Effectiveness of synchronous teledentistry consultations in facilitating treatment compliance of rural pediatric patients.

BACKGROUND: Limited access to pediatric oral health care in rural US areas is a substantial dental public health problem. In 2010, the Eastman Institute for Oral Health at the University of Rochester, initiated a synchronous teledentistry program to enhance oral health screenings, treatment planning, and treatment completion for rural pediatric patients who reside in the Western region of New York. METHODS: Data from dental records of all pediatric patients who were participants in the teledentistry program from its inception on April 13, 2010 through December 31, 2022, were reviewed. Multiple logistic regression models were used to study the association between treatment compliance rate and age, sex, treatment modality, and impact of the COVID-19 pandemic. RESULTS: Data from the dental records of 1,168 children were reviewed. Nine hundred fifty-four children (81.6%) completed the recommended treatment within 6 months of synchronous teledentistry consultation. Treatment completion rates varied significantly according to treatment modality. In-office consultation had the highest rate (96.8%), followed by oral sedation (89.7%) and operating room treatment (89.5%). Nitrous oxide (66.7%) had the lowest rate (P < .0001). Children recommended for nitrous oxide anxiolysis had the lowest odds of completing treatment (odds ratio, 0.25; 95% CI, 0.18 to 0.36; P < .0001) compared with other treatment modalities. Being older decreased the likelihood of completing treatment (odds ratio, 0.92; 95% CI, 0.85 to 0.99; P = .02). The COVID-19 pandemic did not significantly affect compliance rates. CONCLUSIONS: Synchronous teledentistry consultations with rural pediatric patients and their guardians or caregivers can effectively facilitate treatment completion for children with complex treatment needs in underserved areas. PRACTICAL IMPLICATIONS: Synchronous teledentistry is a practical adjunct tool to be considered in dental offices.

Asynchronous teledentistry program in two long-term care facilities: Iowa's virtual dental home pilot project.

INTRODUCTION: Older adults living in long-term care facilities (LTCFs) often have poor oral health and difficulty accessing dental services. The aim was to implement a virtual dental home (VDH) program for residents in two LTCFs utilizing asynchronous teledentistry techniques and mobile dental equipment. METHODS: This pilot project was a 6-month longitudinal cohort study in two LTCFs. Dental hygienists and dentists from a local community health care center utilized asynchronous teledentistry to provide diagnostic and preventive dental services onsite and to establish a dental home for additional comprehensive care services. Data were collected, including resident's demographics, oral health status, and dental services received. Descriptive data analyses, Wilcoxon signed rank, and McNemar tests were conducted. RESULTS: Thirty-four residents completed in-person baseline oral exams and 16 residents completed the recall exams. Ninety-two percent (n = 23) of dentate residents (n = 25) had untreated caries and 64% (n = 16) of dentate residents had at least one sextant of severe gingival inflammation. The median number of teeth with active untreated caries (p = .01) significantly decreased and arrested caries (p = .02) significantly increased from baseline. CONCLUSION: Iowa's VDH pilot project was successful in establishing a dental home using asynchronous teledentistry for residents in two LTCFs and providing resident access to preventive and disease control dental services.

Applying an extended theoretical approach to identifying Canadian dental students' acceptance of teledentistry: A cross-sectional study.

Objective: Teledentistry is a promising innovation for improving service quality and patient outcomes. While studies have shown the relevance of theoretical frameworks in understanding behaviour change predictors for telehealth implementation efforts, their application in dentistry is limited. This study aimed to test different theoretical approaches to identify the factors affecting dental students' behavioural intention to use teledentistry. Methods: This cross-sectional study involved students in their final two years of undergraduate dental programmes, from three Canadian provinces (Quebec, Nova Scotia, and Saskatchewan) using an electronic self-reported questionnaire. Following descriptive analyses, we tested three theoretical models (the technology acceptance model, psychosocial model, and integrated model) using path analysis and multiple linear regression analysis. We analyzed the modifying effect of sociodemographic characteristics and prior use of teledentistry. Results: Out of the 46 students who participated, the majority were female (53.5%) and aged over 25 years (62.8%). The three models successfully explained a substantial portion of the variance in behavioural intention to use teledentistry, ranging from 58.0% to 76.6%. Social role beliefs (p < 0.001) and control beliefs (p < 0.001) were the most significant predictors of behavioural intention to use. Prior use of teledentistry modified the association between control beliefs and behavioural intention to use teledentistry. Conclusions: The original technology acceptance model was a good predictive model of behavioural intention to use teledentistry with perceived use as the strongest predictor. However, the integrated model performed the best in highlighting the relevance of training and education to foster teledentistry implementation in dental schools. The generalizability of the findings is constrained by the modest sample size, warranting larger studies for validation.

