified them as acceptable or not. Sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy of the photographic method relative to face-to-face method were calculated. Furthermore the Mann-Whitney U test was used to statistically compare the two methods in detail. Results The sensitivity, specificity, positive predictive value, and negative predictive value of the smartphone photography method was 69.35%, 48.72%, 87.34%, and 23.75%, respectively. A diagnostic accuracy of 65.97% was obtained. Statistically, in overall the photographic method rated the restorations as better than they were in reality (face-to-face examination) (p = 0.002). Conclusions The diagnostic accuracy of the method of evaluating anterior composite restorations by smartphone photography was moderate and the use of this method in teledentistry, although was promising, needs to be improved.
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Affiliation(s)
- Haleh Valizadeh-Haghi
- Department of Operative Dentistry, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Safa Valizadeh-Haghi
- Department of Operative Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nasim Naslseraji
- Department of Operative Dentistry, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Hamed Zandian
- Social Determinants of Health Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
- Centre for Public Health and Wellbeing, School of Health and Social Wellbeing, College of Health, Science and Society, University of the West of England, Bristol, UK
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Priyank H, Verma A, Zama Khan DU, Prakash Rai N, Kalburgi V, Singh S. Comparative Evaluation of Dental Caries Score Between Teledentistry Examination and Clinical Examination: A Systematic Review and Meta-Analysis. Cureus 2023; 15:e42414. [PMID: 37637546 PMCID: PMC10448226 DOI: 10.7759/cureus.42414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 07/24/2023] [Indexed: 08/29/2023] Open
Abstract
Dental caries is a common dental health problem affecting all age groups across the globe. Accurate detection and assessment of dental caries are crucial for effective treatment and preventive measures. Teledentistry, which involves remote dental assessment using digital technologies, has shown promise as a potential tool for caries screening. This systematic review and meta-analysis aims to compare the dental caries scores obtained from clinical examinations and teledentistry assessments. Literature searches were conducted across databases such as PubMed, Embase, the Cochrane Library, Scopus, the Web of Science, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and PsycINFO by using predefined search terms and inclusion criteria. Two reviewers separately extracted the data. The study designs, evaluation techniques, dentition types, mean scores, and follow-up times of the included studies were examined. The New Castle-Ottawa Scale was used to assess the risk of bias. Review Manager (RevMan) (computer program) Version 5.4, The Cochrane Collaboration 2020, was used for the quantitative assessment of the data. Eight studies met the inclusion criteria and were included in the review. The findings revealed that teledentistry assessments (based on intraoral photographs captured using smartphones or intraoral cameras) demonstrated comparable accuracy to traditional clinical examinations in detecting and assessing dental caries. Among the four studies that were quantitatively analysed, no significant difference was noted at p = 0.09. A mean difference of 0.64 (95% confidence interval (CI): -0.10; 1.38) suggested that clinical examination and teledentistry-based checkup were on par with each other for the detection of dental caries. The New Castle-Ottawa scale (NOS) grading indicated that the studies were of good quality. Teledentistry may be an effective approach for identifying and evaluating dental caries. However, further research is required to substantiate the findings observed in the present review.
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Affiliation(s)
- Harsh Priyank
- Department of Conservative, Endodontics, and Aesthetic Dentistry, Dental College, Rajendra Institute of Medical Sciences, Ranchi, IND
| | - Ankita Verma
- Department of Pedodontics and Preventive Dentistry, Hazaribagh College of Dental Sciences and Hospital, Ranchi, IND
| | - Danish Uz Zama Khan
- Department Of Dentistry, Era's Lucknow Medical College and Hospital, Lucknow, IND
| | - Narendra Prakash Rai
- Department of Oral Medicine and Radiology, Faculty of Dentistry, Malaysian Allied Health Sciences Academy (MAHSA) University, Petaling Jaya, MYS
| | - Veena Kalburgi
- Department of Periodontics and Implantology, People's College of Dental Sciences and Research Centre, People's University, Bhopal, IND
| | - Shweta Singh
- Department of Public Health Dentistry, Babu Banarsi Das College of Dental Sciences, Babu Banarasi Das University, Lucknow, IND
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Azimi S, Estai M, Patel J, Silva D. The feasibility of a digital health approach to facilitate remote dental screening among preschool children during COVID-19 and social restrictions. Int J Paediatr Dent 2023; 33:234-245. [PMID: 36718534 DOI: 10.1111/ipd.13054] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 01/15/2023] [Accepted: 01/21/2023] [Indexed: 02/01/2023]
