Alain Queyroux1, Bernard Saricassapian2, Daniel Herzog3, Karin Müller4, Isabelle Herafa5, Dorothée Ducoux5, Benoît Marin6, Thierry Dantoine7, Pierre-Marie Preux6, Achille Tchalla8. 1. ENT, Head and Neck Surgery Department, Guéret Hospital, Guéret, France. 2. Odontology-Dental Medicine Department, Guéret Hospital, Guéret, France. 3. Dental Care Clinic, Kassel District, Germany. 4. Department of Health, Kassel District, Germany. 5. CHU Limoges, Accompagnement de la Recherche Clinique Hospitalière (ARCH); INSERM U1435 Centre Investigation Clinique (CIC), Limoges, France. 6. Université de Limoges, INSERM, CHU, UMR_S 1094, Institut d'Epidémiologie Neurologique et de Neurologie Tropicale, CNRS FR 3503 GEIST, 87000 Limoges, France; CHU Limoges, Centre d'Epidémiologie de Biostatistique et de Méthodologie de la Recherche, Limoges, France. 7. Université de Limoges, CHU Limoges; EA 6310 HAVAE (Handicap Activité Vieillissement Autonomie et Environnement), IFR 145 GEIST; 87000 Limoges, France; CHU Limoges, Pôle Clinique Médicale et Gérontologie Clinique, Service de Médecine Interne Gériatrique, Limoges, France. 8. Université de Limoges, CHU Limoges; EA 6310 HAVAE (Handicap Activité Vieillissement Autonomie et Environnement), IFR 145 GEIST; 87000 Limoges, France; CHU Limoges, Pôle Clinique Médicale et Gérontologie Clinique, Service de Médecine Interne Gériatrique, Limoges, France. Electronic address: Achille.tchalla@unilim.fr.
Abstract
IMPORTANCE: Dental neglect and high levels of unmet dental needs are becoming increasingly prevalent among elderly residents of long-term care facilities, although frail, elderly, and dependent populations are the most in need of professional dental care. Little is known about the validity of teledentistry for diagnosing dental pathology in nursing home residents. OBJECTIVES: To evaluate the accuracy of teledentistry for diagnosing dental pathology, assessing the rehabilitation status of dental prostheses, and evaluating the chewing ability of older adults living in nursing homes (using direct examination as a gold standard). DESIGN: Multicenter diagnostic accuracy study performed in France and Germany. SETTING: Eight nursing homes in France and Germany. PARTICIPANTS: Nursing home residents with oral or dental complaints, self-reported or reported by caregivers, willing to receive oral or dental preventive care. In total, 235 patients were examined. The mean age was 84.4 ± 8.3 years, and 59.1% of the subjects were female. INTERVENTION: The patients were examined twice. Each patient was his or her own control. First, the dental surgeon established a diagnosis by reviewing a video recorded in the nursing home and accessed remotely. Second, within a maximum of 7 days, patients were examined conventionally (face-to-face) by the same surgeon who established the initial diagnosis. MEASUREMENTS: All residents received a comprehensive clinical examination in their home by a trained geriatrician and underwent a dental hygiene evaluation that used the Silness-Loe and Greene-Vermillion dental hygiene assessment indices. The diagnoses established via the video recording and in the face-to-face setting were compared. The main outcome measure was number of dental pathologies. RESULTS: In total, 128 (55.4%) patients had a dental pathology. The sensitivity of teledentistry for diagnosing dental pathology was 93.8% (95% confidence interval [CI] 90.7-96.9), and the specificity was 94.2% (95% CI 91.2-97.2). Among the 128 cases of dental pathology identified by teledentistry, 6 (4.8%) were false positives. The teledentistry assessments were quicker than the face-to-to-face examinations (12 and 20 minutes, respectively). CONCLUSIONS: Teledentistry showed excellent accuracy for diagnosing dental pathology in older adults living in nursing homes; its use may allow more regular checkups to be carried out by dental professionals.
IMPORTANCE: Dental neglect and high levels of unmet dental needs are becoming increasingly prevalent among elderly residents of long-term care facilities, although frail, elderly, and dependent populations are the most in need of professional dental care. Little is known about the validity of teledentistry for diagnosing dental pathology in nursing home residents. OBJECTIVES: To evaluate the accuracy of teledentistry for diagnosing dental pathology, assessing the rehabilitation status of dental prostheses, and evaluating the chewing ability of older adults living in nursing homes (using direct examination as a gold standard). DESIGN: Multicenter diagnostic accuracy study performed in France and Germany. SETTING: Eight nursing homes in France and Germany. PARTICIPANTS: Nursing home residents with oral or dental complaints, self-reported or reported by caregivers, willing to receive oral or dental preventive care. In total, 235 patients were examined. The mean age was 84.4 ± 8.3 years, and 59.1% of the subjects were female. INTERVENTION: The patients were examined twice. Each patient was his or her own control. First, the dental surgeon established a diagnosis by reviewing a video recorded in the nursing home and accessed remotely. Second, within a maximum of 7 days, patients were examined conventionally (face-to-face) by the same surgeon who established the initial diagnosis. MEASUREMENTS: All residents received a comprehensive clinical examination in their home by a trained geriatrician and underwent a dental hygiene evaluation that used the Silness-Loe and Greene-Vermillion dental hygiene assessment indices. The diagnoses established via the video recording and in the face-to-face setting were compared. The main outcome measure was number of dental pathologies. RESULTS: In total, 128 (55.4%) patients had a dental pathology. The sensitivity of teledentistry for diagnosing dental pathology was 93.8% (95% confidence interval [CI] 90.7-96.9), and the specificity was 94.2% (95% CI 91.2-97.2). Among the 128 cases of dental pathology identified by teledentistry, 6 (4.8%) were false positives. The teledentistry assessments were quicker than the face-to-to-face examinations (12 and 20 minutes, respectively). CONCLUSIONS: Teledentistry showed excellent accuracy for diagnosing dental pathology in older adults living in nursing homes; its use may allow more regular checkups to be carried out by dental professionals.
Authors: Munder O Ben-Omran; Alicia A Livinski; Dorota T Kopycka-Kedzierawski; Shahdokht Boroumand; Demetres Williams; Darien J Weatherspoon; Timothy J Iafolla; Paul Fontelo; Bruce A Dye Journal: J Am Dent Assoc Date: 2021-09-11 Impact factor: 3.634
Authors: Saleh Ali AlKlayb; Mansour K Assery; AlJohara AlQahtani; Madawy AlAnazi; Sharat Chandra Pani Journal: J Int Soc Prev Community Dent Date: 2017-05-22
Authors: Mary E Northridge; Tina Littlejohn; Nathalie Mohadjeri-Franck; Steven Gargano; Andrea B Troxel; Yinxiang Wu; Robert B Bowe; Paul A Testa Journal: J Public Health Res Date: 2020-05-27
Authors: Luca Aquilanti; Andrea Santarelli; Marco Mascitti; Maurizio Procaccini; Giorgio Rappelli Journal: Int J Environ Res Public Health Date: 2020-12-04 Impact factor: 3.390