Background: Digital interventions including teledentistry are promising approaches to address some of the inadequacies of health care systems. Despite existing systematic reviews (SRs) on the benefits, implementation challenges, accuracy, and effectiveness of teledentistry, a comprehensive synthesis of evidence on its impacts requires further analysis. Objective: The purpose of this overview of SRs is to summarize evidence on the impacts of teledentistry in promoting access to and enhancing the quality of oral health care. Methods: We searched electronic databases in MEDLINE (Ovid), Embase (Embase.com), CINAHL (EBSCO), Web of Science, Cochrane Library, and Epistemonikos from inception to March 2024, without date and language restrictions, to identify SRs and meta-analyses. Two independent reviewers performed data selection following the PICOSS (population, intervention, comparison, outcome, and study design) format, as well as the data extraction. We conducted quality assessments using both (A MeaSurement Tool to Assess Systematic Reviews-2) AMSTAR 2 and ROBIS (Risk Of Bias In Systematic reviews) tools. The certainty of evidence and the overlap of the primary studies included in the SRs were assessed. Results were presented in tables and graphs. A narrative synthesis was performed. Results: The search yielded 1020 articles, of which 30 SRs were included in the overview. The number of participants across these reviews ranged from 130 to 7913 people. All dimensions of the quality of care were addressed to varying extents, with the domains of effectiveness (22/30, 73%), patient-centered care (14/30, 47%), and efficiency (11/30, 37%) being the most extensively studied. Teledentistry addressed public health challenges by improving access to oral health care and reducing inequities (9/30, 30%) for vulnerable people. The major teledentistry applications were teleconsultation (13/30, 43%), and telediagnosis (9/30, 33%). Teledentistry enhanced patient-clinician communication, quality of life, and care experiences for both patients and providers. However, multilevel barriers must be addressed to ensure its successful implementation (7/30, 23%). Meanwhile, patient safety (8/30, 27%) and equity (1/30, 10%) were the least explored domains, with few reviews addressing adverse outcomes, as well as concerns related to data privacy (3/30, 10%) and confidentiality (2/30, 6%). Several SRs exhibited a critically low to low methodological quality (25/30, 83%) and a high risk of bias (8/30, 27%). The overlap (corrected covered area) of the primary studies in all the SRs was slight (30/30, 2.3%), while it was moderate (11/30, 5.7%) for SRs with meta-analyses. Conclusions: The findings of this overview suggest that teledentistry is an effective and efficient alternative to in-person oral health care. However, significant concerns regarding the quality of the reviews highlight an urgent need for more methodologically rigorous studies to generate robust and reliable evidence. This is particularly essential to better understand teledentistry’s potential to enhance overall health outcomes and ensure equitable access to care, thereby providing a stronger foundation to guide clinical practices and inform policy decisions.

Digital technologies are becoming essential to address and optimize the suboptimal performance of healthcare systems. Teledentistry involves the use of information and communication technology to improve access to oral health care and the quality of oral health care delivery. Several systematic reviews (SRs) have been conducted to synthesize evidence on the effectiveness of teledentistry but with conflicting results. The aim of this review is to comprehensively summarize available SRs and provide evidence on the impact of teledentistry on access to oral care, patients’ and oral healthcare providers’ outcomes, quality of oral health care and costs. This protocol has been registered with the International Prospective Register of Systematic Reviews (PROSPERO CRD42022373964). Six electronic databases including MEDLINE (Ovid), Embase (Embase.com), CINAHL (EBSCO), Web of Science, Cochrane Library and Epistemonikos will be searched for SRs of quantitative, qualitative, and mixed reviews evaluating teledentistry modalities involving both patients and/or oral health care providers (OHCPs). We will include studies published in English or French. The outcomes will include patients’ outcomes (e.g., access to oral health care, patient-reported outcomes, and patient-reported experiences); patient indicators (e.g., clinical outcomes, adherence to treatment, adverse outcomes and costs); and OHCP indicators (e.g., diagnostic accuracy, barriers and enablers costs and equity). Two independent reviewers will perform data screening, data extraction and will assess the quality of included studies using AMSTAR 2 and ROBIS tools. Data will be synthesized narratively and presented by tables and graphs. We will report any overlap of primary studies in the SRs. A statement on the strength of evidence for each outcome will be provided if possible. This review will inform decision-makers, patients, OHCPs, and researchers on the potential effectiveness, benefits, and challenges of teledentistry and support them in making recommendations for its use. Results will be disseminated through peer-reviewed publications, presentations at conferences, and on social media.