Abstract
BACKGROUND Tele-dentistry can be useful to facilitate screening of children, especially those living in rural and remote communities, and during the COVID-19 pandemic. AIM This study evaluated the feasibility of tele-dental screening for the identification of early childhood caries (ECC) in preschoolers using an app operated by their parents with remote review by oral-health therapists. DESIGN This cross-sectional study was a sub-project nested in ORIGINS Project, a longitudinal birth cohort study in Western Australia. Initially, children were visually examined by a paediatric dentist (gold standard). Subsequently, dental photographs were taken by parents using a smartphone camera. Two trained oral health professionals asynchronously evaluated dental photographs. The presence of dental caries was recorded as per the International Caries Detection and Assessment System-II classification. The diagnostic accuracy and reliability of the tele-dental screening and the gold standard dental examinations were then compared. RESULTS Forty-two children aged <4 years were enrolled in the study. Twenty-five per cent of examined children had dental caries (mean dmfs = 0.7). A total of 370 dental photographs were obtained. Parents were able to take good-quality photographs, with 90% of photographs rated as good to fair quality. Tele-dental screening demonstrated high specificity (>=95.5%) for both reviewers compared to the gold standard dental examination. However, the sensitivity scores for the two reviewers varied, ranging from 44% to 88.4%. CONCLUSION Tele-dental screening for ECC was shown to be a feasible approach following a brief training for primary caregivers. This approach can offer a potential low-cost and sustainable alternative for visual dental examinations for young children, particularly in times of COVID-19-related restrictions.
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Affiliation(s)
- Somayyeh Azimi
- School of Human Sciences, University of Western Australia, Crawley, Western Australia, Australia
| | - Mohamed Estai
- School of Human Sciences, University of Western Australia, Crawley, Western Australia, Australia
- The Australian e-Health Research Centre, CSIRO, Kensington, Western Australia, Australia
| | - Jilen Patel
- Dental School, University of Western Australia, Nedlands, Western Australia, Australia
| | - Desiree Silva
- Telethon Kids Institute, University of Western Australia, Nedlands, Western Australia, Australia
- Joondalup Health Campus, Joondalup, Western Australia, Australia
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Németh O, Simon F, Benhamida A, Kivovics M, Gaál P. eHealth, teledentistry and health workforce challenges: results of a pilot project. BMC Oral Health 2022; 22:552. [PMID: 36456948 PMCID: PMC9713149 DOI: 10.1186/s12903-022-02603-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 11/16/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND In the twenty-first century, health systems have to cope with the challenges posed by their rapidly changing environment. Among these changes, the emergence of digital health solutions is an opportunity to make health systems better, but also a compelling force to change. Community dentistry is one area of health care, where the rapid technological development has the potential for substantial performance improvement benefitting dental patients in terms of access to care and conveniance. METHODS This study is based on a survey of the dental care provided by three units (Oral Medicine, Periodontology, Orthodontics) of the Department of Community Dentistry, Semmelweis University, Budapest. During a period of 12 weeks, we have collected time balance data on 1131 patients, 539 in the traditional and 592 in a pilot teledentistry setting, in order to estimate how much time could be spared by monitoring patients through videoconferencing instead of face-to-face visits. RESULTS According to our findings, teledentistry has the potential to shorten the visit with an average of 5-10 min per patient, which adds up to 58-116 work hours in a year. If the pilot was rolled out to all the 13 chairs of the surveyed 3 specialties (orthodontics, periodontology and oral medicine) the time saving would sum up to 186 workdays in one shift alone, which would translate to close to 4500 additional patients per year, considering remote patient monitoring cases alone. Further, if inactive doctors and highly qualified dental hygienists were involved in delivering telecare, 2.67 times as many workdays could be spared, which would allow about 12,000 more patients treated per year. CONCLUSIONS The rapid development of digital health technologies coupled with the evolving task distribution between health professionals have a great potential to improve health system performance in pursuit of population health. Unfortunately, the adaptation to these technological changes is uneven, and without a national strategy, the poor will unlikely benefit from these opportunities in public dental care.
