Teledentistry Applied to Health and Education Outcomes: Evidence Gap Map
Authors: Nascimento da Silva Mulder Júlia , Ramos Pinto Marcelo , Aníbal Isabelle , Dornellas Ana Paula , Garrido Deise , Huanca Camila , Haddad Ana Estela , Mendes Abdala Carmen Verônica 
Published: September 2024

Background
Teledentistry is a field of activities that comprises information and communication technologies (ICTs) applied to dentistry, including the exchange of clinical information, patient care, and the use of educational strategies across remote distances. Its use has grown progressively over the past decades—intensified by the COVID-19 pandemic—and has been improving the provision of dental services and educational strategies ever since.

Objective
This evidence gap map (EGM) study aims to present a collection of systematic reviews (SRs) with meta-analyses to answer the question “What are the applications of teledentistry in dental services and dental education?” by identifying gaps and current evidence on the improvement of health care and education.

Methods
The EGM methodology has been developed by the Latin American and Caribbean Center on Health Sciences Information and is based on the concept created by the International Initiative for Impact Evaluation. Embase, PubMed, and Virtual Health Library databases were used for the literature research, using terms for teledentistry associated with eHealth, dental education, and oral health care. The data obtained from the included studies were then characterized in a Microsoft Excel spreadsheet, with a matrix containing 8 intervention groups (combined interventions, e-learning and tele-education, teleconsultation and teleservice, telemonitoring, telediagnosis, telescreening, ICTs, and artificial intelligence) and 8 outcome groups (diagnosis accuracy, education and professional training, user behavior, clinical practice, patient-centered outcomes, clinical outcomes, health services management, and access to health services). The quality of the studies was assessed using AMSTAR2 (A Measurement Tool to Assess Systematic Reviews). The visual analytics platform Tableau (Salesforce) was used to graphically display the confidence level, number of reviews, health outcomes, and intervention effects.

Results
The confidence level obtained by the criteria applied was high for 28% (19/68) of the studies, moderate for 6% (4/68), low for 15% (10/68), and critically low for 51% (35/68). Among the interventions, the ICT group stood out with 182 (36.8%) out of 494 associations, followed by interventions with e-learning and tele-education (n=96, 19.4% of associations), telediagnosis (n=67, 13.6%), and combined interventions (n=53, 10.7%). Most of the outcomes were aimed at education and professional training (97/494, 19.6% of associations), patient-centered outcomes (74/494, 15%), and health services management (60/494, 12.1%).

Conclusions
This EGM presents an overview of the contributions of teledentistry in patient care, health services, clinical practice, and education. The study results may help guide future research and policy decisions and serve as a convenient virtual tool for accessing valuable evidence-based information on teledentistry.