Determining dental treatment and behavioral guidance needs in preschool children via teledentistry

Dental caries is one of the most common chronical diseases in children. In recent years, the application of dental general anesthesia has been increasing and this increase is especially in preschool children. Although dental caries is preventable and treatable, the complexity of treatment needs in children in the early stages of cognitive and psychological development makes treatments difficult. Telemedicine is the use of information-based or communication systems for diagnosis, consultation, and follow-up of acute or chronic diseases from long distances. Tele-dentistry is a branch of tele-medicine applications in which patient education, consultation and intraoral examination and/or patient pre-assessment are used by a dentist via video interview and/or photographs in order to improve oral and dental health. The aim of this study is to examine the compatibility between the treatment need determined during the clinical examination, and the recommended behavioral guidance type, with teledentistry examination. A total of 29 children, 12 girls and 17 boys, who were healthy, aged between 4 to 6 years, who had their first examination appointment in our clinic and who did not have a general anesthesia indication due to another medical procedure, and without special care needs, were included in the study after obtaining the consent of their parents. Clinical examination was performed in the dental clinic, sitting in the dental chair, under the reflector light, using a mirror and a probe, accompanied by a parent. Tele dental examination; the appointment was made on the phone at the agreed time, by video call with the child and his parents. In both examinations, a form was used to record and compare the data. In this form, complaints of pain: spontaneous pain, provoked pain, food impaction (yes/no) were recorded, the dmf index was recorded in both examinations, treatment needs were categorized as elective or urgent. While determining the suggested behavioral guidance type; the child's dental and medical history, and the ability to cooperate were taken into account categorized as non-pharmacological and pharmacological. The predicted type of child's behavior during dental treatment was recorded using Frankl scale acording to parental report. Before the study, inter examiner reliability was evaluated on 25 children outside the sample and determined as 100% (high agreement, p= 0.001). IBM SPSS Statistics 27.0 program was used for statistical analysis. Descriptive statistics of the data were presented as mean, standard deviation, and frequency. Mc Nemar test was used to evaluate the agreement between the two examination types, and Kappa value was calculated for the coefficient of agreement. Statistical significance was evaluated at the p< 0.05 level. Spontaneous pain (p= 1,000), provoked pain (p= 1,000), food impaction pain (p= 0.289), need for urgent dental treatment (p= 0.125), need for elective dental treatment (p= 1,000), suggested behavioral guidance type (p= 0.625) were not different between clinical examination and tele-dental examination. Urgent treatment needs aggrement was 78.9% (high compliance, p= 0.000), children with elective treatment needs was 65.1% (high compliance, p= 0.001), and suggested behavioral guidance type was 71.7% (high compliance, p= 0.001) between two examination. According to our results, Tele-dental examination was found to be in high aggrement with clinical examination in distinguishing urgent and elective treatment needs and suggested behavioral guidance type in preschool children. Teledentistry can be used for the first examination in children with accessibility difficulties. Key words: tele-medicine, tele-dentistry, pediatric dentistry