Purohit Bharathi M, Singh Abhinav, Dwivedi Ashish
Department of Public Health Dentistry, People's College of Dental Sciences & Research Centre, Bhopal, India.
Department of Dentistry, All India Institute of Medical Sciences (AIIMS), Bhopal, Ministry of Health & Family Welfare, Government of India.
J Public Health Dent. 2017 Mar;77(2):174-180. doi: 10.1111/jphd.12195. Epub 2016 Dec 30.
The study aims to assess the reliability of video-graphic method as a tool to screen the dental caries among 12-year-old school children in a rural region of India.
A total of 139 school children participated in the study. Visual tactile examinations were conducted using the Decayed, Missing, and Filled Teeth (DMFT) index. Simultaneously, standardized video recording of the oral cavity was performed. Sensitivity and specificity values were calculated for video-graphic assessment of dental caries. Bland-Altman plot was used to assess agreement between the two methods of caries assessment. Likelihood ratio (LR) and receiver-operating characteristic (ROC) curve were used to assess the predictive accuracy of the video-graphic method.
Mean DMFT for the study population was 2.47 ± 2.01 and 2.46 ± 1.91 by visual tactile and video-graphic assessment (P = 0.76; > 0.05). Sensitivity and specificity values of 0.86 and 0.58 were established for video-graphic assessment. A fair degree of agreement was noted between the two methods with Intraclass correlation coefficient (ICC) value of 0.56. LR for video-graphic assessment was 2.05. Bland-Altman plot confirmed the level of agreement between the two assessment methods. The area under curve was 0.69 (CI 0.57, 0.80, P = 0.001).
Teledentistry examination is comparable to clinical examination when screening for dental caries among school children. This study provides evidence that teledentistry may be used as an alternative screening tool for assessment of dental caries and is viable for remote consultation and treatment planning. Teledentistry offers to change the dynamics of dental care delivery and may effectively bridge the rural-urban oral health divide.
本研究旨在评估视频图像法作为筛查印度农村地区12岁学龄儿童龋齿工具的可靠性。
共有139名学龄儿童参与本研究。使用龋失补牙指数（DMFT）进行视觉触觉检查。同时，对口腔进行标准化视频记录。计算视频图像法评估龋齿的敏感度和特异度值。采用布兰德-奥特曼图评估两种龋齿评估方法之间的一致性。使用似然比（LR）和受试者工作特征（ROC）曲线评估视频图像法的预测准确性。
通过视觉触觉评估和视频图像评估，研究人群的平均DMFT分别为2.47±2.01和2.46±1.91（P = 0.76；>0.05）。视频图像评估的敏感度和特异度值分别为0.86和0.58。两种方法之间观察到中等程度的一致性，组内相关系数（ICC）值为0.56。视频图像评估的LR为2.05。布兰德-奥特曼图证实了两种评估方法之间的一致性水平。曲线下面积为0.69（CI 0.57，0.80，P = 0.001）。
在筛查学龄儿童龋齿时，远程牙科检查与临床检查相当。本研究提供了证据表明远程牙科可作为评估龋齿的替代筛查工具，并且对于远程咨询和治疗计划是可行的。远程牙科有望改变牙科护理的模式，并可能有效弥合城乡口腔健康差距。
