Evaluating Maternal Accuracy in Smartphone-Based Tele-Dentistry for Early Childhood Caries Detection.

BACKGROUND: Early childhood caries (ECC) is a public health challenge, leading to long-term dental problems and costs. Limited access to preventive care underscores the need for innovative screening methods. Tele-dentistry, using smartphone-based imaging, offers a scalable solution for ECC detection and intervention. OBJECTIVE: This study evaluates the accuracy of maternal smartphone-based ECC assessments compared to professional evaluations as a reliable screening tool. METHODS: A cross-sectional-study recruited 114 mother-child pairs from primary healthcare centers in Tehran province, Iran. Mothers received online training and conducted visual and smartphone-based caries assessments. Two blinded pediatric dentists remotely reviewed images, with findings compared to in-person dental examinations. Sensitivity, specificity, and intraclass correlation coefficients (ICCs) were calculated. RESULTS: The mean child age was 4.8 ± 0.9 years with 56.1% boys and 43.9% girls. Mothers had a mean age of 33.2 ± 5.6 years with 55% having a high school diploma or higher. Maternal assessments identified caries in 49/58 cases (84.5%), while pediatric dentists detected 51/58 cases (87.9%). Maternal assessments showed 100% sensitivity and specificity, with strong agreement with professional evaluations (ICC = 0.909-0.988, p < 0.0001). The three methods demonstrated near-perfect concordance (ICC = 0.978, p < 0.0001). CONCLUSION: Maternal-assisted tele-dentistry is a reliable, accessible screening method for ECC, improving early intervention, especially in low resources settings and underserved communities.