LinguAPP: An m-Health Application for Teledentistry Diagnostics

A fusion architecture to deliver multipurpose mobile health services

Mobile Health (mHealth) services typically make use of customized software architectures, leading to development-dependent fragmentation. Nevertheless, irrespective of their specific purpose, most mHealth services share common functionalities, where standard pieces could be reused or adapted to expedite service deployment and even extend the follow-up of appearing conditions under the same service. To harness compatibility and reuse, this article presents a data fusion architecture proposing a common design framework for mHealth services. An exhaustive mapping of mHealth functionalities identified in the literature serves as starting point. The architecture is then conceptualized making use of the Joint Directors of Laboratories (JDL) data fusion model. The aim of the architecture is to exploit the multi-source data acquisition capabilities supported by smartphones and Internet of Things devices, and artificial intelligence-enabled feature fusion. A series of interconnected fusion layers ensure streamlined data management; each layer is composed of microservices which may be implemented or omitted depending on the specific goals of the healthcare service. Moreover, the architecture considers essential features related to authentication mechanisms, data sharing protocols, practitioner-patient communication, context-based notifications and tailored visualization interfaces. The effectiveness of the architecture is underscored by its instantiation for four real cases, encompassing risk assessment for youth with mental health issues, remote monitoring for SARS-CoV-2 patients, liquid intake control for kidney disease patients, and peritoneal dialysis treatment support. This breadth of applications exemplifies how the architecture can effectively serve as a guidance framework to accelerate the design of mHealth services.

Perception of Remote Learning by Fixed Prosthodontic Students at a Romanian Faculty of Dentistry

The COVID-19 pandemic has forced the transfer of traditional on-site educational activities to the online environment. This study aimed to evaluate the perception and acceptance of remote learning among fixed prosthodontic students attending the Faculty of Dental Medicine of "Grigore T. Popa" University of Medicine and Pharmacy in Iasi, Romania, and to analyze the feedback regarding their experience with the new online methods, the perceived quality thereof and suggestions for improvement. An observational cross-sectional, online study based on 22 questions was conducted with 259 students. The general opinion of online education was good or very good (40.15%); regarding its efficiency, 28.57% found it efficient while 34.36% found it inefficient or very inefficient; regarding the pleasure of learning online, 45.95% of students enjoyed online learning, while 36.64% did not enjoy it. The problem that was most cited by respondents was that of keeping all students motivated and involved (65.6%). Sixty-two percent of the respondents believe that online dental education should not exist, or just to a small extent, a result justified by the practical nature of the profession. The general opinion was that health risks should be managed and mitigated by using a hybrid system that would allow students to do on-site clinical training with direct contact with patients.

Teledentistry use during the COVID-19 pandemic: perceptions and practices of Ontario dentists

BACKGROUND

Teledentistry has demonstrated to expedite oral health consultations, diagnosis, and treatment planning while mitigating COVID-19 transmission risk in dental offices. However, the use of teledentistry by clinicians remains suboptimal. Therefore, this study aimed to determine the perceptions and practices of teledentistry among dentists during the COVID-19 pandemic in Ontario, Canada, and identify associated factors.

METHODS

A cross-sectional study using an online 39 item survey was conducted among Ontario dentists in December 2021. The questionnaire inquired about socio-demographic attributes, as well as perceptions of teledentistry use during the pandemic, and its future application. Descriptive statistics including frequency distribution of categorical variables and univariate analysis of continuous variables were conducted. Chi-square test was used determine the associations between professionals' attributes such as age, gender, years of practice, and location of practice, and respondents use of teledentistry. SPSS Version 28.0 was used for statistical analysis.

RESULTS

Overall, 456 dentists completed the survey. The majority were general dentists (91%), worked in private practices (94%), were between 55 and 64 years old (33%), and had over 16 years of professional experience (72%). Approximately 49.3% reported using teledentistry; 13% started before the pandemic, and 36% during the pandemic. The most common reason for non-utilization was a lack of interest (54%). Respondents identified patient triage, consultation, and patient education as the three most important uses of teledentistry. Female dentists (p < 0.05), dentist working in private practice (p < 0.05), and those who worked in a single dental office (p < 0.05) adopted teledentistry more during the pandemic. Respondents who accessed more resources were more likely to report greater utilization of teledentistry, while those who reported being unconformable with teledentistry (p < 0.05) reported less utilization. Additionally, participants who reported feeling comfortable discussing teledentistry with others (p < 0.05), were more inclined to use it in the future.

