Aim: A cross-sectional study was carried out to compare the diagnostic accuracy of digital images using an intraoral camera with visual examination for the detection of caries in a primary school setting as part of a supervised toothbrushing programme.
Methods: Qualified Dental Care Professionals (DCPs) captured intraoral digital images of all children from two randomly selected schools participating in a supervised toothbrushing program using an intraoral camera between January and February 2023. In parallel, an experienced dentist performed a visual examination on all children using a dental mirror and a torch. Examinations were assisted by DCP students. All children received supervised toothbrushing training and fluoride varnish application. Subsequently, digital images were remotely and asynchronously evaluated by another dentist. High-risk cases were referred to local dental services. The study was approved by the University of Portsmouth Ethics Committee (SHFEC 2022 – 100) and parental consent was obtained for each child.
Results: 56 children (Mean age=5.7 years old) from two primary schools were screened. A total of 547 digital images were obtained. On average, 7 images per child were considered usable. Caries prevalence was 21.4% with a visual examination and 51.8% using digital photographs. Digital images had 91.7% sensitivity and specificity 59.1% compared with the visual screening for caries detection.
Conclusions: Digital images obtained through intraoral cameras showed comparable diagnostic accuracy to visual examination for caries detection in children. The digital images had a high sensitivity for caries detection. Asynchronous assessment of digital images may serve as an alternative approach for caries detection in oral health screening programs in school settings.