Present state and perceived future use of teledentistry in long-term care facilities in Japan: A cross-sectional study.

Objectives: Teledentistry could be effective in managing oral health through the provision of oral hygiene instruction and diagnostic services. This study aimed to assess the perception and usefulness of teledentistry in Japanese long-term care facilities. Methods: We conducted a questionnaire survey to compare related factors of the usefulness of teledentistry and identify issues in its implementation. We chose 1000 facilities using a stratified random sampling method. The questionnaires were sent to the facilities in August 2021 and collected in December of the same year. Responses to the questionnaire items regarding the usefulness of teledentistry for oral management were divided into three groups according to the answer: perceiving teledentistry as "useful," "not useful," or "neither," including facilities that do not currently use teledentistry. Results: In total, 26.1% (261) responded to the questionnaire, and among these, 184 facilities answered the question regarding the usefulness of teledentistry. Only two of these facilities implemented teledentistry. Facilities with dental hygienists (p = 0.040) and those that receive insured medical treatment: reimbursement for oral feeding maintenance II (p = 0.040) tended to perceive teledentistry as useful in the management of patients with coronavirus disease. The higher the number of services that responded to the question "what kind of services do you think can be provided via teledentistry?" the higher the percentage of "useful" responses. Conclusions: Although only a few facilities use teledentistry, many long-term care facilities perceive it as useful even without using it. The presence of dental hygienists and interprofessional work done with reimbursement for oral feeding maintenance II contributed to the perception of the usefulness of teledentistry in long-term care facilities.

Assessment of teledentistry in improving access to dental care: a systematic review.

Teledentistry has emerged as a promising approach to improving access to dental care, particularly for underserved populations. This systematic review aims to evaluate the effectiveness of teledentistry interventions in enhancing access to dental care. A comprehensive search across multiple databases was conducted to identify studies evaluating teledentistry interventions. Studies were included if they investigated the impact of teledentistry on dental care accessibility, utilization, or patient outcomes. Eligibility criteria were applied systematically to select relevant studies for inclusion. Forty-six studies met the inclusion criteria and were included in the review. The synthesized evidence showed the effectiveness of teledentistry interventions in improving access to oral healthcare services, facilitating timely diagnosis and treatment planning, and enhancing patient outcomes. Despite variations in study designs and methodologies, teledentistry interventions consistently exhibited high diagnostic accuracy and concordance rates compared to traditional face-to-face consultations. The findings highlight teledentistry's transformative potential in modernizing oral healthcare delivery and reducing access disparities.

Integrating oral health in stroke care: a critical necessity.

OBJECTIVES: To highlight the critical role of integrating oral health assessments into routine stroke care for better patient outcomes. MATERIALS AND METHODS: The Eto et al. study utilizes the modified oral assessment grade (mOAG) to evaluate the oral health of acute ischemic stroke patients upon admission and its predictive value for functional outcomes and hospital-acquired pneumonia (HAP). RESULTS: Evidence from Eto et al. study shows that mOAG scores at admission significantly predict 3-month functional outcomes and the incidence of HAP, emphasizing the need for comprehensive oral evaluations. CONCLUSIONS: Integrating oral health assessments into stroke care protocols can improve recovery outcomes, reduce HAP incidence, and lower healthcare costs through preventive oral care. CLINICAL RELEVANCE: Routine oral health evaluations for stroke patients are crucial for better recovery and overall health outcomes, advocating for policy changes and multidisciplinary approaches to patient care.

