Joon Soo Park1, Estie Kruger2, Wendy Nicholls3, Mohamed Estai2, John Winters3, Marc Tennant2. 1. Paediatric Oral Health Research Group, UWA Dental School, The University of Western Australia, Crawley, Australia. alex.park@uwa.edu.au. 2. International Research Collaborative - Oral Health and Equity, The University of Western Australia, Crawley, Australia. 3. Dental Department, Princess Margaret Hospital for Children, Subiaco, Australia.
Abstract
OBJECTIVES: To determine the detectability of the intra-oral photographic method in comparison to the baseline, comprehensive dental examination (CDE), in children when performed by different levels of dental practitioners. MATERIALS AND METHODS: As part of a quality assurance program, intra-oral photographs were obtained from 77 patients (2-18 years) as part of a CDE before undertaking dental treatment under general anaesthesia. A DSLR camera was utilised to acquire images which were subsequently uploaded to a cloud-based server. The baseline for each participant was established during the CDE, utilising both visual and radiographic examination, which was then compared to the assessment made by a mid-level dental practitioners (MLDP). The evaluation was based on utilising an odontogram where the teeth were charted either as decayed or filled. RESULTS: Specificity (95%) was higher than sensitivity (61.5%) when comparing the photographic assessment with the benchmark CDE assessment. The inter-rater reliability between the two methods of assessment was substantial, with a kappa score of 0.62. The photographic assessment method underestimated the decayed and filled teeth, as observed by the caries experience (dft/DFT scores) (CDE = 7.01 vs. photographic assessment = 5.22). There were lower levels of diagnostic detection in the posterior teeth as compared to the anterior teeth assessments. CONCLUSIONS: Although the CDE is still considered to be the gold-standard, this study found that the photographic caries assessment by MLDP produced an acceptable diagnostic level of detection particularly for the anterior teeth. CLINICAL RELEVANCE: The photographic method could offer a potential cost-saving and user-friendly screening.
OBJECTIVES: To determine the detectability of the intra-oral photographic method in comparison to the baseline, comprehensive dental examination (CDE), in children when performed by different levels of dental practitioners. MATERIALS AND METHODS: As part of a quality assurance program, intra-oral photographs were obtained from 77 patients (2-18 years) as part of a CDE before undertaking dental treatment under general anaesthesia. A DSLR camera was utilised to acquire images which were subsequently uploaded to a cloud-based server. The baseline for each participant was established during the CDE, utilising both visual and radiographic examination, which was then compared to the assessment made by a mid-level dental practitioners (MLDP). The evaluation was based on utilising an odontogram where the teeth were charted either as decayed or filled. RESULTS: Specificity (95%) was higher than sensitivity (61.5%) when comparing the photographic assessment with the benchmark CDE assessment. The inter-rater reliability between the two methods of assessment was substantial, with a kappa score of 0.62. The photographic assessment method underestimated the decayed and filled teeth, as observed by the caries experience (dft/DFT scores) (CDE = 7.01 vs. photographic assessment = 5.22). There were lower levels of diagnostic detection in the posterior teeth as compared to the anterior teeth assessments. CONCLUSIONS: Although the CDE is still considered to be the gold-standard, this study found that the photographic caries assessment by MLDP produced an acceptable diagnostic level of detection particularly for the anterior teeth. CLINICAL RELEVANCE: The photographic method could offer a potential cost-saving and user-friendly screening.