CONCLUSIONS

Participants expressed mixed perceptions toward teledentistry with more than half indicating it is reliable for patient triaging and patient follow-ups. Despite the increased utilization during the COVID-19 pandemic, participants' lack of interest in teledentistry emerged as a barrier to its use. More education and knowledge dissemination about teledentistry's areas of application and technical aspects of use can increase interest in this tool, which may lead to a greater uptake by dental professionals.

COVID-19 Related Information on Pediatric Dental Care including the Use of Teledentistry: A Narrative Review

In addition to the direct impact of the SARS-CoV-2 infection, the COVID-19 pandemic reports multiple effects on people's health and psycho-physical well-being. In the dental field, oral hygiene sessions, regular dental check-ups, and aerosol-generating procedures were commonly postponed, thus resulting in repercussions on oral health also favored by the changing eating and oral hygiene habits during the multiple lockdowns. Furthermore, dental settings and practices were generally perceived as at high risk for SARS-CoV-2 transmission, thus unsafe, and by general and pediatric dentists themselves. Last, the consequences of stress related to deprivation of social life and playful activities should not be underestimated in children, exposing them to the deleterious effects of bad oral habits, with repercussions on the balanced growth and development of the stomatognathic system. The present work intends to analyze the medium-term and long-term impact of COVID-19 on pediatric oral and dental care provision, reviewing pediatric dentistry practice and oral and dental needs of pedodontics patients during the first peak and the various waves of the COVID-19 pandemic, and lessons learned.

Human Monkeypox: Oral Implications and Recommendations for Oral Screening and Infection Control in Dental Practice

The World Health Organization declared the spread of the human monkeypox virus (MPXV) an "emerging threat of moderate health concern" on 23 June 2022. Although about 20,000 cases of Monkeypox (MPX) were recorded in Europe and more than 28,000 in the United States from May to October 2022, their number is still small compared to the number of dental patients treated annually. Therefore, the likelihood of oral healthcare workers encountering an MPX case is relatively low in not endemic regions. In addition, MPX-positive individuals are considered contagious only during the prodromal or acute phase. However, the exact shedding and transmission routes of MPX and the associated risk of transmission in the dental setting remain unclear. Moreover, infected subjects whose disease is confined to the head and neck may require oral and dental care because they complain of lymphadenopathy involving the cervical lymph nodes. Furthermore, MPX lesions may first appear in the oral cavity or perioral area. Therefore, given the recent spread of MPXV in non-endemic areas where dentists are not used to considering this disease in the differential diagnosis and taking appropriate preventive measures, all oral healthcare providers nowadays should be aware of the oral presentation of MPX for adequate oral screening and appropriate preventive measures for infection control in the dental practice.

Teledentistry Implementation During the COVID-19 Pandemic: Scoping Review

Background

COVID-19 spreads via aerosol droplets. The dental profession is at high risk of contracting the virus since their work includes treatment procedures that produce aerosols. Teledentistry offers an opportunity to mitigate the risk to dental personnel by allowing dentists to provide care without direct patient contact.

Objective

The purpose of this scoping review was to examine the implementation, challenges, strategies, and innovations related to teledentistry during the COVID-19 pandemic lockdown.

Methods

This scoping review evaluated teledentistry use during the pandemic by searching for articles in PubMed and Google Scholar using the search terms teledentistry, tele-dentistry, covid-19, coronavirus, telehealth, telemedicine, and dentistry. Inclusion criteria consisted of articles published in English from March 1, 2020, to April 1, 2022, that were relevant to dentistry and its specialties, and that included some discussion of teledentistry and COVID-19. Specifically, the review sought to explore teledentistry implementation, challenges, strategies to overcome challenges, and innovative ideas that emerged during the pandemic. It followed the 2020 Preferred Reporting Items for Systematic reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR). This approach is organized into 5 distinct steps: formulating a defined question, using the question to develop inclusion criteria to identify relevant studies, an approach to appraise the studies, summarizing the evidence using an explicit methodology, and interpreting the findings of the review.