Oral Health Assessment for Older Residents in Long-Term Care Facilities Using Video Recording by a Mobile Electronic Device.

BACKGROUND/OBJECTIVES: Many older adults who require long-term care need oral health management. However, access to dental care is limited, and connecting older patients with dental professionals is a future challenge. Therefore, the development of a remote oral health assessment system is required. This study aimed to investigate the usefulness of video-based oral health assessments in older adults residing in facilities. METHODS: This study comprised 60 older adults residing in facilities who consented to dental home visit treatment by the Department of Oral Function Management at Showa University Dental Hospital between July 2021 and December 2022. The Oral Health Assessment Tool (OHAT) was used to evaluate the oral health status at the facilities by one dentist. The concordance of the oral health assessments conducted by this dentist at the facilities (OHAT-B) was compared with those conducted by the same dentist (OHAT-V1) and two other dentists (OHAT-V2 and V3) using approximately 1 min video recordings of the oral cavity taken with a mobile electronic device. RESULTS: On the OHAT total score, the intraclass correlation coefficient (ICC [1.1]) for OHAT-B and V1 was 0.931; the ICC (2.1) was 0.889 when compared with V2 and 0.788 when compared with V3. Moreover, the comparison between V2 and V3 showed high agreement, with an ICC (2.1) of 0.750. CONCLUSIONS: This study revealed that the oral health assessment of older adults residing in facilities using video recordings of the oral cavity taken with a mobile electronic device may be possible, suggesting the possibility of remote oral health assessment.

Diabetes and Oral Health: Advancements in Prevention, Screening and Treatment of Periodontal Diseases.

Diabetes is a pervasive metabolic disorder that notably impacts various body systems, including oral health. One of the critical manifestations of diabetes in oral health is its exacerbating effect on periodontal diseases. Recent advancements in the prevention, screening, and treatment of periodontal diseases have become increasingly significant due to the bidirectional link between periodontal health and diabetes management. This review explores contemporary strategies and technological innovations in the comprehensive management of periodontal diseases among diabetic patients. It highlights the integration of digital dentistry tools such as artificial intelligence (AI) and teledentistry in enhancing diagnostic precision and treatment outcomes. Preventive measures, including new pharmacological formulations and lifestyle interventions tailored for diabetic individuals, are discussed. Additionally, the review underscores the importance of routine screening protocols that incorporate glycemic control status to refine treatment plans for periodontal therapies. Furthermore, advancements in regenerative therapies, including the application of growth factors and stem cell therapy, are examined for their potential to restore periodontal tissue integrity, offering promising directions for future research and clinical practice. Through a synthesis of recent literature, this review aims to provide insights into effective periodontal disease management strategies that are critical for improving the overall health and quality of life of individuals with diabetes.

The Use of Audiovisual Distraction Tools in the Dental Setting for Pediatric Subjects with Special Healthcare Needs: A Review and Proposal of a Multi-Session Model for Behavioral Management.

BACKGROUND: A Special Health Care Need (SHCN) is characterized by any type of physical, mental, sensorial, cognitive, emotional, or developmental condition that requires medical treatment, specialized services, or healthcare interventions. These conditions can negatively impact oral health as SHCN children can hardly cooperate or communicate and experience higher levels of dental fear/anxiety, which interfere with regular appointments. The present narrative review aims to analyze the use of audiovisual (AV) tools in dental setting for the management of SHCN children during dental treatment and to evaluate their effectiveness in anxiety/behavior control from the child, dentist, and care-giver perspectives. This analysis leads to the proposal of a new multi-session model for the behavioral management of SHCN pediatric subjects. METHODS: An electronic search on the MEDLINE/Pubmed, Scopus, and Web of Science databases was carried out and through this analysis, a new model was proposed, the "UNISA-Virtual Stepwise Distraction model", a multi-session workflow combining traditional behavior management and the progressive introduction of AV media to familiarize the SHCN child with dental setting and manage behavior. RESULTS: AV tools helped in most cases to manage SHCN behavior and decreased stress in both the dentist and child during dental treatments. Care-givers also welcomed AV distractors, reporting positive feedback in using them during future treatments. CONCLUSIONS: The present narrative review found increasing evidence of the use of AV media for SHCN pediatric subjects as distraction tools during dental treatment. In the majority of the studies, AV tools proved to be effective for the management of anxiety, dental fear, and behavior in dental setting.

