Comparison of dental findings between dentists and pediatricians using intraoral scan-based teledentistry in children.

Background: Asynchronous transmission of health information via teledentistry offers the potential for remote diagnosis in pediatric dentistry. The aim of this study was to compare teledental findings obtained from intraoral scans (IOS) with those from conventional visual examinations (VIS) in children. Specifically, the study assessed the diagnostic accuracy of teledentistry using IOS in evaluating oral health and determining treatment needs focusing on comparisons between dentists and pediatricians.

Methods: Children (mean age 10.04 ± 2.90 years) underwent VIS during routine dental examinations. Two examiners performed the VIS, followed by digital IOS imaging of the oral cavity. Independent teledental evaluations based on the IOS data were then performed by a dentist (DEN) and a pediatrician (PED). Evaluation criteria included general dental status, presence of caries and molar incisor hypomineralization (MIH) (yes/no), restorations (yes/no; and type, if applicable), urgency of dental intervention, and treatment recommendations (no treatment, prophylaxis, follow-up, or immediate intervention). Agreement was analyzed using Gwet's AC1, Cohen's d, sensitivity, specificity, and area under the curve (AUC).

Results: Almost perfect agreement (AC1 ≥ 0.81) was found for all test criteria, with two exceptions showing substantial agreement (AC1 = 0.61-0.80). Agreement values of overall dental status were 0.953/0.962 (primary dentition/permanent dentition (pD/PD)) for DEN and 0.908/0.923 for PED. Caries detection (yes/no) showed an agreement of 0.965/0.995 for DEN vs. 0.930/0.979 for PED, while restorations agreement was 0.988/0.993 (DEN) vs. 0.950/0.946 (PED). MIH assessment showed agreement of 0.996 (DEN) vs. 0.987 (PED). Cohen's d for the comparison between DEN and PED ranged from small for MIH (0.17), caries detection (0.23) and overall dental status (0.34/0.35) to large for restoration type (0.89). The clinically most relevant item "urgency of dental intervention" showed almost perfect agreement (0.903 for DEN vs. 0.878 for PED), and the final treatment recommendations showed an almost perfect to substantial agreement of 0.832 (DEN) vs. 0.775 (PED). Notably, both examiners showed similar accuracy in assessing the urgency of intervention.

Conclusions: This study demonstrates the potential of IOS-based teledentistry for pediatric dental assessments. The results indicate that pediatricians can effectively assess oral health and provide reliable treatment recommendations. This approach has the potential to increase access to dental care and to promote interdisciplinary collaboration in pediatric health care.