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The efficacy of remote screening for dental caries by mid‐level dental providers using a mobile teledentistry model
Author(s) -
Estai Mohamed,
Kanagasingam Yogesan,
Huang Boyen,
Checker Hellen,
Steele Lesley,
Kruger Estie,
Tennant Marc
Publication year - 2016
Publication title -
community dentistry and oral epidemiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.061
H-Index - 101
eISSN - 1600-0528
pISSN - 0301-5661
DOI - 10.1111/cdoe.12232
Subject(s) - medicine , dentistry , telemedicine , health care , economics , economic growth
Objectives This study aimed to determine whether intraoral photographic assessment by mid‐level dental providers ( MLDP s) offers a valid and reliable means of dental caries screening. Methods A mobile teledentistry model was developed to facilitate the acquisition of dental images, and transmission and reviewing of data. One hundred regularly attending patients at a dental clinic participated in the study. Following an on‐site clinical examination by a senior dentist, photographs of participants' teeth were taken by a teledental assistant, using a smartphone camera. These intraoral photographs were directly uploaded from an Android App to a cloud‐based server, ‘Remote‐i’, using an encrypted store‐and‐forward telemedicine technology. The photographic assessment carried out by two independent screeners ( MLDP s), was compared to the visual oral examination scores of a benchmark examiner. Results The sensitivity and specificity values for the photographic assessment method (assessed by screeners) as compared to the direct visual examination ranged from 60% to 68%, and 97% to 98%, respectively. The intra‐rater reliability for the photographic assessment was almost perfect, with a kappa score of 0.89. The inter‐rater reliability between the photographic and visual oral assessments ranged from moderate to substantial agreement, with kappa scores ranging from 0.57 to 0.61. Conclusion A new smartphone‐based mobile teledentistry model used by mid‐level dental providers shows potential for remote screening of dental caries.