Lim Songping Nicholas, Woon Xuan Ru, Goh Enhui Charlene, Ng Jingwen Claudia, Ang Seng Yao, Lim Teong Joe, Allen Patrick Finbarr
Division of Prosthodontics, Faculty of Dentistry, National University of Singapore, Singapore; Dental Branch, Singapore Armed Forces Medical Corps, Singapore.
Moh Holdings PTE Ltd, Singapore.
Int Dent J. 2025 Apr;75(2):1148-1154. doi: 10.1016/j.identj.2024.07.006. Epub 2024 Aug 5.
Symptom checkers (SCs) are virtual health aids to assist laypersons in self-assessing dental complaints. This study aimed to investigate the triage performance, clinical efficacy, and user-perceived utility of a prototype dental SC, Toothbuddy, in assessing unscheduled dental complaints in Singapore.
A pilot trial was conducted amongst all unscheduled dental attendees to military dental facilities in Singapore from January to May 2023. The accuracy of Toothbuddy to tele-triage dental conditions into 3 categories-routine, urgent, and emergency-was determined. Based on the patient-reported symptoms input, clinical recommendations were provided to users for each category. Thereafter, all dental attendees were clinically assessed to determine the definitive category. Finally, a user questionnaire assessed the application's functionality and utility and the user's satisfaction. Sensitivity and specificity analyses were performed.
During the study, 588 patients with unscheduled dental visits presented. Of these cases, 275 (46.8%) were evaluated to be routine dental conditions for which treatment could be delayed or self-managed, 243 (41.3%) required urgent dental care, and 60 (10.2%) required emergency dental intervention. The accuracy of Toothbuddy in identifying the correct category was 79.6% (468/588). Sensitivity and specificity in categorising routine vs non-routine conditions were 94.5% (95% confidence interval, 92.0%-97.1%) and 74.0% (95% confidence interval, 68.8%-79.2%), respectively. The app was generally well received and rated highly.
Preliminary data suggest that Toothbuddy can perform accurate dental self-assessment for a suitable range of common dental concerns and this is a promising platform for virtual advice on spontaneous dental issues. Furthermore, dental facilities are typically not sized to handle the large volumes of unplanned dental visits that may occur in the military population. SC apps to self-manage or delay treatment without adversely affecting disease prognosis may preserve the limited bandwidth of dental facilities in providing acute care and managing true dental emergencies expediently.
症状检查器（SCs）是一种虚拟健康辅助工具，可帮助外行人自我评估牙齿问题。本研究旨在调查一款牙科症状检查器原型Toothbuddy在评估新加坡非预约牙齿问题时的分诊性能、临床疗效以及用户感知的效用。
于2023年1月至5月在新加坡所有前往军事牙科设施的非预约牙科就诊者中进行了一项试点试验。确定了Toothbuddy将牙齿状况远程分诊为常规、紧急和急诊三类的准确性。根据患者报告输入的症状，为每个类别向用户提供临床建议。此后，对所有牙科就诊者进行临床评估以确定最终类别。最后，通过用户问卷评估该应用程序的功能和效用以及用户满意度。进行了敏感性和特异性分析。
在研究期间，共有588名非预约牙科就诊患者。其中，275例（46.8%）被评估为常规牙齿状况，治疗可延迟或自我管理；243例（41.3%）需要紧急牙科护理；60例（10.2%）需要紧急牙科干预。Toothbuddy识别正确类别的准确率为79.6%（468/588）。在区分常规与非常规状况时，敏感性和特异性分别为94.5%（95%置信区间，92.0%-97.1%）和74.0%（95%置信区间，68.8%-79.2%）。该应用程序总体上受到好评且评分很高。
初步数据表明，Toothbuddy可以对一系列合适的常见牙齿问题进行准确的自我评估，这是一个为自发牙齿问题提供虚拟建议的有前景的平台。此外，牙科设施的规模通常不足以应对军事人群中可能出现的大量非计划牙科就诊。能够自我管理或延迟治疗且不会对疾病预后产生不利影响的症状检查器应用程序，可能会在提供急性护理和有效管理真正的牙科急诊方面，保留牙科设施有限的资源。
