Diagnostic accuracy of tele-dentistry in screening children for dental caries by community health workers in a lower-middle-income country.

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.