Qari Alaa Husni, Hadi Moayad, Alaidarous Alawi, Aboalreesh Abdulrahman, Alqahtani Majed, Bamaga Ibraheem K, Patel Jilen, Estai Mohamed
College of Dental Medicine, Umm Al-Qura University, Makkah, Saudi Arabia.
UWA Dental School, University of Western Australia, Perth, Australia.
Saudi Dent J. 2024 Jan;36(1):105-111. doi: 10.1016/j.sdentj.2023.10.006. Epub 2023 Oct 11.
Unaided visual inspection is a primary dental screening technique. Given the uneven distribution of dental services and prolonged waiting periods, an alternative screening approach is required to increase access to dental care. The purpose of this study was to evaluate the accuracy and reliability of tele-screening for detecting dental caries using mobile intra-oral photos taken by participants.
Dental care seekers attending Umm Al-Qura University Teaching Dental Hospital in 2022 were invited to participate in this study. The participants were initially examined by dental interns at the hospital under the supervision of faculty dentists (reference standard) before intra-oral photos were acquired by a trained sixth-year dental student using a Samsung S10 camera. Following an introduction to the photography guide, the same participants then took intra-oral photos of their teeth at home using their mobile devices, which were all uploaded to WhatsApp for later review. Two trained dental reviewers (sixth-year dental students) independently reviewed the intra-oral photos. Sensitivity, specificity, and Kappa scores were estimated to assess the performance of the tele-screening approach relative to the reference unaided dental examination.
Twenty-three participants, with a mean age of 30 ± 12 years, were enrolled. The mean decayed, missing, and filled teeth (DMFT) was 13.43 ± 5.48. Patient-delivered tele-screening demonstrated a sensitivity, specificity, and inter-rater reliability kappa of 94 %, 90 %, and 0.81, respectively, when compared to unaided dental examination. Dentist-delivered tele-screening approach demonstrated a sensitivity of 88-89 %, specificity of 88-91 %, and kappa score of 0.75-0.79 relative to unaided dental examination.
This study demonstrated that the tele-screening approach based on reviewing intra-oral photos taken by participants can be a valid and reliable alternative to unaided dental examination. This is important for ensuring sustainable access to dental care.
裸眼视觉检查是一种主要的牙科筛查技术。鉴于牙科服务分布不均且等待时间较长，需要一种替代筛查方法来增加获得牙科护理的机会。本研究的目的是评估使用参与者拍摄的口腔内照片进行远程筛查龋齿的准确性和可靠性。
邀请2022年在乌姆古拉大学教学牙科医院寻求牙科护理的患者参与本研究。参与者首先由医院的牙科实习生在教员牙医的监督下进行检查（参考标准），然后由一名经过培训的六年级牙科学生使用三星S10相机拍摄口腔内照片。在介绍摄影指南后，相同的参与者随后在家中使用移动设备拍摄自己牙齿的口腔内照片，并全部上传到WhatsApp以供后续审查。两名经过培训的牙科评审员（六年级牙科学生）独立审查口腔内照片。估计敏感性、特异性和Kappa分数，以评估远程筛查方法相对于参考裸眼牙科检查的性能。
招募了23名参与者，平均年龄为30±12岁。平均龋失补牙数（DMFT）为13.43±5.48。与裸眼牙科检查相比，患者提供的远程筛查的敏感性、特异性和评分者间可靠性kappa分别为94%、90%和0.81。相对于裸眼牙科检查，牙医提供的远程筛查方法的敏感性为88-89%，特异性为88-91%，kappa评分为0.75-0.79。
本研究表明，基于审查参与者拍摄的口腔内照片的远程筛查方法可以是裸眼牙科检查的一种有效且可靠的替代方法。这对于确保可持续获得牙科护理很重要。