Assessing the usability and reliability of a web-based teledentistry tool for remote diagnosis of oral lesions: a cross-sectional study.

BACKGROUND: Oral mucosa lesions are the third most prevalent oral pathology, following caries and periodontal diseases. Teledentistry offers an effective way to manage patients with these lesions. The accuracy of remote diagnoses and consultations relies heavily on the quality of the information and photos sent to remote specialists. This study aims to evaluate the usability and reliability of a teledentistry tool for the remote diagnosis of oral lesions. METHODS: The cross-sectional study included both usability evaluation and reliability assessment. The teledentistry platform, "OralMedTeledent", facilitated synchronous and asynchronous interactions, allowing for patient consultations, remote follow-ups, and doctor-to-doctor consultations. Usability was evaluated by 5 experts using the Nielsen heuristic checklist. Reliability was assessed from August 2022 to September 2023 with 109 patients, using Cohen's kappa coefficient to measure agreement between examiners and the gold standard in diagnosing oral lesions. RESULTS: The findings revealed 66 usability issues, most of which were related to helping users recognize, diagnose, and recover from errors, as well as issues with help and documentation. Among these, 11 issues were of minor severity. The reliability test, conducted with 109 participants (57.8% female, 42.2% male) showed that the web-based teleconsultation system performed significantly well. The system demonstrated significant substantial performance (0.81 ≤ κ < 1; P > 0.05). CONCLUSION: Overall, the web-based teleconsultation system has proven to be reliable for the remote diagnosis of oral lesions, making it a valuable alternative during emergencies such as the COVID-19 pandemic. However, several usability issues have been identified and need to be addressed.

Knowledge and attitude of Iranian dental practitioners toward teledentistry: A web-based descriptive survey.

Background: It is necessary to improve the knowledge and attitude of dental practitioners toward teledentistry for its implementation in the oral healthcare system. The objective of the current study was to investigate the knowledge and attitude of Iranian dental practitioners toward teledentistry. Methods: This descriptive, cross-sectional survey was performed among 387 dental practitioners working in two big cities in Iran. An online self-structured questionnaire that included 34 questions was applied to collect information about the general profile of participants (age, sex, work experience, city of work, and dental specialty), their knowledge, and attitude about teledentistry. Results: Most participants were males (57.9%) and general practitioners (79.6%). Dental practitioners expressed poor knowledge and only 23.50% of them were familiar with teledentistry. However, most of the participants, mainly in Zahedan city, expressed agreement on the potential benefits of teledentistry for patient care and access. More than 80% of dental practitioners agreed with the statement on the application of teledentistry in enhancing access to guidelines, recommendations, and preventive dentistry. However, the majority of dental practitioners believe that the diagnosis by teledentistry is not as accurate as the diagnosis in clinical practice. Conclusion: Our study reveals a positive attitude toward teledentistry among Iranian dentists with a significant knowledge gap. This knowledge gap may be a barrier to teledentistry adoption. Educational programs tailored to address these knowledge gaps are necessary to pave the way for the successful integration of teledentistry into routine dental practice.

The Effect of Coronavirus Disease 2019 and Other Emerging Infections on Dentistry.

The appearance of coronavirus disease 2019 (COVID-19) and other emerging infections has significantly impacted the field of dentistry, leading to widespread changes in practices and protocols. This has included the implementation of strict infection control measures, such as meticulous use of personal protective equipment, minimizing aerosol-generating procedures, and the adoption of teledentistry to reduce in-person contact. To date, the complete impact of delays in dental care caused by lockdowns has yet to be determined. The challenges faced during the COVID-19 pandemic have propelled innovation, shaping a new era of dentistry focused on safety against novel and re-emerging infections.

