Developing a Mobile App (iGAM) to Promote Gingival Health by Professional Monitoring of Dental Selfies: User-Centered Design Approach

Abstract

Background Dental visits are unpleasant; sometimes, patients only seek treatment when they are in intolerable pain. Recently, the novel coronavirus (COVID-19) pandemic has highlighted the need for remote communication when patients and dentists cannot meet in person. Gingivitis is very common and characterized by red, swollen, bleeding gums. Gingivitis heals within 10 days of professional care and with daily, thorough oral hygiene practices. If left untreated, however, its progress may lead to teeth becoming mobile or lost. Of the many medical apps currently available, none monitor gingivitis. Objective This study aimed to present a characterization and development model of a mobile health (mHealth) app called iGAM, which focuses on periodontal health and improves the information flow between dentists and patients. Methods A focus group discussed the potential of an app to monitor gingivitis, and 3 semistructured in-depth interviews were conducted on the use of apps for monitoring gum infections. We used a qualitative design process based on the Agile approach, which incorporated the following 5 steps: (1) user story, (2) use cases, (3) functional requirements, (4) nonfunctional requirements, and (5) Agile software development cycles. In a pilot study with 18 participants aged 18-45 years and with different levels of health literacy, participants were given a toothbrush, toothpaste, mouthwash, toothpicks, and dental floss. After installing iGAM, they were asked to photograph their gums weekly for 4 weeks. Results All participants in the focus group believed in the potential of a mobile app to monitor gingivitis and reduce its severity. Concerns about security and privacy issues were discussed. From the interviews, 2 themes were derived: (1) “what's in it for me?” and (2) the need for a take-home message. The 5 cycles of development highlighted the importance of communication between dentists, app developers, and the pilot group. Qualitative analysis of the data from the pilot study showed difficulty with: (1) the camera, which was alleviated with the provision of mouth openers, and (2) the operation of the phone, which was alleviated by changing the app to be fully automated, with a weekly reminder and an instructions document. Final interviews showed satisfaction. Conclusions iGAM is the first mHealth app for monitoring gingivitis using self-photography. iGAM facilitates the information flow between dentists and patients between checkups and may be useful when face-to-face consultations are not possible (such as during the COVID-19 pandemic).

Modified Gingival Index (MGI) Classification Using Dental Selfies

“…Recently, we presented iGAM [21] which is the first mHealth app for monitoring gingivitis using dental selfies. In a qualitative pilot study, we showed the potential acceptance of iGAM to facilitate information flow between dentists and patients, which may be especially useful when face-to-face consultations are not possible.…”

“…The participants were using the application developed by us, the iGAM app which is currently available on the Google Play store (https://play.google.com/store/ apps/details?id=com.igmpd.igam). The application development process was described in a recently published article [21]. Following initial registration, the patient logs in, personal patient data (such as age, gender, etc.)…”

“…Regarding the inclusion and exclusion criteria, the inclusion criteria are as follows: the subject must be 18 years or older, must understand Hebrew, and have a smartphone with the Android operating system. Exclusion criteria: as outlined [21] the app had several initial versions, and tested with different mouth openers. Once the app was stabilized, and the second generation "optimal" mouth opener was used [21], there were no other exclusion criteria, any subject who successfully used the app and uploaded a photo, their dental selfie was included in the dataset.…”

A Mobile Serious Game About the Pandemic (COVID-19 - Did You Know?): Design and Evaluation Study

“…The SCRUM development methodology proved to be efficient, enabling the division of the project into small increments; this methodology allowed for tests, rapid changes when necessary, and weekly deliveries to the end user. Functional software deliveries in a shorter period (1 week) generated greater customer satisfaction and provided a development environment with motivated individuals, as reported by Tobias and Spanier [ 37 ].…”

The Evolution of Photographic Arts Is Linked to Progress in Chemistry: A Review of Two Centuries of Symbiosis

“…Dental medicine is so depended on photography now that a good dental treatment cannot be conceived by an X-Ray photograph. There are many studies emphasizing the role of photography in detecting and following up dental and oral cavity pathology (Sofyanti et al, 2020, Dave et al, 2020, Costa et al, 2020, Tobias & Spanier, 2020, Konishi et al, 2020.…”