DOI: 10.5061/dryad.g79cnp5qb
title: Diagnostic accuracy of teledentistry for dental caries among children and adolescents (6-18 years): a systematic review

description: Teledentistry can be used to enhance access to dental care by reducing
 treatment and travel costs. It can also improve the quality of dental care
 by sharing patient information remotely with dental specialists and
 getting their advice in diagnosis and treatment planning. This systematic
 review is aimed to assess the diagnostic accuracy of teledentistry
 compared to the standard visual inspection for dental caries among
 children and adolescents. We developed search strategies for different
 databases (PubMed, CINAHL, Dentistry and oral sciences source) using MeSH
 terms and keywords. Two reviewers independently screened and extracted the
 studies against the eligibility criteria. The quality assessment for
 diagnostic accuracy studies-2 tool was used to assess the risk of bias of
 the included studies. In case of any disagreement, the third reviewer was
 consulted. We included seven studies that met the inclusion criteria. six
 studies reported on validity and one study reported on the feasibility of
 teledentistry in diagnosing dental caries. The pooled sensitivity of
 teledentistry, when compared to visual examination was 82% (95% CI:
 81-84%), and specificity was 90% (95% CI: 89-92). In one study from
 Australia, it was reported that the total estimated cost for teledentistry
 and visual examination was 50 million dollars and 135 million dollars,
 respectively. According to the study findings, teledentistry was 2.7 times
 less expensive than the visual examination method. Based on the limited
 findings, it is concluded that teledentistry has the potential for
 diagnosing dental caries in children and adolecents, but further studies
 in varying contexts are needed to ascertain its benefits especially in
 low- and middle- income countries.
description: <b>Search strategy
 and study selection</b> We developed
 search strategies for different databases (PubMed, CINAHL, Dentistry and
 oral sciences source) using medical subheading (MESH) terms and keywords.
 The references of the systematic reviews and other identified articles
 were also searched manually to find any relevant article that might have
 been missed in the database search. To manage the records of the studies
 imported from the electronic databases, a citation management system
 (Endnote X9 software) was used. The studies were later imported into
 Covidence (a web-based systematic review program) for screening. After the
 de-duplication of studies in Covidence, two reviewers (YA and MKR) carried
 out the title and abstract screening to identify relevant studies. The
 same reviewers carried out the full-text screening of the screened studies
 against the eligibility criteria for final inclusion of studies for data
 extraction. Two reviewers carried out the whole screening process, and any
 disagreement between the two reviewers was resolved by discussion. A third
 reviewer (JKD) was consulted for a final decision in case of any
 disagreement. We followed the Preferred Reporting Items for Systematic
 Review and Meta-Analysis (PRISMA) guidelines. <b>Data
 extraction</b> We used double data extraction
 whereby two reviewers (YA and MKR) independently extracted data from the
 included studies on a designed data extraction form on Microsoft Excel.
 Discrepancies were resolved through discussion. The data extraction sheet
 included information about the study (first author, year of publication,
 journal, study title, country, income region of the country according to
 the world bank, aim of the study, study design, study setting, sample
 size, the participants (age range), the index test, the reference
 standard, the results (sensitivity and specificity), study limitations,
 funding source of the study, conflict of interest, and the comments by the
 reviewer).