Impact of behavior and mood of people with specific needs on quality and feasibility of teledentistry: A five years retrospective study.

Background: The e-DENT program, initiated by Montpellier University Hospital's Department of Dentistry, seeks to enhance dental care access for individuals with special needs through teledentistry. This five-year retrospective study focuses on the program's impact, particularly assessing patients' mood and behavior during telemedicine dental examinations and the influence of these factors on diagnostic quality and feasibility. Methods: This retrospective, multicentric observational study analyzed data from January 1, 2018, to April 24, 2023, involving residents of medico-social institutions who participated in the e-DENT program. The study utilized a scoring system based on the PANAS scale, which is used to brief measures of positive and negative affects. We aimed to evaluate mood and behavior. The statistical analysis was conducted using R software, incorporating mixed logistic and linear regressions to assess the impact of various factors on patient behavior, mood scores, and the quality and feasibility of diagnoses. Findings: The study included 682 patients, revealing that the majority exhibited cooperative behavior during their telemedicine consultations, with a median mood score of 2.5. Analysis showed a significant improvement in mood scores from the first to subsequent consultations. The mood score positively correlated with diagnostic feasibility and negatively with visit duration. Specific factors such as type of disability, fear of dental instruments, and patient cooperation significantly influenced the quality of videos taken and the feasibility of diagnoses. Facilities catering to different disability types showed varied mood scores, suggesting tailored approaches may be necessary. Interpretation: The findings underscore the efficacy of teledentistry in providing dental care to individuals with special needs, highlighting the importance of patient mood and behavior in improving diagnostic outcomes. The study suggests that teledentistry can be a well-accepted and effective mode of dental care delivery for this patient group, with implications for optimizing telemedicine practices in medico-social settings.

Dental Caries: The Way Forward.

KNOWLEDGE TRANSFER STATEMENT: It is evident that some progress in reducing ECC prevalence in children has been made, but these improvements are not equally distributed. Systemic inequities in oral health among the youngest, most vulnerable children must be reduced.

Telemedicine Awareness Among Chennai-Based Dentists: A Web-Based Questionnaire Survey.

OBJECTIVES: Teledentistry has emerged as a crucial tool to address oral health needs amidst social distancing measures and lockdowns. Teledentistry during COVID-19 underscores its potential as an adaptive solution, transforming the delivery of dental care and providing a platform for maintaining oral health while prioritizing public safety. The purpose of this study is to investigate the views of Chennai dental professionals on teledentistry, which may serve as a foundation for advancements in patient care and virtual dentistry in the future, and to evaluate awareness, usefulness, and data security regarding telemedicine among Chennai dental professionals using a pretested questionnaire. METHODS: By distributing a pretested web-based questionnaire to licensed dental professionals in Chennai, a descriptive cross-sectional study was conducted. The results were statistically analyzed and evaluated. RESULTS: A total of 90 dentists in Chennai responded to the questionnaire, out of which 65 (72.2%) were aware of teledentistry and 32 (35.6%) practiced teledentistry. Around 25 to 29 (30%-37%) dentists were very much concerned about obtaining patients' consent, digital forgery, confidentiality, and hardware reliability in teledentistry. CONCLUSION: This is the first kind of study ever done among dentists in Chennai, which shows enormous work is required to create awareness and knowledge among dental professionals. To inform dentists and the general public about teledentistry, targeted advertisements pertaining to the same are required.

Developing the teledentistry acceptance survey for dentists - TAS-D: a Delphi study.

