Adolescence is closely associated with a high risk of caries. The identification of specific bacteria in an oral microniche, the interdental space of the molars, according to carious risk can facilitate the prediction of future caries and the anticipation of the progression or stabilization of caries in adolescents. A cross-sectional clinical study according to the bacteriological criteria of interdental healthy adolescents and carious risk factors—low and high—using a real-time polymerase chain reaction technique was conducted. The presence of 26 oral pathogens from the interdental microbiota of 50 adolescents aged 15 to 17 years were qualitatively and quantitatively analyzed. Bacteria known to be cariogenic (Bifidobacterium dentium, Lactobacillus spp., Rothia dentocariosa, Streptococcus cristatus, Streptococcus mutans, Streptococcus salivarius, Streptococcus sobrinus, and Streptococcus wiggsiae) did not present differences in abundance according to carious risk. Periodontal bacteria from the red complex are positively correlated with carious risk. However, only 3 bacteria—S. sobrinus, E corrodens and T. forsythia—presented a significant increase in the highest group. Estimating the risk of caries associated with bacterial factors in interdental sites of molars in adolescents contributes to the better definition of carious risk status, periodicity and intensity of diagnostic, prevention and restorative services.

Background: During the past decade e-oral health technology has been used to address the oral health care challenges in rural and remote settings. This review systematically evaluated the literature on patient satisfaction with e-oral health care in rural and remote communities.Methods: The systematic review included interventional and observational studies published between 1946 and 2021, in the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, and Global Health. Patient satisfaction with received oral health care using self-reported measures, at any time after the intervention, was the main outcome of the review. The other primary outcomes were undesirable consequences of the health care (e-health or conventional) such as diagnostic error. The secondary outcomes considered were waiting time, number of visits, travel, and the cost of oral health care. Two independent researchers assessed the risk of bias using the ROBINS-I risk of bias assessment tool for non-randomized studies.Results: Among 898 studies, 16 studies were included in the review. In most studies reporting patient satisfaction, all patients had shown willingness for teleconsultation for a dental problem and they were mostly satisfied due to saved travel time, saved working days, and prompt treatment onset. Most of the studies acknowledged teledentistry as a cost-effective and cost-saving method. Moreover, the teledentistry consultations showed diagnostic reliability and validity values comparable to conventional dental consultations. The majority of studies were considered level 4 and 3b, due to limited sample populations, analysis based on limited alternatives or costs, non-consistent sensitivity analysis, failure to appropriately control known confounders, and/or failure to carry out an appropriate follow-up of patients.Conclusion: Available evidence indicates that e-oral health is associated with higher patient satisfaction and has been found to be an effective and reliable method for patients in rural and remote areas. Therefore, in these areas, the use of e-oral health should be encouraged. However, methodological inconsistencies in the current evidence suggest the need for long-term cohort studies and clinical trials, as well as cost analysis on e-oral health in rural settings.Systematic review registration: The systematic review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) under the registration number CRD42016039942.

Teledentistry offers possibilities for improving efficiency and quality of care and supporting cost-effective healthcare systems. This umbrella review aims to synthesize existing systematic reviews on teledentistry and provide a summary of evidence of its clinical- and cost-effectiveness. A comprehensive search strategy involving various teledentistry-related terms, across seven databases, was conducted. Articles published until 24 April 2023 were considered. Two researchers independently reviewed titles, abstracts and full-text articles. The quality of the included reviews was critically appraised with the AMSTAR-2 checklist. Out of 749 studies identified, 10 were included in this umbrella review. Two reviews focusing on oral-health outcomes revealed that, despite positive findings, there is not yet enough evidence for the long-term clinical effectiveness of teledentistry. Ten reviews reported on economic evaluations or costs, indicating that teledentistry is cost-saving. However, these conclusions were based on assumptions due to insufficient evidence on cost-effectiveness. The main limitation of our umbrella review was the critically low quality of the included reviews according to AMSTAR-2 criteria, with many of these reviews basing their conclusions on low-quality studies. This highlights the need for high-quality experimental studies (e.g., RCTs, factorial designs, stepped-wedge designs, SMARTs and MRTs) to assess teledentistry’s clinical- and cost-effectiveness.

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.

Teledentistry oral examination protocol was evaluated for one year at the Villeneuve-lès-Maguelone Correctional Facility. The aim of the study was to simplify the obligatory dental consultation protocol at the entrance visit for new detainees. 1051 detainees were enrolled and 651 of them (58.9%) accepted an oral examination by teledentistry throughout the entire year of 2018. Only 1 inmate did not need treatment and 88.06% of those who have been examined had at least one untreated cavitated carious lesion. Forty-four percent of people who received a teledentistry check-up were referred to a dentist with a dental emergency. The use of teledentistry at the entry visit in a detention facility may facilitate the oral health screening without wasting the dentist’s time, and may allow an optimization of the inmate’s oral healthcare.

Purpose: In France, all incarcerated prisoners are required to undergo a dental examination (Ministère de la santé et de la protection sociale, 2004 and Ministère de la justice, 2004). However, only one in two prisoners benefits from this oral health check-up. Oral teleconsultation could improve the quality of oral care in prisons. The paper aims to discuss these issues.Design/methodology/approach: The focus of this study was therefore to apply oral teleconsultation as an experiment. Using an oral teleconsultation system, a dentist and a nurse were separately asked to give patients a score, according to how urgently their dental issue needed to be treated. This score will henceforth be referred to as the “dental emergency scores given”.Findings: The separate dental emergency scores given by the dentist and the nurse were compared and the results demonstrate the following: – 36.7 per cent (11) of the two scores were equal – 53.3 per cent (16) of the two scores differed by 1 point – 10 per cent (3) of the two scores differed by 2 points. The average score of the nurse was 2.23 and that of the dentist was 2.13. The small disparity should not obscure the fact that 63 per cent of the diagnoses turned out to be incorrect.Practical implications: Dental care could easily be improved with oral teleconsultation as a care plan could be developed for each patient.Social implications: The condition of one’s dental health is, of course, very important for general health, but it also affects social aspects. Good oral hygiene and health are very important when looking for a job after having been released from prison.Originality/value: This is the first study on oral teleconsultation in prisons. Dental care is rarely studied on prisoners. Telemedicine in dentistry is just beginning all over the world. This study is the first step of an extensive project in the University Hospital of Montpellier and the Villeneuve-les-Maguelone prison.