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Teledentistry as a novel pathway to improve dental health in school children: a research protocol for a randomised controlled trial

Authors
  • Estai, Mohamed1, 2
  • Kanagasingam, Yogesan1
  • Mehdizadeh, Maryam1
  • Vignarajan, Janardhan1
  • Norman, Richard3
  • Huang, Boyen4
  • Spallek, Heiko5
  • Irving, Michelle5
  • Arora, Amit6, 6, 7, 8
  • Kruger, Estie2
  • Tennant, Marc2
  • 1 CSIRO, 147 Underwood Avenue, Floreat WA, Perth, 6014, Australia , Perth (Australia)
  • 2 University of Western Australia, Perth, Australia , Perth (Australia)
  • 3 Curtin University, Perth, Australia , Perth (Australia)
  • 4 Charles Sturt University, Orange, Australia , Orange (Australia)
  • 5 University of Sydney, Sydney, Australia , Sydney (Australia)
  • 6 Western Sydney University, Campbelltown Campus, NSW, Australia , Campbelltown Campus (Australia)
  • 7 Sydney Local Health District and Sydney Dental Hospital, NSW Health, Surry Hills, NSW, Australia , Surry Hills (Australia)
  • 8 The University of Sydney, Westmead, NSW, Australia , Westmead (Australia)
Type
Published Article
Journal
BMC Oral Health
Publisher
Springer (Biomed Central Ltd.)
Publication Date
Jan 14, 2020
Volume
20
Issue
1
Identifiers
DOI: 10.1186/s12903-019-0992-1
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundDespite great improvement in child oral health, some children subgroups still suffer from higher levels of dental caries. Geographic and socioeconomic barriers and the lack of access to dental care services are among common reasons for poor oral health in children. Historically in Australia, oral health therapists or dental therapists have been responsible for providing dental care for school children through the School Dental Services (SDS). The current SDS has been unable to provide sustainable dental care to all school children due to a reduction in workforce participation and limited resources. We propose a paradigm shift in the current service through the introduction of user-friendly technology to provide a foundation for sustainable dental care for school children.Methods/designWe describe an ongoing parallel, two-armed, non-inferiority randomised controlled trial that compares routine and teledental pathway of dental care in children aged 4–15 years (n = 250). Participating schools in Western Australia will be randomly assigned to the control or teledental group, approximately three schools in each group with a maximum of 45 children in each school. All participants will first receive a standard dental examination to identify those who require urgent referrals and then their teeth will be photographed using a smartphone camera. At the baseline, children in the control group will receive screening results and advice on the pathway of dental care based on the visual dental screening while children in the teledental group will receive screening results based on the assessment of dental images. At 9 months follow-up, all participants will undergo a final visual dental screening. The primary outcomes include decay experience and proportion of children become caries active. The secondary outcomes include the diagnostic performance of photographic dental assessment and costs comparison of two pathways of dental care.DiscussionThe current project seeks to take advantage of mobile technology to acquire dental images from a child’s mouth at school settings and forwarding images electronically to an offsite dental practitioner to assess and prepare dental recommendations remotely. Such an approach will help to prioritise high-risk children and provide them with a quick treatment pathway and avoid unnecessary referrals or travel.Trial registrationAustralian New Zealand Clinical Trials Registry, ACTRN12619001233112. Registered 06 September 2019.

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