Results

A total of 32 articles was included in this scoping review and summarized by article type, methodology and population, and key points about the aims; 9 articles were narrative review articles, 10 were opinion pieces, 4 were descriptive studies, 3 were surveys, 2 were integrative literature reviews, and there was 1 each of the following: observational study, systematic review, case report, and practice brief. Teledentistry was used both synchronously and asynchronously for virtual consultations, often employing commercial applications such as WhatsApp, Skype, and Zoom. Dental professionals most commonly used teledentistry for triage, to reduce in-person visits, and for scheduling and providing consultations remotely. Identified challenges included patient and clinician acceptance of teledentistry, having adequate infrastructure, reimbursement, and security concerns. Strategies to address these concerns included clinician and patient training and utilizing Health Insurance Portability and Accountability Act-compliant applications. Benefits from teledentistry included providing care for patients during the pandemic and extending care to areas lacking access to dental care.

Conclusions

Pandemic lockdowns led to new teledentistry implementations, most commonly for triage but also for follow-up and nonprocedural care. Teledentistry reduced in-person visits and improved access to remote areas. Challenges such as technology infrastructure, provider skill level, billing issues, and privacy concerns remain.

Dental Care and Education Facing Highly Transmissible SARS-CoV-2 Variants: Prospective Biosafety Setting: Prospective, Single-Arm, Single-Center Study

With the arrival of the highly transmissible Omicron variants (BA.4 and BA.5), dentistry faces another seasonal challenge to preserve the biosafety of dental care and education. With the aim of protecting patients, students, teachers and healthcare professionals, this paper introduces a prospective sustainable biosafety setting for everyday dental care and education. The setting developed by dental clinicians, epidemiologists, and teachers of dentistry consists of a combination of modern technologies focused on the air-borne part of the viral pathway. The introduced biosafety setting has been clinically evaluated after 18 months of application in the real clinical environment. The protocol has three fundamental pillars: (1) UVC air disinfection; (2) air saturation with certified virucidal essences with nebulizing diffusers; (3) complementary solutions including telehealth and 3D printing. A pseudonymous online smart form was used as the evaluation method. The protocol operates on the premise that everybody is a hypothetical asymptomatic carrier. The results of a clinical evaluation of 115 patient feedbacks imply that no virus transmission from patient to patient or from doctor to nurse was observed or reported using this protocol, and vice versa, although nine patients retrospectively admitted that the clinic visit is likely to be infectious. Despite these promising results, a larger clinical sample and exposition to the current mutated strains are needed for reliable conclusions about protocol virucidal efficiency in current dental environments.

Is Teledentistry a Method for Optimizing Dental Practice, Even in the Post-Pandemic Period? An Integrative Review

Background: For the past two and half years, dentists all across the world, along with their patients, have faced numerous challenges. In this context, the aim of this integrative review was to assess if dentists’ and patients’ attitudes regarding teledentistry (TD) have changed since the COVID-19 outbreak, and if the use of TD will continue to rise, even in the post-pandemic period; (2) Methods: A literature search was performed between August 2021 and January 2022. The PubMed, Scopus, and Science Direct databases were searched for articles published between 2012 and 2022 using a combination of the following Mesh terms: “COVID-19”, “pandemic”, “oral telemedicine”, “teledentistry”; (3) Results: Among the 52 included papers, nine papers were published between 2011 and 2019, and 43 articles were published after 2020 (12 were published in 2020, 29 papers were published in 2021, and two in 2022). Among the articles published before 2020, seven out of nine included papers were reviews, and two were original research. Among the 43 papers published after 2020, 18 were reviews and 25 original research. (4) Conclusions: Based on the results of this integrative review, there is clear evidence that the interest in teledentistry and teleassistance in the dental field has increased rapidly, especially in the context of the COVID-19 pandemic. Therefore, while dental practitioners should be encouraged to keep themselves updated about new technologies, patients should also be constantly informed about their options for receiving special oral health care.