The efficacy of remote screening for dental caries by mid-level dental providers using a mobile teledentistry model

Mohamed Estai, Yogesan Kanagasingam, Boyen Huang, Hellen Checker, Lesley Steele, Estie Kruger, Marc Tennant

Research output: Contribution to journalArticlepeer-review

44 Scopus citations


Objectives: This study aimed to determine whether intraoral photographic assessment by mid-level dental providers (MLDPs) offers a valid and reliable means of dental caries screening. Methods: A mobile teledentistry model was developed to facilitate the acquisition of dental images, and transmission and reviewing of data. One hundred regularly attending patients at a dental clinic participated in the study. Following an on-site clinical examination by a senior dentist, photographs of participants' teeth were taken by a teledental assistant, using a smartphone camera. These intraoral photographs were directly uploaded from an Android App to a cloud-based server, ‘Remote-i’, using an encrypted store-and-forward telemedicine technology. The photographic assessment carried out by two independent screeners (MLDPs), was compared to the visual oral examination scores of a benchmark examiner. Results: The sensitivity and specificity values for the photographic assessment method (assessed by screeners) as compared to the direct visual examination ranged from 60% to 68%, and 97% to 98%, respectively. The intra-rater reliability for the photographic assessment was almost perfect, with a kappa score of 0.89. The inter-rater reliability between the photographic and visual oral assessments ranged from moderate to substantial agreement, with kappa scores ranging from 0.57 to 0.61. Conclusion: A new smartphone-based mobile teledentistry model used by mid-level dental providers shows potential for remote screening of dental caries.

Original languageEnglish (US)
Pages (from-to)435-441
Number of pages7
JournalCommunity Dentistry and Oral Epidemiology
Issue number5
StatePublished - 2016
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd


  • caries
  • digital imaging
  • mid-level dental providers
  • remote
  • screening
  • smartphone
  • teledentistry


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