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Artificial Intelligence-based Tele-dentistry Programme gives housebound seniors access to dental care

Senior citizen smiling while having his teeth examined by a dentist (Image: freepik)

Tue. 13. December 2022


With the help of the Temasek Foundation, the National Dental Centre Singapore (NDCS) carried out a cooperative teledentistry initiative to provide preventative dental treatment for elderly individuals who are at risk of neglect, are housebound or confined to nursing homes, and have mobility issues

In this experimental program, Vanguard Healthcare and St. Andrew's Community Hospital (SACH) both took part.

Older adults' general health, sense of well-being, and level of life enjoyment can all be impacted by bad dental health. The dental health of Singaporean elders is frequently poor, with 31 percent of them being fully disabled or wearing dentures and 38 percent having fewer than 20 healthy teeth, according to a 2017 year survey.

Clinical Associate Professor Christina Sim, Principal Investigator, T-DOCS & Senior Consultant, Department of Restorative Dentistry - Prosthodontics, NDCS, explained, “The T-DOCS initiative uses teledentistry technology to monitor and conduct routine oral examinations on elderly individuals for early detection. This covers a crucial gap in preventative oral care for elderly people from disadvantaged backgrounds, among whom 80 percent of the 200 seniors who participated in the pilot T-DOCS program had dental issues such tooth decay and periodontal disease, which refers to gum infections.”

Professor Sim added, “This new form of care offers ease to caregivers and our partners, prompt oral care for senior citizens, and resource optimization for superior community care.”

More than 40 local nursing home staff members and volunteers of the SACH homecare team have received training to conduct oral health exams, intra-oral imaging of senior citizens' oral cavities, and basic oral and denture hygiene care.

This pilot program's artificial intelligence (AI) software can automatically evaluate a patient's early indicators of tooth decay and gum inflammation using images taken with an intra-oral camera equipped with fluorescence technology. By alerting the remote dentist to any problematic areas, the AI will reduce the amount of time needed to study and comprehend the images. Additionally, it might give the home care nurse a visual cue on the regions that need more focus.

Following the examination, the intra-oral scans and medical information are uploaded to an electronic system, which enables NDCS dentists to access the patient's records and offer treatment plans that will be reported to SACH and Vanguard Healthcare specialists for further action.

Many of the nurses and staff members that regularly visit the 199 elders for health checks who were a part of the pilot program took care of the seniors.

Due to mobility concerns, retired Lim Kwang Chuey has not visited a dentist in more than ten years. Every six months, a homecare team from SACH visits the 64-year-old man to perform a health examination. The same team also included an oral health examination at his home when he was enrolled in the T-Docs program in February 2022.


Mr. Lim stated, “My previous dental checks were a hassle for me to travel to. I am now overjoyed that I don't have to leave my house.” He continued, “Since I already know the nurse that assists me, I feel secure and at ease when she examines my teeth.”

Head of SACH's Home Medical Services, Dr. Patricia Lee shared, “Patients in SACH Home Care who took part in the trial program benefited from T-DOCS, as we saw. The home care staff can solve the patient's medical and dental problems in only one visit. This can help control or possibly lessen the stress that carers experience when they must make arrangements for their loved ones to receive dental care if they are physically limited.”

Richard Lim, a retired taxi driver, is the primary caretaker for his 89-year-old mother, who is housebound and unable of performing any everyday activities. The 66-year-old claimed that in January 2022, his mother was added to the program.

“We had a difficult time going to the dentist because my mother is confined to her home. The home medical team introduced us to T-DOCS and gave us their recommendation. This program significantly lessens my burden as well, he said.” With the homecare team's instruction, Mr. Lim is now also better equipped to assist his mother with her oral hygiene.

Temasek Foundation's Head of Programs, Mr. Lim Hock Chuan, mentioned, “Many weak seniors require oral care from their caretakers or healthcare assistants because they have cognitive or physical limitations. While some of them require specific arrangements to get oral care in the community, others are unable to convey their needs. Temasek Foundation is pleased to fund the T-DOCS initiative to provide these elders with preventive oral care in recognition of these requirements.” Temasek Foundation has provided $1.23 million over three years to fund this program.

NDCS is expanding the T-DOCS program to accommodate more senior citizens, including those who are in prison, in special needs facilities, senior activity centers, and daycare centers.

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