Teledentistry and mHealth for Promotion and Prevention of Oral Health: A Systematic Review and Meta-analysis

Abstract

The dental profession has experienced a dramatic acceleration in the use of communication systems and information-based technologies over recent years, originating new paradigms for the prevention and promotion of oral health. The purpose of this systematic review was to determine the effect of teledentistry-based (telematic) strategies, reported in randomized controlled trials and quasi-randomized trials, with a focus on oral health prevention and promotion–related outcomes in patients of all ages. We searched Medline via PubMed, SCOPUS, and Web of Science from inception until August 2020, regardless of the language of publication. We selected studies for inclusion and conducted data extraction, assessed risk of bias (Cochrane tool), and evaluated the certainty of the evidence (GRADE approach) in duplicate and independently. Out of 898 potentially eligible references, we selected 43 for full-text screening, of which 19 studies proved eligible: 18 randomized controlled trials and 1 quasi-randomized study. Virtual interventions were mostly asynchronous via apps ( n = 9), text messages ( n = 9), or computer-aided learning ( n = 1). The use of teledentistry as compared with conventional strategies may result in a large reduction in the plaque index (standardized mean difference, −1.18; 95% CI, −1.54 to −0.82; I2 = 92%; low certainty) and will likely result in a large reduction in the gingival index (standardized mean difference, −2.17; 95% CI, −3.15 to −1.19; I2 = 97%; moderate certainty) and in the incidence of white spot lesions (risk ratio, 0.48; 95% CI, 0.35 to 0.66; I2 = 0%; moderate certainty), with an increased effect over time. Evidence suggests that teledentistry, particularly mHealth (messages and apps), is a promising clinical tool for preventing and promoting oral health, especially under the accelerated virtualization of dentistry. Future studies should include a broader spectrum of the population, including adults and elders, to better inform policy and implementation of teledentistry (PROSPERO: CRD42020192685).

Telemedicine for healthcare: Capabilities, features, barriers, and applications

“…This shortage of doctors can be easily fulfilled by using this technology. [ [120] , [121] , [122] , [123] ] 12 Digital health monitoring Telemedicine systems with digital health monitoring capabilities, combined with artificial intelligence and machine learning, will provide more accurate diagnoses and treatment recommendations. Using video conferencing tools and machine learning technologies with the help of each patient's case will enable refining the algorithm to provide a better diagnosis for each one.…”

Teledentistry—Knowledge, Practice, and Attitudes of Dental Practitioners in Saudi Arabia: A Nationwide Web-Based Survey

“…TD has been applied in different disciplines of dentistry, including but not limited to, preventive dentistry, endodontics, orthodontics, and oral medicine settings, with promising outcomes [ 2 , 4 , 5 , 6 ]. A recent systematic review and meta-analysis of 19 studies found that TD was a very effective means for oral health improvement in terms of prevention and promotion [ 7 ]. Another systematic review of 10 studies indicated that TD can successfully be implemented in the diagnosis and detection of dental caries [ 8 ].…”

“…Another systematic review of 10 studies indicated that TD can successfully be implemented in the diagnosis and detection of dental caries [ 8 ]. The key advantages of TD include cost-effectiveness, providing access to dental care in rural areas and for frail people, reducing wait times, and making referrals in an efficient way [ 5 , 6 , 7 , 8 , 9 , 10 ]. In addition, TD is an opportunity for peer education and consultation through video conferencing, facilitating better dental care for patients [ 2 ].…”

Using mHealth to Promote Mothers’ Brushing of Preschool Children’s Teeth: A Study Protocol using the Multi-phase Optimization Strategy (MOST)

“…Teledentistry and mobile health (mHealth) are proving to be an effective tool for the promotion of oral health in various age groups [25]. mHealth components will be incorporated in the proposed study to reduce the time needed for mothers to receive health education, adhere to physical distancing in the time of COVID-19 and make use of the popularity of these tools among the younger generations.…”