Dental screening of preschool children using teledentistry: a feasibility study

Abstract

Purpose: The purpose of this study was to assess the feasibility and reliability of using intraoral cameras and telehealth communication technology to screen preschool children for oral disease, in particular early childhood caries (ECC).

Methods: The authors used the existing infrastructure of the Health-e-Access telehealth Network to: (1) assess the diagnostic quality of dental images using the Dr. Camscope intraoral camera; and (2) compare the resulting images to a traditional oral examination. A calibrated dental examiner observed 50 preschool children 4 to 6 years old who were enrolled in an inner-city childcare center. Following the oral examination, images of the children's teeth were obtained by a trained telehealth assistant and transmitted to the remote site computer; identifiers were removed and the images were randomized. After a 2-week washout period, the images were read by the same examiner.

Results: A complete set of dental images was obtained from all 50 children in the study. A greater proportion of children examined using the intraoral camera were observed to have caries (42%) compared to children examined visually (28%). Furthermore, a greater number of carious teeth were detected from the images than from the visual examinations. The mean teledentistry dfs score was 2.10, and the oral examination 1.50 (P > .05). The kappa agreement was 61 (kappa = 0.61; 95% CI = 039-0.89).

Conclusions: There was no statistically significant difference between a visual examination and an examination using an intraoral camera, thus suggesting that the intraoral camera is a feasible and potentially cost-effective alternative to a visual oral examination for caries screening, especially early childhood caries, in preschool children attending childcare centers.