Background: There is growing literature on the potential of digital technologies for improving access to, ensuring continuity and quality of health care, and to strengthen health systems. Some studies have reported the cost-effectiveness of teledentistry, its reliability for remote dental screening, diagnosis, consultation, and treatment planning. Nonetheless, current evidence suggests that teledentistry implementation faces many challenges and is not yet adopted by dental health care providers (DHCPs). Developing strategies to improve teledentistry adoption requires an understanding of the factors that promote or hinder its successful implementation. Objective: This systematic review aims to identify and synthetize barriers and enablers to implementing teledentistry as perceived by DHCPs in their clinical practices, using the Theoretical Domains Framework (TDF) and the Capacity, Opportunity, and Motivation Behavior (COM-B) model. Methods: This protocol follows the PRISMA-P (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Protocols) checklist. Literature will be searched in the following databases: PubMed, Cochrane Library, Web of Science, CINAHL, Embase, and PsycINFO. We will perform additional searches on Google, Google Scholar, and ProQuest Dissertations & Theses Global, screen the references of the included studies to capture additional relevant studies, and contact the authors of studies if we need more details. We will consider studies using qualitative, quantitative, and mixed methods. There will be no restrictions on the publication date and dental setting. We will include studies published in French, English, and Portuguese. Two independent reviewers will select the study, extract data, and assess methodological quality using the Mixed Methods Appraisal Tool’s checklist. Data analysis will include a descriptive and a thematic content analysis. We will synthetize and categorize the barriers and enablers using the TDF and COM-B model and present a narrative synthesis of our results using tables, figures, and quotes. Results: By March 2023, the literature search has retrieved 7355 publications. We will identify the range of barriers and enablers to implementing teledentistry through DHCPs’ perspectives. Considering the critical need for theory-based implementation interventions to improve the use of evidence-informed practices, we will synthesize the factors influencing the adoption of teledentistry based on the TDF domains and the 3 essential conditions predicting behavior change in accordance with the COM-B model. As needed, we will include additional determinants if not included in the TDF. We will conduct some subgroups analyses if studies are sufficient. We expect to complete the review by July 2024. Conclusions: This review will provide some insights on the determinants of teledentistry implementation as perceived by DHCPs in dental settings. These findings will cater to patients, families, DHCPs, researchers, academic and professional decision-makers, and policy makers. The results of the systematic review could be used to develop theory-led interventions in improving teledentistry implementation. Trial Registration: PROSPERO CRD42021293376; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=293376 International Registered Report Identifier (IRRID): PRR1-10.2196/44218

Background: Recent studies have identified significant gaps in equity, diversity, and inclusion (EDI) considerations within the lifecycle of artificial intelligence (AI), spanning from data collection and problem definition to implementation stages. Despite the recognized need for integrating EDI principles, there is currently no existing guideline or framework to support this integration in the AI lifecycle. Objective: This study aimed to address this gap by identifying EDI principles and indicators to be integrated into the AI lifecycle. The goal was to develop a comprehensive guiding framework to guide the development and implementation of future AI systems. Methods: This study was conducted in 3 phases. In phase 1, a comprehensive systematic scoping review explored how EDI principles have been integrated into AI in health and oral health care settings. In phase 2, a multidisciplinary team was established, and two 2-day, in-person international workshops with over 60 representatives from diverse backgrounds, expertise, and communities were conducted. The workshops included plenary presentations, round table discussions, and focused group discussions. In phase 3, based on the workshops’ insights, the EDAI framework was developed and refined through iterative feedback from participants. The results of the initial systematic scoping review have been published separately, and this paper focuses on subsequent phases of the project, which is related to framework development. Results: In this study, we developed the EDAI framework, a comprehensive guideline that integrates EDI principles and indicators throughout the entire AI lifecycle. This framework addresses existing gaps at various stages, from data collection to implementation, and focuses on individual, organizational, and systemic levels. Additionally, we identified both the facilitators and barriers to integrating EDI within the AI lifecycle in health and oral health care. Conclusions: The developed EDAI framework provides a comprehensive, actionable guideline for integrating EDI principles into AI development and deployment. By facilitating the systematic incorporation of these principles, the framework supports the creation and implementation of AI systems that are not only technologically advanced but also sensitive to EDI principles.

Access to timely oral healthcare services is paramount for any oral healthcare system, as good oral health contributes to overall quality of life and wellbeing. Despite several initiatives’ efforts, there are still persistent deficiencies in accessing oral healthcare. As a result, teledentistry is recognized as a promising and cost-effective intervention to reduce oral health inequalities, enhance patients’ outcomes and experiences, improve oral healthcare providers’ wellbeing, reduce costs, and contribute to environmental sustainability in dentistry. However, there is confusion in its terminology with many interchangeably used terms referring to this concept. Therefore, based on our research on systematic reviews on teledentistry, we define teledentistry as the use of technology for remote oral healthcare delivery between patients and oral healthcare providers or between healthcare providers. Its goals are to facilitate access to care, reduce oral health inequalities, mitigate the economic impact of oral diseases and treatment, and foster interprofessional collaboration.

During the COVID-19 pandemic, teledentistry was suggested as a cost-effective and promising approach to improve access to oral health care. In response, Canadian provincial and territorial dental regulatory authorities (DRAs) published teledentistry-related clinical practice guidances (TCPGs). However, an in-depth comparison between them is needed to understand their gaps and commonalities so as to inform research, practice, and policy. This review aimed to provide a comprehensive analysis of TCPGs published by Canadian DRAs during the pandemic. A critical comparative analysis of these TCPGs published between March 2020 and September 2022 was conducted. Two members of the review team screened the official websites of dental regulatory authorities (DRAs) to identify TCPGs and performed data extraction. Among Canada’s 13 provinces and territories, only four TCPGs were published during the relevant time period. There were some similarities and differences in these TCPGs, and we identified gaps pertaining to communication tools and platforms, and measures to safeguard patients’ privacy and confidentiality. The insights from this critical comparative analysis and the unified workflow on teledentistry can aid DRAs in their development of new or an improvement to existing TCPGs or the development of nationwide TCP guidelines on teledentistry.