Validity and reliability of remote dental screening by different oral health professionals using a store-and-forward telehealth model.

Objective This study was conducted to evaluate the validity and reliability of intraoral photographic assessments by different members of a dental team as a means for dental screening in children.Methods The intraoral photographic records of 126 children (2 to 18 years old) were obtained from routine clinical records taken before dental treatment. Intraoral photographs were obtained using a DSLR camera and then uploaded to a cloud-based server using store-and-forward telehealth technology. Images were reviewed by an expert panel to formulate a benchmark screening baseline, to which the screeners' data were compared. The photographic assessments conducted by a mid-level dental practitioner (MLDP) and dentist, were compared to the benchmark expert panel assessment.Results The screeners' assessments by means of intraoral photography, when compared to the expert panel assessment had a sensitivity value of 82-89% and specificity value of 97%. The inter-examiner agreement between the expert panel assessment and photographic method (assessed by a dentist and MLDP), was almost perfect, with a kappa score ranging from 0.82 to 0.88. The mean DFT/dft score for the children as determined by the expert panel's review and photographic assessment ranging from 5.41 to 5.79, with mean scores between the two assessment methods not significantly different (P = 0.746).Conclusion Our results suggested that oral health professionals (other than dentists) have the potential to screen for caries from intraoral photographs with the same diagnostic accuracy and reliability as dentists. This strategy has implications for supporting the use of MLDPs such as dental therapists or hygienists to screen for oral disease using telehealth.

Perceptions of Australian dental practitioners about using telemedicine in dental practice.

Objective This study aimed to explore Australian dental practitioners' perceptions of the usefulness of teledentistry in improving dental practice and patient outcomes.Methods A descriptive cross-sectional study involving an anonymous electronic survey of a sample of 169 Australian dental practitioners. We designed a 24-item, 5-point Likert-scale questionnaire assessing perceptions of dentists in four domains: usefulness of teledentistry for patients; usefulness of teledentistry for dental practice; capability of teledentistry to improve practice; and perceived concerns about the use of teledentistry.Results Of the 144 respondents (response rate 85%), 135 completed responses that were suitable for analysis. More than 80% of respondents agreed or strongly agreed that teledentistry would improve dental practice through enhancing communication with peers, guidance and referral of new patients. The majority also felt that teledentistry is quite useful in improving patient management, and increasing patient satisfaction. A substantial proportion of respondents expressed uncertainty with technical reliability, privacy, practice expenses, the cost of setting up teledentistry, surgery time and diagnostic accuracy.Conclusion Dental practitioners generally reported optimism and support to the concept of teledentistry and its integration into current dental practices. Addressing how teledentistry can benefit specific practice issues, would encourage more dentists to use telemedicine in routine practice.