Analysis of the accuracy of tele dentistry approach in treatment planning in comparison with conventional methods during covid-19 pandemic

Abstract

Background and purpose: Teledentistry is the application of information-based technologies and communication systems in order to provide oral and dental health care from remote geographical areas, which can be useful during the outbreak of pandemics such as covid-19. In this study, the accuracy of the teledentistry method with a mobile phone in providing treatment plan was investigated compared to the usual examination by dental students during the covid-19 epidemic. Materials and methods: This descriptive interventional study (double-blinded) included 20 children (6-12 years old) with the main complaint of tooth decay (with or without pain). For each patient, a radiograph appropriate to the problem and 5 standard intraoral photographs (1. Frontal occlusion 2. Occlusal maxilla 3. Occlusal mandible 4. Right lateral view 5. Left lateral view) according to the guidelines of the American Pediatric Dental Association was prescribed. Then, the patient's treatment plan for decayed teeth was recorded according to Indiana University's recommended oral findings and treatment chart. Each child was examined by 2 students separately and randomly. Examinations were conducted first in person and then virtually. Finally, the treatment plan of the students was compared with a pediatric dental specialist with 10 years of clinical work experience. The results were reported as descriptive statistics in the form of mean and standard deviation and percentage. The rate of correct diagnoses and sensitivity and specificity were calculated for the groups. Results: The average Kappa coefficient (in 24 types of teeth) for the agreement between two examiners was 0.62 in face-to-face examinations and 0.69 in virtual examinations. In both face-to-face and virtual examinations, the type of treatment plans provided by the students did not have a significant difference with the gold standard (pediatric specialist examinations). The values of sensitivity and specificity in face-to-face therapy were 73.22 and 95.8 percent, respectively, and in virtual therapy, 76.44 and 92.9 percent, respectively. The internal reliability of the examiners using the ICC index was equal to 0.92. Conclusion: Teledentistry, with the help of photographs taken by mobile phone, is a suitable method for providing treatment plans for 6-12 year old children by dental students.