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Affiliation(s)
- Orsolya Németh
- grid.11804.3c0000 0001 0942 9821Department of Community Dentistry, Faculty of Dentistry, Semmelweis University, Budapest, 1088 Hungary
| | - Fanni Simon
- grid.11804.3c0000 0001 0942 9821Department of Community Dentistry, Faculty of Dentistry, Semmelweis University, Budapest, 1088 Hungary
| | - Abdallah Benhamida
- grid.440535.30000 0001 1092 7422Abdallah Benhamida BioTech Research Center, Óbuda University, Bécsi Út 96/B, Budapest, 1034 Hungary
| | - Márton Kivovics
- grid.11804.3c0000 0001 0942 9821Department of Community Dentistry, Faculty of Dentistry, Semmelweis University, Budapest, 1088 Hungary
| | - Péter Gaál
- grid.11804.3c0000 0001 0942 9821Health Services Management Training Centre, Faculty of Health and Public Administration, Semmelweis University, Budapest, 1125 Hungary ,grid.5120.60000 0001 2159 8361Department of Applied Social Sciences, Faculty of Technical and Human Sciences, Târgu-Mureș, Hungarian University of Transylvania, Transylvania, Romania
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Poirier B, Jensen E, Sethi S. The evolution of the teledentistry landscape in Australia: A scoping review. Aust J Rural Health 2022; 30:434-441. [PMID: 35567780 PMCID: PMC9542832 DOI: 10.1111/ajr.12874] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 03/24/2022] [Accepted: 04/06/2022] [Indexed: 01/18/2023] Open
Abstract
INTRODUCTION There has been a recent surge in the use of teledentistry services in Australia that has paralleled the COVID-19 pandemic. Due to the limited published literature reflecting on this transition, this article employed a systematic scoping review methodology. OBJECTIVE The objective was to explore the role of teledentistry in the provision of clinical dental services in Australia. DESIGN Two independent reviewers searched PubMed, Embase, Scopus, Web of Science and grey literature sources to identify literature eligible for inclusion. The search was restricted to Australia and service delivery. Data were categorically synthesised by modalities and reported benefits and limitations; findings were cross-referenced with the COVID-19 pandemic timeline. FINDINGS The systematic search identified 758 articles, of which 25 met the inclusion criteria. Results highlight a range of service providers and definitions of teledentistry. A shift in modality from asynchronous towards synchronous teledentistry pre- and post-COVID-19 pandemic is detailed. DISCUSSION Whilst highly useful during the COVID-19 pandemic, teledentistry provides a unique opportunity to continue to increase the accessibility of dental services, especially for patients in rural areas or those who are immunocompromised. CONCLUSION Clinicians and researchers must consider opportunities to merge existing research with the recent clinical uptake of teledentistry for patients that would benefit from teledental services beyond the COVID-19 pandemic.
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Affiliation(s)
- Brianna Poirier
- Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Emilija Jensen
- Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia.,Department of Paediatric Dentistry, Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - Sneha Sethi
- Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
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AlShaya M, Farsi D, Farsi N, Farsi N. The accuracy of teledentistry in caries detection in children – A diagnostic study. Digit Health 2022; 8:20552076221109075. [PMID: 35774249 PMCID: PMC9237921 DOI: 10.1177/20552076221109075] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 06/06/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction : The increasing burden of dental caries and the lack of effective dental caries screening protocols in non-dental settings, such as schools, demand an innovative and cost-effective approach. Teledentistry is the field of dentistry that combines telecommunication with health records and digital imaging to improve access to dental care and help in epidemiological surveys. This study aimed to assess the accuracy of non-dentist teledentistry in caries detection compared with the clinical dental examination of a sample of 5–10-year-old schoolchildren. Methods A calibrated dentist examined schoolchildren aged 5–10 years old. The dentist and two teachers took intraoral photographs for each child, using a smartphone. The photographs were concealed; therefore, the dentist assessed the three sets of photographs blindly two weeks after the clinical examination. Accuracy was measured to compare the teledentistry examination with the clinical dental examination. Results The mean DMFT of primary teeth was 3.38, 3.42, and 3.17 upon clinical examination, dental-teledentistry examination (findings of photographs taken by a dentist), and non-dental teledentistry (findings of photographs taken by teachers), respectively. The mean DMFT of permanent teeth was 0.75, 0.69, and 0.65 upon clinical examination, dental-teledentistry examination, and non-dental teledentistry examination, respectively. In primary teeth, dental teledentistry and non-dental teledentistry examinations showed 95 and 98.3 sensitivity and 94.3 and 91.4 specificity, respectively. In permanent teeth, dental teledentistry and non-dental teledentistry examinations showed 80.8 and 88.5 sensitivity and 94.1 and 96.1 specificity, respectively. Conclusions Teledentistry has acceptable accuracy for caries detection in schoolchildren compared to a clinical dental examination.
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Affiliation(s)
- Mohammad AlShaya
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
- Ministry of Health, Jeddah, Saudi Arabia
| | - Deema Farsi
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Nada Farsi
- Dental Public Health Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Najat Farsi
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
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