Current state of dental informatics in the field of health information systems: a scoping review

Barriers and facilitators for the implementation of electronic dental record systems: Perspectives from a developing country

INTRODUCTION

The need for dental data in healthcare services and the inadequacy of paper records due to their inherent limitations have led to a shift towards electronic dental record systems (EDR). Implementing EDR comes with numerous barriers and challenges. Therefore, this research was conducted to identify the implementation barriers and facilitators for EDRs.

METHODS

This descriptive-analytical cross-sectional study was conducted on dentists working in public and private clinics in Tehran, Iran. A questionnaire consisting of three sections was designed to collect data on the demographic information of dentists, the barriers in five categories including financial barriers (6 questions), organizational barriers (11 questions), technical barriers (5 questions), personal barriers (3 questions), and ethical and legal barriers (6 questions), as well as facilitators for the implementation of EDR (15 questions) based on the literature, using a five-point Likert scale. 130 dentists from 60 dental clinics participated in the study. The data were analyzed using descriptive statistics (calculating frequency distribution, mean, and standard deviation). The mean scores were classified into four categories based on quartiles from very low importance to very high importance including very low importance (mean ≤ 1.25), low importance (1.25 ≥ mean < 2.5), important (2.5 ≥ mean < 3.75), and very high importance (mean ≥ 3.75). Finally, each of the barriers and facilitators among user dentists and non-user dentists was compared using the Mann-Whitney U test. The data were analyzed using SPSS software.

RESULTS

The findings indicate that dentists consider all barriers and challenges in implementing EDR to be important, and all the proposed facilitators for addressing these challenges to be very important. Among these important barriers are the rapid turnover of managers and policymakers at higher levels (3.69 out of 5) as a personal barrier, legal issues related to electronic records (3.65 out of 5) as an ethical-legal barrier, the lack of necessary standards for data exchange between different systems (3.64 out of 5) as a technical barrier, dentists' limited awareness of the benefits of this system (3.63 out of 5) as a personal barrier, and the lack of suitable legal infrastructure for EDR implementation (3.62 out of 5) as an ethical-legal barrier. Additionally, among the very important facilitators, training dentists and staff on EDR (4.31 out of 5) is noteworthy.

CONCLUSION

To address the important barriers to EDR implementation, including legal-ethical barriers, legal institutions, and regulators must establish relevant laws and regulations to overcome these obstacles. Furthermore, if system users learn about the features, goals, benefits, and positive impact of EDR on their work and gain the necessary awareness, their resistance to changes will decrease, and their interest and readiness to accept EDR will increase.

Artificial intelligent-driven decision-making for automating root fracture detection in periapical radiographs

BACKGROUND

The detection and early diagnosis of root fractures can be challenging; this difficulty applies particularly to newly qualified dentists. Aside from clinical examination, diagnosis often requires radiographic assessment. Nonetheless, human fallibility can introduce errors due to a lack of experience.

AIM

The proposed system aimed to assist in detecting root fractures through the integration of artificial intelligence techniques into the diagnosis process as a step for automating dental diagnosis and decision-making processes.

MATERIALS AND METHOD

A total of 400 radiographic images of fractured and unfractured teeth were obtained for the present research. Data handling techniques were implemented to balance the distribution of the samples. The AI-based system used the voting technique for five different pretrained models namely, VGG16, VGG19, ResNet50. DenseNet121, and DenseNet169 to perform the analysis. The parameters used for the analysis of the models are loss and accuracy curves.

RESULTS

VGG16 exhibited notable success with low training and validation losses (0.09% and 0.18%, respectively), high specificity, sensitivity, and positive predictive value (PPV). VGG19 showed potential overfitting concerns, while ResNet50 displayed progress in minimizing loss but exhibited bias toward unfractured cases. DenseNet121 effectively addressed overfitting and noise issues, achieving balanced metrics and impressive PPVs for both fractured and unfractured cases (0.933 and 0.898 respectively). With increased depth, DenseNet169 demonstrated enhanced generalization capability.

CONCLUSION

The proposed AI- based system demonstrated high precision and sensitivity for detecting root fractures in endodontically treated teeth by utilizing the voting method.

Improvements in appropriate placement of dental sealants after implementation of a clinical decision support system

BACKGROUND

Dental sealants are effective for the prevention of caries in children at elevated risk levels, and increasing the proportion of children and adolescents who have dental sealants on 1 or more molars is a Healthy People 2030 objective. Electronic health record (EHR)-based clinical decision support systems (CDSSs) have the ability to improve patient care. A dental quality measure related to dental sealant placement for children at elevated risk of caries was targeted for improvement using a CDSS.

METHODS

A validated dental quality measure was adapted to assess a patient's need for dental sealant placement. A CDSS was implemented to advise care team members whether a child was at elevated risk of developing caries and had sealant-eligible first or second molars. Data on dental sealant placement at examination visits during a 5-year period were analyzed, including 32 months before CDSS implementation and 28 months after CDSS implementation.

