Can teledentistry - in particular, photographs - be used to accurately diagnose caries and healthy teeth?

Abstract

Aim To assess the use of teledenistry (TD) via photographs taken at home in identifying occlusal and vestibular caries by comparing the results with direct clinical assessment.

Study design Cross-sectional pilot study.

Methods In total, 43 dental students were recruited. The subjects were sent a protocol curated by the authors, outlining the required photographic views. Out of the ten photographs taken (five with flash, five without), the best five were selected for caries assessment by one clinician. The caries assessment was based on the International Caries Assessment System (ICDAS II). The students were then assessed in clinic by a second clinician and the results compared. Statistical analysis was then undertaken.

Results A total of 430 photographs were sent in and 215 photographs were selected for analysis. In total, 1,201 teeth were analysed on 43 patients. Statistical tests showed TD to have a sensitivity of 74.0, specificity 99.1, a positive predictor value of 91.7 and a negative predictive value of 96.4. A Spearman correlation was undertaken for TD and caries detection, with a value of 0.816.

Conclusions The results of this study showed that there is potential for reliably incorporating TD into routine caries diagnosis.