title: Diagnostic accuracy of teledentistry in the detection of dental caries: a systematic review.
abstract: This study sought to systematically review the literature for research evidence for the diagnostic accuracy of teledentistry in the detection of dental caries.
  
  
  
  Two reviewers searched PubMed, EMBASE, and Scopus databases through January 2016 for comparative studies that examined the diagnostic accuracy of teledentistry for detecting caries compared with nontelemedicine alternatives. Retrieved studies were screened for inclusion criteria and were evaluated for methodological quality using the quality assessment of diagnostic accuracy studies (QUADAS-2) checklist.
  
  
  
  Of 287 citations identified, 10 met the preset inclusion criteria. Sensitivity and specificity were the most common measures of diagnostic accuracy used in 10 studies. Despite very limited published evidence on the diagnostic accuracy of teledentistry, the reviewed teledentistry studies showed comparable diagnostic performance compared with nontelemedicine alternatives. The average methodological quality of the selected articles is low, since none of the selected studies satisfied all 4 QUADAS-2 domains. Only 6 articles were scored as having a low risk of bias in 3 of 4 of QUADAS-2 domains. All the selected studies had low concerns regarding applicability. The main shortcoming was that in most of the selected studies, the methodology, in particular patient selection and index tests, was insufficiently described.
  
  
  
  Teledentistry has an acceptable diagnostic performance in the detection of dental caries. However, due to the heterogeneity of the reviewed studies, the generalization of results may be difficult. Further well-designed research to investigate the effectiveness of the teledentistry approach to caries detection is needed to determine the capability of this technology in epidemiologic oral surveys.
authors.affiliation: International Research Collaborative-Oral Health and Equity: School of Anatomy, Physiology and Human Biology, University of Western Australia, Perth, Western Australia, Australia. Electronic address: abdalla177@gmail.com.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Estai
authors.affiliation: International Research Collaborative-Oral Health and Equity: School of Anatomy, Physiology and Human Biology, University of Western Australia, Perth, Western Australia, Australia.
authors.forename: Stuart
authors.initials: S
authors.lastname: Bunt
authors.affiliation: Australian e-Health Research Centre, CSIRO, Perth, Western Australia, Australia.
authors.forename: Yogesan
authors.initials: Y
authors.lastname: Kanagasingam
authors.affiliation: International Research Collaborative-Oral Health and Equity: School of Anatomy, Physiology and Human Biology, University of Western Australia, Perth, Western Australia, Australia.
authors.forename: Estie
authors.initials: E
authors.lastname: Kruger
authors.affiliation: International Research Collaborative-Oral Health and Equity: School of Anatomy, Physiology and Human Biology, University of Western Australia, Perth, Western Australia, Australia.
authors.forename: Marc
authors.initials: M
authors.lastname: Tennant
mesh_terms: D003731:Dental Caries / Q000175:diagnosis*; D006801:Humans; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D017216:Telemedicine
keywords: Dental caries; Diagnosis; Photography; Telemedicine; Validity