A proof-of-concept evaluation of a cloud-based store-and-forward telemedicine app for screening for oral diseases

Mohamed Estai, Yogesan Kanagasingam, Di Xiao, Janardhan Vignarajan, Boyen Huang, Estie Kruger, Marc Tennant

Research output: Contribution to journalArticlepeer-review

38 Citations (Scopus)
150 Downloads (Pure)


Objective: It is widely considered that telemedicine can make positive contributions to dental practice. This study aimed to evaluate a cloud-based telemedicine application for screening for oral diseases. Methods: A telemedicine system, based on a store-and-forward method, was developed to work as a platform for data storage. An Android application was developed to facilitate entering demographic details and capturing oral photos. As a proof-of-concept, six volunteers were enrolled in a trial to obtain oral images using smartphone cameras. Following an onsite oral examination, images of participants' teeth were obtained by a trained dental assistant. Oral images were directly uploaded from the smartphone to a cloud-based server via broadband network. The assessments of oral images by offsite dentists were compared with those carried out via face-to-face oral examinations. Results: A complete set of 30 oral images was obtained from all six participants. Out of 192 teeth reviewed, the proportion of ungradable teeth was 8%. Sensitivity and specificity of teledental screening were 57% and 100% respectively. The inter-grader agreement estimated for two examination modalities and between two teledental graders was 70% and 62% respectively. Findings: indicate that the proposed system for screening of oral diseases can be implemented to provide a valid and reliable alternative to traditional oral screening. Conclusion: This study provided evidence that a robust system for store-and-forward screening for dental problems can be developed, and leads to the need for further testing of its robustness to confirm the accuracy and reliability of the teledentistry system.
Original languageEnglish
Pages (from-to)319-325
Number of pages7
JournalJournal of Telemedicine and Telecare
Issue number6
Early online dateSept 2015
Publication statusPublished - Sept 2016


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