None listed
Conditions
Brief summary
Why is this study needed? Despite great improvement in child oral health, some children still suffer from higher levels of tooth decay. Geographic and socioeconomic barriers and the lack of access to dental care services are among common reasons for poor oral health in children. Although dental caries is largely preventable, it is still the most common childhood chronic disease. If dental caries remains untreated, it can have a significant impact not only on children’s teeth but also on their general health, wellbeing and quality of life. Historically in Australia, school dental therapists have been responsible for providing dental care for school children through a State-funded programme called the School Dental Services (SDS). The current SDS has been unable to provide sustainable dental care to all school children due to a reduction in workforce participation and limited resources. Thus, there is a need for an equitable and cost-efficient model of dental care to enhance the opportunity to provide sustainable dental care for school children, particularly, among those living in rural or remote regions. What will we do? We propose a paradigm shift in the current service through the introduction of user-friendly technology to provide a foundation for sustainable SDS. The current project is aimed to take advantage of mobile technologies, using a smartphone camera to acquire dental images from a child’s mouth at his/her school and forwarding images electronically to an offsite dental practitioner to assess and prepare recommendations remotely. Such an approach will enable dental practitioners to assess the teeth of school children without needing to be physically present. This would help to prioritise high-risk children and provide them with a quick treatment pathway and avoid unnecessary referrals or travelling.
Interventions
The proposed study involves evaluating the efficacy of a new model of dental care that involves dental assessment of school children on the basis of dental images reviewed by registered oral health therapists from a distance. In addition to the provision of dental advice/recommendation (that may include referrals, oral health promotion leaflets or instructions to parents) based on the photographic assessment. The oral health promotion leaflets are readily available on the Dental Health Services
The proposed study involves evaluating the efficacy of a new model of dental care that involves dental assessment of school children on the basis of dental images reviewed by registered oral health therapists from a distance. In addition to the provision of dental advice/recommendation (that may include referrals, oral health promotion leaflets or instructions to parents) based on the photographic assessment. The oral health promotion leaflets are readily available on the Dental Health Services WA website (https://www.dental.wa.gov.au/). Permission has been obtained to use these leaflets for this research. Six schools from different geographical locations in WA agreed to join the study. Schools will be randomly allocated to the study (3 schools) or control (3 schools) group. At the baseline, participants (children, age 4-15 years) in the study group (teledental) will receive a standard visual dental inspection (without radiography) and dental photography using a smartphone camera performed by trained oral health therapists. Four registered oral health therapists will first conduct visual dental inspection using a disposable mirror, probe and head-mounted light. Visual dental inspection along with reporting of findings will take on average 10 minutes. Then trained research assistants will acquire standard five dental images (of different views) from the child’s mouth using a smartphone camera and a mobile app designed for a dental screening. The image acquisition App called 'Teledental’ developed and validated by software scientists at the CSIRO and will be used to facilitate entry of patient information, capturing dental images, and transferring data to a server using a Wi-Fi or 4G network. Disposable oral retractors will be used during photography. Acquiring dental images and transmission of data to a secure server located in CSIRO will take up to 10 minutes. Dental photography will take place within the schools so no transportation is required. Two independent oral health therapists based in Sydney will review dental images from a distance. Reviewing dental images online and preparing the screening report will take on average 20 minutes per child. Parents of participants in the study group (3 schools) will receive a copy of screening result on the basis of dental images assessment which could include oral health promotion leaflets or referrals to a dental school provider/dentist depending on the urgency and severity. After 9 months from the initial dental screening and dental photography, all participants in both study and control groups will be invited to attend only visual dental inspection follow up performed by a dentist. Regular auditing for participating oral health therapists will be conducted to assess the fidelity to the intervention.
Sponsors
CSIRO's Australian eHealth Research Centre
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Diagnosis
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
4 Years to 15 Years
Healthy volunteers
Yes
Inclusion criteria
Children aged 4-15 years, enrolled in one of the six schools agreed to join the study.
Exclusion criteria
Parents or caregivers of children unable to provide written consent in English.
Outcome results
None listed