Teledentistry for Older Community-Dwelling Patients: A Scope Review of Concordance Between Virtual and Clinical Examination.

Abstract

Teledentistry, which integrates telecommunications and digital imaging, offers a versatile solution for addressing the oral health needs of the growing global older adult population. This approach enhances access to care, mitigates geographical barriers, and optimizes costs, proving particularly beneficial for institutionalized older adults. Studies assessing the accuracy of virtual versus in-person examinations in this population have reported positive outcomes, reinforcing the feasibility of remote consultations, diagnoses, and treatment planning. However, studies specifically focusing on community-dwelling older adults remains absent from the literature. This study aims to examine the dental literature regarding the accuracy, concordance, and effectiveness of virtual examinations in comparison to in-person assessments for screening and diagnosing of oral diseases in community-dwelling older adults. A scoping review was conducted using the PICo strategy. A health sciences librarian performed a comprehensive search across six databases (MEDLINE, EMBASE, CINAHL, Cochrane, Scopus, and Web of Science) using Mesh keywords. Article selection involved a three-stage process: screening titles/abstracts, reading full texts, and final selection based on pre-defined inclusion and exclusion criteria. Two researchers independently selected articles using Rayyan for blind review, and their disagreements was solved by a third-reviewer researcher, with more experience. A total of 11 187 articles were initially identified across all included databases. Of these, 3719 duplicates were detected and removed. The remaining 7468 articles were imported into the Rayyan platform, where an additional 311 duplicate records were identified and manually excluded by the reviewers. After this step, 7154 articles were excluded for not meeting the predefined inclusion criteria. As a result of the screening and eligibility process, three articles remained, of which only one was ultimately included in the final analysis. This single study evaluated the accuracy of diagnosing dental caries in geriatric patients attending an outpatient clinic using smartphone intraoral photographs compared to a standard clinical examination. The study identified a strong concordance between virtual and in-person examinations, demonstrating an acceptable level of diagnostic accuracy for caries detection in older adults using smartphone-based assessments. Despite a comprehensive search, the identification of only a single article on concordance among community-dwelling older adults highlights the scarcity of literature on this topic. There is a significant research gap in the integration of teledentistry and radiographic examinations for this population. Community-dwelling older adults possess distinct characteristics that necessitate focused attention. Subgingival proximal root caries, a prevalent dental condition in this group, relies heavily on radiographic assessment for accurate diagnosis. This review identified a notable scarcity of literature regarding the accuracy of virtual versus in-person clinical assessments for older adults living in the community, with only a single study available. Further research is imperative to develop and refine appropriate digital assessment protocols tailored to the needs of this specific population.