Picture perfect: study protocol for assessing the accuracy, feasibility and acceptability of intraoral photographs captured by parents for remote dental screening in children – an observational mixed-methods study

Sep 17, 2025BMJ open

Using parent-taken mouth photos to check children's teeth remotely: a study of accuracy, ease, and acceptance

AI simplified

Circadian Biology on OpenScience ↗PubMed ↗DOI ↗OA ↗

Abstract

A total of 110 parent-child dyads will participate in assessing the diagnostic accuracy of smartphone-based intraoral photography for children's dental health.

The study aims to evaluate the accuracy of diagnoses based on photographs compared to standard clinical examinations.
Key diagnostic focuses include plaque accumulation, gingival health, restoration status, and dental caries.
Feasibility and acceptability will be measured through task completion rates, photograph quality, and participant feedback.
Qualitative interviews and surveys will capture experiences from parents and children regarding the photographic monitoring process.
The effectiveness of integrating remote photographic monitoring into dental care pathways for children will be assessed.

AI simplified

BACKGROUND: Children with limited access to dental care can be negatively impacted by reduced frequency of oral health monitoring, delays in diagnosis of dental disease and increased waits for dental care, resulting in them experiencing more disease (extent and amount). Smartphone-based intraoral photography has been cited as having the potential to improve oral health monitoring for children through screening; however, it has not been well evaluated, and its limitations are unclear. The picture-perfect study aims to assess diagnostic accuracy, feasibility and acceptability to determine whether remote photographic monitoring can be effectively integrated into pathways of dental care for children aged 6-16 years.

METHODS: Observational, cross-sectional, mixed-methods study with three workflows:development of user-friendly, comprehensive guidance to help parent/carers (parents) take high-quality intraoral photographs of their children's mouths. The guidance will be codesigned with parents and healthcare professionals.diagnostic accuracy using intraoral photographs taken by a parent of their children will be evaluated by comparing clinicians' diagnoses from the photographs to gold-standard clinical visual-tactile examinations. Parent-child dyads (n=110) will be recruited to capture intraoral photographs using positioning aids, guidance and smartphones provided by the research team. The diagnoses will focus on plaque accumulation, gingival health, restoration status and dental caries. Diagnostic accuracy will be assessed using sensitivity, specificity, positive predictive value, negative predictive value and area under the curve.assessment of feasibility and acceptability will be through task completion rates, photograph quality and participant feedback. Qualitative interviews and an online survey will capture parents' and children's experiences. Observational data will provide insights into practical challenges. Workflow 1: Workflow 2: Workflow 3:

ETHICS AND DISSEMINATION: This study, approved by the(Integrated Research Application System [IRAS]: 24/EE0137), will be conducted in adherence to the Declaration of Helsinki and Good Clinical Practice (GCP) guidelines. Written informed consent will be obtained from all participating parents, with age-appropriate assent from children prior to enrolment. Participants have the right to withdraw at any time without explanation, and their data will be anonymised to ensure privacy and confidentiality. Study findings will be disseminated through peer-reviewed journals, conference presentations and reports to relevant stakeholders. National Health Service (NHS) Research Ethics Committee

TRIAL REGISTRATION: The study protocol has been registered on the Open Science Framework: https://doi.org/10.17605/OSF.IO/WX29D.

Key numbers

110 parent–child dyads

Sample Size

Participants will capture intraoral photographs for evaluation.

66%

Plaque Prevalence

Assumed prevalence for sample size calculations.

Full Text

We can’t show the full text here under this license. Use the link below to read it at the source.

View full text ↗

Picture perfect: study protocol for assessing the accuracy, feasibility and acceptability of intraoral photographs captured by parents for remote dental screening in children – an observational mixed-methods study

Abstract

Key numbers

Full Text

You found one interesting study. We’ll send the next 7.

what lands in your inbox each week:

Recent issues from the circadian biology brief

Abstract

Key numbers

Full Text

Related papers

You found one interesting study. We’ll send the next 7.

what lands in your inbox each week:

Recent issues from the circadian biology brief