The feasibility of a digital health approach to facilitate remote dental screening among preschool children during COVID‐19 and social restrictions

Jan 31, 2023International journal of paediatric dentistry

Using digital tools to support remote dental check-ups for preschool children during COVID-19 restrictions

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Abstract

Twenty-five percent of preschoolers examined had dental caries, with 90% of parental photographs rated as good to fair quality.

Tele-dental screening was evaluated for identifying early childhood caries in children under 4 years old.
A total of 370 dental photographs were taken by parents using a smartphone camera.
The tele-dental screening showed high specificity (>=95.5%) when compared to traditional dental examinations.
Sensitivity scores for the tele-dental screening varied among reviewers, ranging from 44% to 88.4%.
The approach was found to be feasible following brief training for primary caregivers.

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BACKGROUND: Tele-dentistry can be useful to facilitate screening of children, especially those living in rural and remote communities, and during the COVID-19 pandemic.

AIM: This study evaluated the feasibility of tele-dental screening for the identification of early childhood caries (ECC) in preschoolers using an app operated by their parents with remote review by oral-health therapists.

DESIGN: This cross-sectional study was a sub-project nested in ORIGINS Project, a longitudinal birth cohort study in Western Australia. Initially, children were visually examined by a paediatric dentist (gold standard). Subsequently, dental photographs were taken by parents using a smartphone camera. Two trained oral health professionals asynchronously evaluated dental photographs. The presence of dental caries was recorded as per the International Caries Detection and Assessment System-II classification. The diagnostic accuracy and reliability of the tele-dental screening and the gold standard dental examinations were then compared.

RESULTS: Forty-two children aged <4 years were enrolled in the study. Twenty-five per cent of examined children had dental caries (mean dmfs = 0.7). A total of 370 dental photographs were obtained. Parents were able to take good-quality photographs, with 90% of photographs rated as good to fair quality. Tele-dental screening demonstrated high specificity (>=95.5%) for both reviewers compared to the gold standard dental examination. However, the sensitivity scores for the two reviewers varied, ranging from 44% to 88.4%.

CONCLUSION: Tele-dental screening for ECC was shown to be a feasible approach following a brief training for primary caregivers. This approach can offer a potential low-cost and sustainable alternative for visual dental examinations for young children, particularly in times of COVID-19-related restrictions.

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The feasibility of a digital health approach to facilitate remote dental screening among preschool children during COVID‐19 and social restrictions

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