Objective
The objective of this observational study was to evaluate telediagnosis of oral lesions using smartphone photography.
Materials and Methods
Individuals with visible oral lesions composed a convenience sample. The lesions were photographed using a smartphone camera and emailed along with clinical information to three evaluators, who formulated up to two diagnostic hypotheses for each case. A total of 235 photographs from 113 clinical cases were obtained. The evaluators answered questions regarding referral decisions, requests for additional tests, diagnostic difficulties, and image quality. The diagnostic hypotheses were compared to the gold standard by means of percent agreement and kappa coefficient. Consensual face‐to‐face diagnoses of three specialists—when only a clinical diagnosis was necessary—or histopathological results—when a biopsy was necessary—were considered the gold standard.
Results
The telediagnosis was similar to the gold standard in 76% of the cases, and kappa coefficients showed almost perfect agreement (k = 0.817–0.903). The evaluators considered that referrals could have been avoided on an average of 35,4% of the cases.
Conclusion
Diagnosis of oral lesions using images taken with a smartphone showed almost perfect agreement and diagnostic accuracy comparable to face‐to‐face diagnosis.
Introduction
Fanconi anemia (FA) is a rare genetic disease characterized by congenital malformations and bone marrow failure. One of the most common oral diseases in individuals with FA is periodontitis and adequate self-perception of periodontal status could contribute to its prevention and early detection.
Aim
To compare oral health self-perception, measured by a questionnaire, with the clinical oral condition of patients with FA.
Methods and Results
Fifty-six patients with FA, over 11 years of age, answered a questionnaire about dental history and self-reported oral health. Decayed, missing, and filled teeth (DMFT), Visible Plaque Index (VPI) and Gingival Bleeding Index (GBI) were measured. The median age of participants was 21 years (min 11, max 44), 31 (55%) were females and 25 (45%) males. Thirty-five (62.5%) participants rated their oral condition as satisfactory and 7 (12.5%) participants reported tooth mobility, 10 (17.9%) exposed roots and 21 (37.5%) gingival bleeding. Clinical examination detected average DMFT = 5.23, VPI = 31.36% and GBI = 33.77%. The gingival bleeding report was more frequent among individuals with higher GBI (
p
= 0.014). The DMFT was higher in those who had already undergone dental treatments (
p
= 0.031). There was an association between participants who presented dental caries and who rated their oral health as poor (
p
= 0.03). The question “Do your gums bleed easily?” had good accuracy in the evaluation of periodontal disease (
p
= 0.68).
Conclusion
Oral health self-perception of individuals with FA about gingival inflammation was associated with their gingival bleeding index.
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