BANGKOK, Thailand: The use of telehealth services increased rapidly during the COVID-19 pandemic, prompting wider acceptance of digital consultations and interest in using telehealth as a tool to improve healthcare access and equity. A study by researchers in Thailand has explored the efficacy of using intra-oral cameras to conduct remote screening for oral diseases in the Thai prison population, for whom access to care is constrained because of limited prison staff, among other reasons. They found that the cameras enabled an acceptable level of diagnostic accuracy that could help to prioritise treatment and facilitate greater access to care.
The researchers aimed to test the diagnostic accuracy of remote screenings compared with that of physical oral examinations. Prisoner health volunteers—prisoners given basic medical training in order to promote disease prevention and health and conduct disease surveillance in Thai prisons as part of a healthcare project started in 2019—were taught to use intra-oral cameras to capture photographs of symptomatic areas in the mouths of prisoners who had reported dental problems. Based on the captured data, treatment needs were independently determined by the volunteers and a dentist, and the results were compared with assessments by a second dentist, who performed oral examinations of the same prisoners.
A total of 152 male prisoners confined at the Sisaket provincial correctional facility in Thailand were screened by the volunteers and dentists and the data collected pertained to 215 teeth. The researchers found that the teledentistry and direct oral examinations resulted in a diagnostic accuracy of at least 80% for all patients. The volunteers were found to be less effective in determining the need for dental scaling and surgical removal of impacted teeth.
The researchers concluded that the use of teledentistry to screen for oral problems enabled the treating dentists to achieve an acceptable diagnostic accuracy, but that the technology used was not sufficient to identify all dental problems and treatment needs. Diagnosing periodontal problems was identified as an area of weakness, owing to difficulties in capturing subgingival calculus deposits with the intra-oral cameras. “Furthermore, the imaging cannot provide information that can be obtained from tactile evaluation, such as active or arrested dental caries,” the researchers wrote.
Discussing the results, the authors said that teledentistry screenings in prisons could enable prompt assessment and prioritisation of oral care needs and reduce the number of direct dental examinations required, thereby enabling the facilities to use their limited healthcare resources better. They said that, for further studies, “using the [intra-oral camera] to record a video for additional information, such as tooth mobility and gingival bleeding, may be required to increase diagnostic accuracy of dental treatment need”.
The study, titled “Facilitating dental disease screening program in prisoners using an intraoral camera in teledentistry”, was published online on 29 April 2023 in BDJ Open.
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