INTRODUCTION: The increasing interest in teledentistry since the COVID-19 pandemic warrants an evaluation of dentists' willingness to adopt it. This study aimed to develop a questionnaire to assess dentist's intention to use teledentistry and the associated factors. METHODS: A literature search was used to identify items for the questionnaire. The Unified Theory of Acceptance and Use of Technology (UTAUT2) was adopted as framework. A Delphi panel was constituted of researchers with relevant publications and the International Association of Dental Research e-Oral Health Network members. Three Delphi consultations were conducted to establish consensus on items. Consensus was set at 80% agreement and content validity ratio (CVR), reaffirmed iteratively. RESULTS: Nineteen out of 25 (76%) invited experts participated in the first round, 17 in the second and 15 in the third. The preliminary questionnaire had 81 items in three sections, reduced to 66, 45 and 33 items in the first, second and third rounds. After revision, the final version comprised eight items assessing dentists' backgrounds in Sect. 1, seven items identifying teledentistry uses in Sect. 2, and 17 items assessing intention to use teledentistry and its determinants in seven dimensions in Sect. 3. The initial CVR was 0.45, which increased to 0.80 at the end of the third round. CONCLUSION: A survey tool was developed to assess the acceptance of teledentistry, and its determinants based on the UTAUT2 framework through consensus among teledentistry experts. The tool had excellent validity and needs further evaluation of its psychometric properties.

A Tele-detection and referral pAthways model for early childhood cariEs control- a protocol for a randomized factorial study: the TRACE study.

BACKGROUND: Early childhood caries (ECC) is one of the most common childhood diseases affecting the primary teeth of children younger than 6 years of age. ECC progression can be reversed in the early stages although these lesions often go undetected. New approaches are needed to detect oral diseases at an early stage when they can be better controlled. The aim of the study is to assess the effectiveness of ECC tele-detection methods combined with referral pathways with and without user fee removal in controlling ECC. METHODS: A randomized factorial trial will be used to compare two tele-dentistry detection methods for ECC (intraoral camera and smartphone camera) and two referral pathways (user fee removal versus conventional care). The study will recruit children younger than 6 years of age in marginalized communities in Alexandria, Egypt. The primary outcome is the percentage of teeth receiving indicated care, while the secondary outcomes are the oral health-related quality of life, acceptance of teledentistry by dentists, procedure time, and child cooperation. Two-way analysis of variance will be used to assess the effect of the two factors as between group variables on the outcomes after 6 and 12 months. The interaction between detection methods and referral pathways will also be assessed, and the effect of confounders will be controlled in a multivariable linear regression model. DISCUSSION: The findings of this study have the potential to inform clinical practice and oral healthcare policies for ECC management. Successful tele-detection and referral pathways could be integrated into oral healthcare systems, leading to improved oral health outcomes for children. TRIAL REGISTRATION: The trial has been registered on ClinicalTrials.gov in August 2023 (initial release) ID: NCT06019884.

Accuracy of Dental Symptom Checker Web Application in the Singapore Military Population.

PURPOSE: Symptom checkers (SCs) are virtual health aids to assist laypersons in self-assessing dental complaints. This study aimed to investigate the triage performance, clinical efficacy, and user-perceived utility of a prototype dental SC, Toothbuddy, in assessing unscheduled dental complaints in Singapore. METHODS: A pilot trial was conducted amongst all unscheduled dental attendees to military dental facilities in Singapore from January to May 2023. The accuracy of Toothbuddy to tele-triage dental conditions into 3 categories-routine, urgent, and emergency-was determined. Based on the patient-reported symptoms input, clinical recommendations were provided to users for each category. Thereafter, all dental attendees were clinically assessed to determine the definitive category. Finally, a user questionnaire assessed the application's functionality and utility and the user's satisfaction. Sensitivity and specificity analyses were performed. RESULTS: During the study, 588 patients with unscheduled dental visits presented. Of these cases, 275 (46.8%) were evaluated to be routine dental conditions for which treatment could be delayed or self-managed, 243 (41.3%) required urgent dental care, and 60 (10.2%) required emergency dental intervention. The accuracy of Toothbuddy in identifying the correct category was 79.6% (468/588). Sensitivity and specificity in categorising routine vs non-routine conditions were 94.5% (95% confidence interval, 92.0%-97.1%) and 74.0% (95% confidence interval, 68.8%-79.2%), respectively. The app was generally well received and rated highly. CONCLUSIONS: Preliminary data suggest that Toothbuddy can perform accurate dental self-assessment for a suitable range of common dental concerns and this is a promising platform for virtual advice on spontaneous dental issues. Furthermore, dental facilities are typically not sized to handle the large volumes of unplanned dental visits that may occur in the military population. SC apps to self-manage or delay treatment without adversely affecting disease prognosis may preserve the limited bandwidth of dental facilities in providing acute care and managing true dental emergencies expediently.

