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A teledentistry approach
      for oral health screening
          in nursing homes
 Rodrigo Mariño*, Matthew Hopcraft, Richard Collmann,
David Manton, Michael McCullough, Ken Clarke, Elizabeth
               Ozanne, Irene Blackberry


IFA 11th global conference on ageing
"Ageing connects“ 28 May-1 June 2012 Prague
Backgound
• Face-to-face patient examinations are
  regarded as the most accurate method for
  correct oral health diagnosis.
• However, members of specific groups of the
  community are less likely to have seen a
  dentist in the past 12 months.

  • For example, the elderly (homebound or living in
    nursing homes).
Backgound
Information from the Australian state of
Victoria indicates that:
  • only 11% percent of residents have seen a dentist in the
    past 12 months,
  • few dentists available to provide dental care for
    residents of aged care facilities
  • only half of Victoria dentists reported providing care
    to residents of RACFs, and spent on average only one
    hour per month providing care in this setting.
ICT provides opportunities to supplement
traditional methods of oral diagnosis, delivery
care and health promotion.
Objectives
1. evaluate the concordance between
   distance assessments (teledentistry) and
   face-to-face dental examination.
2. identify barriers to the implementation
   of this approach
3. provide recommendations towards wider
   implementation of this approach.
Methods
• An oral health professional was trained to
  manipulate an intraoral camera and use exiting
  ICT infrastructure to send the information for
  remote examination.
• A dentist performed a ‘virtual dental
  examination’ on a group of patients.
• This information will then be compared with a
  real-life dental examination performed in a
  dental surgery setting.
Methods
• Participants were asked to self-complete a
  questionnaire to assess barriers to the
  implementation of a teledentistry approach.

          Concordance between real-time
        teledentistry* assessments and face-
                 to-face examination

* http://www.youtube.com/watch?v=mFP3u_UBqKQ
Results

• 14 volunteers.
• Intra-examiner agreements:
   • Dental examination: Excellent
     (Kappa=0.94)
   • Periodontal examination: Good
     (Kappa=0.74)
• Patient expressed high levels of
  satisfaction with teledentistry.
Conclusions

• The proposed teledentistry approach
  using an intraoral camera proved to be
  feasible and reliable as an alternative to
  traditional oral health examination.
• Patients expressed high levels         of
  satisfaction with the approach.
Field testing of teledentistry
                technology
The second stage:
• A nursing home was recruited to participate in
  the study, and the teledentistry assistant at
  the home will assist in the virtual oral
  examination, with the oral health professional
  located at the Melbourne Dental School.
• Manual for the operation of intraoral cameras
  was prepared.
Future developments

This will lead to Stage 3 where a multi-State
  community-based trial of the technology.
• Economic modelling
• Qualitative evaluation

              Stay tuned


               Thanks!
3 mariňo-oral health if apresentation29-may2012

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3 mariňo-oral health if apresentation29-may2012

  • 1. A teledentistry approach for oral health screening in nursing homes Rodrigo Mariño*, Matthew Hopcraft, Richard Collmann, David Manton, Michael McCullough, Ken Clarke, Elizabeth Ozanne, Irene Blackberry IFA 11th global conference on ageing "Ageing connects“ 28 May-1 June 2012 Prague
  • 2. Backgound • Face-to-face patient examinations are regarded as the most accurate method for correct oral health diagnosis. • However, members of specific groups of the community are less likely to have seen a dentist in the past 12 months. • For example, the elderly (homebound or living in nursing homes).
  • 3. Backgound Information from the Australian state of Victoria indicates that: • only 11% percent of residents have seen a dentist in the past 12 months, • few dentists available to provide dental care for residents of aged care facilities • only half of Victoria dentists reported providing care to residents of RACFs, and spent on average only one hour per month providing care in this setting. ICT provides opportunities to supplement traditional methods of oral diagnosis, delivery care and health promotion.
  • 4. Objectives 1. evaluate the concordance between distance assessments (teledentistry) and face-to-face dental examination. 2. identify barriers to the implementation of this approach 3. provide recommendations towards wider implementation of this approach.
  • 5. Methods • An oral health professional was trained to manipulate an intraoral camera and use exiting ICT infrastructure to send the information for remote examination. • A dentist performed a ‘virtual dental examination’ on a group of patients. • This information will then be compared with a real-life dental examination performed in a dental surgery setting.
  • 6. Methods • Participants were asked to self-complete a questionnaire to assess barriers to the implementation of a teledentistry approach. Concordance between real-time teledentistry* assessments and face- to-face examination * http://www.youtube.com/watch?v=mFP3u_UBqKQ
  • 7. Results • 14 volunteers. • Intra-examiner agreements: • Dental examination: Excellent (Kappa=0.94) • Periodontal examination: Good (Kappa=0.74) • Patient expressed high levels of satisfaction with teledentistry.
  • 8. Conclusions • The proposed teledentistry approach using an intraoral camera proved to be feasible and reliable as an alternative to traditional oral health examination. • Patients expressed high levels of satisfaction with the approach.
  • 9. Field testing of teledentistry technology The second stage: • A nursing home was recruited to participate in the study, and the teledentistry assistant at the home will assist in the virtual oral examination, with the oral health professional located at the Melbourne Dental School. • Manual for the operation of intraoral cameras was prepared.
  • 10. Future developments This will lead to Stage 3 where a multi-State community-based trial of the technology. • Economic modelling • Qualitative evaluation Stay tuned Thanks!