Comparison of a Smartphone-Based Photographic Method with Face-to-Face Caries Assessment: A Mobile Teledentistry Model

Mohamed Estai, Yogesan Kanagasingam, B Huang, J Shikha, Estie Kruger, Stuart Bunt, Marc Tennant

Research output: Contribution to journalArticlepeer-review

44 Citations (Scopus)


Objectives: This study sought to evaluate the efficacy of a mobile teledentistry approach using a smartphone camera for remote screening of dental caries. Materials and Methods: An image acquisition Android App was created to facilitate the acquisition and transmission of dental images to a store-and-forward based telemedicine server. One hundred participants who were attending routine checkups at dental clinics were enrolled in 2014. Following a face-to-face oral screening by a screener (dentist), images of patients' teeth were obtained using a smartphone camera. These images, along with patient information, were then transmitted from the Android App to the server through the Internet for later independent assessment by two charters (off-site dentists). The assessments of these charters were then compared to the benchmark face-to-face caries assessment. Results: Sensitivity values for the photographic method when compared to the benchmark face-to-face caries assessment were moderate, and ranged from 60% to 63%. Weighted kappa (K) as a measure of intragrader agreement for the photographic assessment was estimated as almost perfect (K = 0.84). The intergrader agreement for the photographic method compared to the face-to-face caries assessment ranged from moderate to substantial (K = 0.54-0.66). Conclusions: Despite some limitations, the mobile teledentistry approach has shown the potential to detect occlusal caries from photographs taken by a smartphone camera with an acceptable diagnostic performance compared to traditional face-to-face screening. This study suggests that telemedicine and cellular phone technology can be combined to create an inexpensive and reliable screening tool.

Original languageEnglish
Pages (from-to)435-440
Number of pages6
JournalTelemedicine and e-Health
Issue number5
Publication statusPublished - May 2017


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