Technological aspects and recommendations for applying teledentistry in oral medicine: a scoping review.

BACKGROUND: Teledentistry is applied in oral medicine to help dental practitioners and specialists manage complex oral conditions. This scoping review aims to synthesize the available evidence regarding the technical requirements and the provision of security services, as well as the recommendations on standard oral cavity photography methods for using teledentistry in oral medicine. METHOD: The present scoping review was conducted in 2022 according to the Joanna Briggs Institute (JBI) manual. Four databases were systematically searched, including ISI Web of Science, PubMed, Scopus, and ProQuest, from January 1999 to December 2021. After finalizing the search strategy, all the original articles, reviews, editorials, letters, comments, and book chapters were included. All the dissertations uploaded in English with a full-text electronic file were also included to achieve a comprehensive picture of the available literature. Two types of analysis were applied: the quantitative descriptive analysis applying Excel 2016 and the qualitative thematic analysis using MAXQDA version 10. RESULTS: The included papers were published during 1999-2021. Most of the included articles were from Brazil (n = 9, 21.43%), India (n = 6, 14.28%), the USA (n = 6, 14.28%), and the UK (n = 5, 11.90%). Social media usage as a teledentistry platform increased considerably between 2019 and 2021. Teledentistry platforms have been classified into four categories, including email, telephone, social network applications (WhatsApp, zoom, Google Meeting, Instagram, line Application, Viber, and Messenger), and teledentistry systems (teledentistry systems, which were designed specially to perform a teledentistry project). Teledentistry has been conducted to store and forward (n = 15, 30.71%), real-time (n = 9, 21.43%), or both (n = 12, 35.71%). According to the thematic results, basic technical requirements have been categorized into four, including teledentistry platform, type of interactions, internet connection, and photography tool. Other thematic results demonstrate seven categories of recommendations, including general factors, light, patient position, phone position, setting of a mobile phone camera, photo sending requirements, and photo visualization. CONCLUSION: According to the results, over the past 7 years, especially during the COVID-19 pandemic, social network applications such as WhatsApp and Zoom have been used more frequently. Also, photography recommendations with a mobile phone camera depend on several factors such as general factors, light, patient position, phone position, setting of the mobile phone camera, and photo-sending requirements. Given the increased use of mobile cameras for oral photography, these recommendations can help improve the quality of images and subsequently improve the reliability of clinical decision-making in managing patients' conditions.

The role of teledentistry in improving oral health outcomes and access to dental care: An umbrella review.

OBJECTIVES: This umbrella review aims to synthesise and summarise the role of teledentistry in improving oral health outcomes and access to dental care. METHODS: We searched the databases PubMed (Medline), Scopus, CINHAL, OVID, ScienceDirect, JSTOR, JBI Database of Systematic Reviews & Implementation Reports and the Cochrane Database of Systematic Reviews through March 2024. Systematic reviews and meta-analyses on teledentistry were eligible for inclusion. No publication time or language restrictions were applied. Our search retrieved 24 studies for which we conducted quality assessments using the Joanna Biggs Institute (JBI) for Systematic Reviews and Research Synthesis Critical Appraisal Tool. Results were reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS: Studies addressed clinical oral health outcomes, health-related quality of life and patient experience, access to dental care and cost-effectiveness of teledentistry compared to conventional, face-to-face dental consultations. We found that there was consensus that teledentistry enhanced oral health through the early detection of oral lesions and increased access to dental care in remote areas and was time- and cost-saving. CONCLUSION: Teledentistry can improve oral health outcomes and access to dental care. Future research on its impact on oral health equity is warranted.