RESULTS

From January 1, 2018, through December 31, 2022, the authors assessed 59,047 examination visits for children at elevated risk of developing caries and with sealant-eligible teeth. With the implementation of a CDSS and training to support the clinical care team members in September 2020, the appropriate placement of dental sealants at examination visits increased from 27% through 60% (P < .00001).

CONCLUSIONS

Integration of a CDSS into the EHR as part of a quality improvement program was effective in increasing the delivery of sealants in eligible first and second molars of children aged 5 through 15 years and considered at high risk of developing caries.

PRACTICAL IMPLICATIONS

An EHR-based CDSS can be implemented to improve standardization and provide timely and appropriate patient care in dental practices.

Surveying the landscape of diagnostic imaging in dentistry's future: Four emerging technologies with promise

BACKGROUND

Advances in digital radiography for both intraoral and panoramic imaging and cone-beam computed tomography have led the way to an increase in diagnostic capabilities for the dental care profession. In this article, the authors provide information on 4 emerging technologies with promise.

TYPES OF STUDIES REVIEWED

The authors feature the following: artificial intelligence in the form of deep learning using convolutional neural networks, dental magnetic resonance imaging, stationary intraoral tomosynthesis, and second-generation cone-beam computed tomography sources based on carbon nanotube technology and multispectral imaging. The authors review and summarize articles featuring these technologies.

RESULTS

The history and background of these emerging technologies are previewed along with their development and potential impact on the practice of dental diagnostic imaging. The authors conclude that these emerging technologies have the potential to have a substantial influence on the practice of dentistry as these systems mature. The degree of influence most likely will vary, with artificial intelligence being the most influential of the 4.

CONCLUSIONS AND PRACTICAL IMPLICATIONS

The readers are informed about these emerging technologies and the potential effects on their practice going forward, giving them information on which to base decisions on adopting 1 or more of these technologies. The 4 technologies reviewed in this article have the potential to improve imaging diagnostics in dentistry thereby leading to better patient care and heightened professional satisfaction.

Implementation of Blockchain Technology Across Different Domains of Dentistry: A Systematic Review

Blockchain technology has gained attention as a potential solution for improving data security, privacy, and interoperability in various industries, including healthcare. In the field of dentistry, the implementation of blockchain holds promise for transforming dental practice and management. However, a comprehensive evaluation of the existing literature regarding the implementation of blockchain technology in dental practice is lacking. This systematic review aimed to assess the current evidence on the implementation of blockchain technology in dental practice and management. A systematic literature search was conducted using major databases to identify relevant studies. The search strategy included keywords related to blockchain technology and dentistry. The investigation was performed as per the PRISMA guidelines. Studies reporting on the implementation, adoption, and outcomes of blockchain technology in dental practice and management were included. Quality assessment and data extraction were performed following predefined criteria. The initial search yielded a multitude of articles, and after applying the inclusion and exclusion criteria, six studies were included in the systematic review. The studies explored various aspects of blockchain technology implementation in dental practice, including data security, interoperability, supply chain management, and patient consent management. Furthermore, the use of blockchain-based systems showed potential benefits in enhancing supply chain management efficiency and patient consent authentication. This systematic review provided insights into the current state of blockchain technology implementation in dental practice and management. The findings suggested that blockchain technology has the potential to enhance data security, privacy, and interoperability in dental practices. However, further research and real-world implementation studies are needed to fully understand the impact of blockchain technology on dental practice and to address the existing challenges.

The Potential of Blockchain Technology in Dental Healthcare: A Literature Review

Blockchain technology in the healthcare industry has potential to enable enhanced privacy, increased security, and an interoperable data record. Blockchain technology is being implemented in dental care systems to store and share medical information, improve insurance claims, and provide innovative dental data ledgers. Because the healthcare sector is a large and ever-growing industry, the use of blockchain technology would have many benefits. To improve dental care delivery, researchers advocate using blockchain technology and smart contracts due to their numerous advantages. In this research, we concentrate on blockchain-based dental care systems. In particular, we examine the current research literature, pinpoint issues with existing dental care systems, and consider how blockchain technology may be used to address these issues. Finally, the limitations of the proposed blockchain-based dental care systems are discussed which may be regarded as open issues.

The Forefront of Dentistry-Promising Tech-Innovations and New Treatments

KNOWLEDGE TRANSFER STATEMENT

This article discusses innovations in technology and treatments that have enormous potential to revolutionize our dental care, including novel concepts in electronic health records, communication between dentists and patients, biologics around diagnosis and treatment, digital dentistry, and, finally, the real-time optimization of information technology. The early implementation and validation of these innovations can drive down their costs and provide better dental and medical services to all members of our society.