Email for distance diagnosis of oral diseases: a preliminary study of teledentistry

Abstract

We examined the feasibility of distance diagnosis of oral diseases, using transmission of digital images by email. Twenty-five cases of oral lesions were documented during a 12-month study in a primary care public health clinic in Paraná in Southern Brazil. Clinical electronic charts and images were produced and sent by email to two oral medicine specialists with a median of 10 years experience in the field. The consultants provided a maximum of two clinical hypotheses for each case. In 15 of the 25 cases (60%) both consultants made a correct diagnosis; in seven cases (28%) only one consultant made a correct diagnosis; and in three cases (12%) neither consultant made a correct diagnosis. Thus in 88% of cases, at least one consultant was able to provide the correct diagnosis. The results suggest that distant diagnosis can be an effective alternative in the diagnosis of oral lesions and that the using two distant consultants improves diagnostic accuracy. Primary care public health clinics may benefit from the use of email and digital cameras for telehealth in remote areas where oral medicine specialists are not available.

Teledentistry: Distant Diagnosis of Oral Disease Using E-Mails

“…Alternatively, they can be sent via e-mail to another specialist to obtain a second opinion at any time. 2,[5][6][7][11][12][13][14][15] In contrast, videoconferences or real-time consultations use direct, online computer telecommunication technologies among specialists, general dental practitioners, telehealth assistants, or patients located in remote communities, with the specialist remaining in a central region to provide support and supervision. 1,4,[8][9][10] The majority of studies in the dentistry literature were developed using store-and-forward methodologies, perhaps because these methods are cheaper and demand fewer resources than videoconferencing.…”

“…13 The agreement between the consultants and the ''gold standard'' was measured by the j coefficient of agreement. The sensitivity of telediagnosis, which is considered the probability that a test result will be positive when the disease is present (true-positive rate), was also calculated.…”

“…Leão developed a study to evaluate telemedicine in implant dentistry and to investigate whether indications and prosthetic objectives could be determined using this tool. Torres-Pereira et al 13 investigated the feasibility of distant diagnosis in oral medicine; their objectives were to study teledentistry via e-mail and to use digital photography to quantify the accuracy of diagnosis by remote specialist consultants. Aziz and Ziccardi 11 explored the application of smartphone technology in telemedicine for oral and maxillofacial surgeons.…”

Telemedicine in Dentistry (Teledentistry)

“…Specialist of oral medicine then analyze independently the obtained images and clinical information. They make the diagnosis (usually one or two) and electronically return the results (Torres-Pereira et al, 2008). The approach such as this is able to produce good results, which could be further improved with the use of a comprehensive electronic patient history, containing the complete history of all current and past diseases, medications taken, diagnostic and therapeutic procedures, and recorded all other factors of influence on the status of currently assessed lesion.…”

Approaching the oral pathology to primary care dentists through Telepathology in the Health Service of Concepción.

“…1 We have found several applications for this technology in oral pathology, reaching a diagnostic accuracy of 88% in some cases. 2 The application of oral Telepathology has reduced waiting lists with an adequate prioritization of the most complex cases and the attention of the less complex cases directly in primary care centers, under the supervision of specialists. This model had a 90% acceptance among patients and professionals.…”