Accuracy and effectiveness of teledentistry: a systematic review of systematic reviews

Abstract

IntroductionThe COVID-19 pandemic has urged healthcare systems to develop new ways to safely provide care. Telehealth has become a compelling alternative. Our purpose was to evaluate the accuracy and effectiveness of teledentistry for screening, diagnosis and therapeutic management of dental care in children and adults. MethodsWe conducted a systematic review (SR) of systematic reviews. Multiple databases, the grey literature and conference archives were searched. Eligible SRs included those reporting virtual screening, diagnostic investigations and therapeutic interventions. Two investigators independently reviewed abstracts, articles, critically appraised SRs and extracted the data. ResultsWe identified 817 citations and included six SRs. The accepted SRs involved >7,000 participants, used primarily asynchronous communication for diagnostic/screening outcomes and used synchronous communication for treatment outcomes. SRs were of low quality and included 30 primary studies of our interest. Sensitivity and specificity for dental referrals and diagnostic treatment planning were higher than other index/reference tests, ranging from 80-88% and 73-95%, respectively. Treatment outcome measured patient compliance and professional supervision. ConclusionThis SR provides the best existing evidence for clinical decision-making involving teledentistry. Current evidence supports teledentistry as an effective means for dental referrals, treatment planning and compliance and treatment viability. Asynchronous communication and the adoption of smartphones for image capturing are feasible and convenient for the implementation of teledentistry.

Factors Associated with Avoiding Referrals by Dental Teleconsulting Sessions in Brazil

“…The asynchronous teleconsulting sessions have reportedly been one of the most offered and used [ 25 , 26 ], despite the low rates of utilization of teledentistry services [ 15 , 16 ] within the modalities offered by the telehealth program to support professionals. In this study, most of the teleconsulting sessions requested in 2020 avoided referring patients to other care levels.…”

“…It reinforces the potential of dental teleconsulting in contributing to PHC effectiveness [ 1 , 4 , 14 , 15 , 16 , 27 ]. Teleconsultants clarify PHC professionals’ concerns and confirm patients’ diagnoses, qualifying them for the referral process [ 13 , 26 ], saving resources, time, and stress [ 28 ].…”

“…Contextual factors, such as the organization of local health systems and services, the size of municipalities, institutional support, and the program’s implantation, can influence telehealth utilization by PHC professionals. The heterogeneous incorporation of the telehealth program into the Brazilian territory, which presents marked developmental differences, must be considered to improve the program’s effectiveness and efficiency [ 26 ].…”

“…This rate reinforces the need for a resolutive PHC in the country [ 2 ]. In the context of significant variability in healthcare coverage [ 3 , 26 , 33 , 35 ], performance [ 36 ], and infrastructure [ 4 ], telehealth is an essential strategy to narrow the gaps within care levels and reduce health inequalities [ 24 , 26 ].…”

Dental clinicians' perceptions on the use of tele‐dentistry consultations during COVID‐19 within public dental clinics in Sydney, Australia

“…found that teledentistry could be used as an acceptable tool to detect dental caries among children. With the rapid advancement of technology, such as high‐speed internet and the widespread use of mobile phones, the implementation of telehealth and teledentistry is becoming more feasible in clinical practice 8 …”