The efficacy of remote screening for dental caries by mid-level dental providers using a mobile teledentistry model.
This study aimed to determine whether intraoral photographic assessment by mid-level dental providers (MLDPs) offers a valid and reliable means of dental caries screening.



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 (MLDPs), was compared to the visual oral examination scores of a benchmark examiner.



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.



A new smartphone-based mobile teledentistry model used by mid-level dental providers shows potential for remote screening of dental caries.
International Research Collaborative - Oral Health and Equity, School of Anatomy, Physiology and Human Biology, University of Western Australia, Crawley, WA, Australia.
Mohamed
M
Estai
Australian e-Health Research Centre, CSIRO, Perth, WA, Australia.
Yogesan
Y
Kanagasingam
School of Dentistry and Health Sciences, Charles Sturt University, Orange, NSW, Australia.
Boyen
B
Huang
International Research Collaborative - Oral Health and Equity, School of Anatomy, Physiology and Human Biology, University of Western Australia, Crawley, WA, Australia.
Hellen
H
Checker
Faculty of Health Sciences, University of Adelaide, Adelaide, SA, Australia.
Lesley
L
Steele
International Research Collaborative - Oral Health and Equity, School of Anatomy, Physiology and Human Biology, University of Western Australia, Crawley, WA, Australia.
Estie
E
Kruger
International Research Collaborative - Oral Health and Equity, School of Anatomy, Physiology and Human Biology, University of Western Australia, Crawley, WA, Australia.
Marc
M
Tennant
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003726:Dental Assistants; D003731:Dental Caries / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D017146:Models, Organizational; D015588:Observer Variation; D023861:Photography, Dental / Q000379:methods; D012680:Sensitivity and Specificity; D000068997:Smartphone; D017216:Telemedicine / Q000379:methods*; D055815:Young Adult
caries; digital imaging; mid-level dental providers; remote; screening; smartphone; teledentistry