ORCID Profile
0000-0001-7109-0267
Current Organisations
WA Country Health Service
,
University of Western Australia
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Publisher: Wiley
Date: 25-04-2016
DOI: 10.1111/CDOE.12232
Abstract: This study aimed to determine whether intraoral photographic assessment by mid-level dental providers (MLDPs) offers a valid and reliable means of dental caries screening. A mobile teledentistry model was developed to facilitate the acquisition of dental images, and transmission and reviewing of data. One hundred regularly attending patients at a dental clinic participated in the study. Following an on-site clinical examination by a senior dentist, photographs of participants' teeth were taken by a teledental assistant, using a smartphone camera. These intraoral photographs were directly uploaded from an Android App to a cloud-based server, 'Remote-i', using an encrypted store-and-forward telemedicine technology. The photographic assessment carried out by two independent screeners (MLDPs), was compared to the visual oral examination scores of a benchmark examiner. The sensitivity and specificity values for the photographic assessment method (assessed by screeners) as compared to the direct visual examination ranged from 60% to 68%, and 97% to 98%, respectively. The intra-rater reliability for the photographic assessment was almost perfect, with a kappa score of 0.89. The inter-rater reliability between the photographic and visual oral assessments ranged from moderate to substantial agreement, with kappa scores ranging from 0.57 to 0.61. A new smartphone-based mobile teledentistry model used by mid-level dental providers shows potential for remote screening of dental caries.
Publisher: Wiley
Date: 26-01-2022
DOI: 10.1111/JPHD.12443
Abstract: This study was conducted to compare the use of intraoral photographs with the unaided visual dental examination as a means of dental caries detection in children. Children aged 4‐ to 14‐year‐olds were visually examined at their schools. Following dental examinations, children had five photographs of their teeth taken using a smartphone camera. Four dental reviewers, who are different from those who visually examined the children, assessed intraoral photographs for dental caries. Sensitivity, specificity, and inter‐rater reliability agreement were estimated to assess the diagnostic performance of the photographic method relative to the benchmark visual dental assessments. Caries prevalence was measured using dft/DFT (decayed and filled teeth) index. One hundred thirty‐eight children (67 male and 71 female) were enrolled and had a mean age of 7.8 ± 2.1 years. The caries prevalence (dft/DFT 0) using photographic dental assessments ranged from 30 percent to 39 percent but was not significantly different from the prevalence (42 percent) estimated with the visual dental examination ( P ≥ 0.07). The sensitivity and specificity of the photographic method for detection of dental caries compared to visual dental assessments were 58–80 percent and 99.7–99.9 percent, respectively. The sensitivity for the photographic assessments was high in the primary dentition (63–82 percent) and children ≤7‐year‐olds (67–78 percent). The inter‐rater reliability for the photographic assessment versus the benchmark ranged from substantial to almost perfect agreement (Kappa = 0.72–0.87). The photographic approach to dental screening, used within the framework of its limitations, yielded an acceptable diagnostic level of caries detection, particularly in younger children with primary dentition.
Publisher: Springer Science and Business Media LLC
Date: 14-01-2020
DOI: 10.1186/S12903-019-0992-1
Abstract: Despite great improvement in child oral health, some children subgroups still suffer from higher levels of dental caries. Geographic and socioeconomic barriers and the lack of access to dental care services are among common reasons for poor oral health in children. Historically in Australia, oral health therapists or dental therapists have been responsible for providing dental care for school children through the School Dental Services (SDS). The current SDS has been unable to provide sustainable dental care to all school children due to a reduction in workforce participation and limited resources. We propose a paradigm shift in the current service through the introduction of user-friendly technology to provide a foundation for sustainable dental care for school children. We describe an ongoing parallel, two-armed, non-inferiority randomised controlled trial that compares routine and teledental pathway of dental care in children aged 4–15 years ( n = 250). Participating schools in Western Australia will be randomly assigned to the control or teledental group, approximately three schools in each group with a maximum of 45 children in each school. All participants will first receive a standard dental examination to identify those who require urgent referrals and then their teeth will be photographed using a smartphone camera. At the baseline, children in the control group will receive screening results and advice on the pathway of dental care based on the visual dental screening while children in the teledental group will receive screening results based on the assessment of dental images. At 9 months follow-up, all participants will undergo a final visual dental screening. The primary outcomes include decay experience and proportion of children become caries active. The secondary outcomes include the diagnostic performance of photographic dental assessment and costs comparison of two pathways of dental care. The current project seeks to take advantage of mobile technology to acquire dental images from a child’s mouth at school settings and forwarding images electronically to an offsite dental practitioner to assess and prepare dental recommendations remotely. Such an approach will help to prioritise high-risk children and provide them with a quick treatment pathway and avoid unnecessary referrals or travel. Australian New Zealand Clinical Trials Registry, ACTRN12619001233112 . Registered 06 September 2019.
Publisher: Elsevier BV
Date: 2011
Publisher: Mary Ann Liebert Inc
Date: 05-2017
Abstract: This study sought to evaluate the efficacy of a mobile teledentistry approach using a smartphone camera for remote screening of dental caries. An image acquisition Android App was created to facilitate the acquisition and transmission of dental images to a store-and-forward based telemedicine server. One hundred participants who were attending routine checkups at dental clinics were enrolled in 2014. Following a face-to-face oral screening by a screener (dentist), images of patients' teeth were obtained using a smartphone camera. These images, along with patient information, were then transmitted from the Android App to the server through the Internet for later independent assessment by two charters (off-site dentists). The assessments of these charters were then compared to the benchmark face-to-face caries assessment. Sensitivity values for the photographic method when compared to the benchmark face-to-face caries assessment were moderate, and ranged from 60% to 63%. Weighted kappa (K) as a measure of intragrader agreement for the photographic assessment was estimated as almost perfect (K = 0.84). The intergrader agreement for the photographic method compared to the face-to-face caries assessment ranged from moderate to substantial (K = 0.54-0.66). Despite some limitations, the mobile teledentistry approach has shown the potential to detect occlusal caries from photographs taken by a smartphone camera with an acceptable diagnostic performance compared to traditional face-to-face screening. This study suggests that telemedicine and cellular phone technology can be combined to create an inexpensive and reliable screening tool.
Publisher: British Institute of Radiology
Date: 02-2022
Abstract: This study aimed to evaluate an automated detection system to detect and classify permanent teeth on orthopantomogram (OPG) images using convolutional neural networks (CNNs). In total, 591 digital OPGs were collected from patients older than 18 years. Three qualified dentists performed in idual teeth labelling on images to generate the ground truth annotations. A three-step procedure, relying upon CNNs, was proposed for automated detection and classification of teeth. Firstly, U-Net, a type of CNN, performed preliminary segmentation of tooth regions or detecting regions of interest (ROIs) on panoramic images. Secondly, the Faster R-CNN, an advanced object detection architecture, identified each tooth within the ROI determined by the U-Net. Thirdly, VGG-16 architecture classified each tooth into 32 categories, and a tooth number was assigned. A total of 17,135 teeth cropped from 591 radiographs were used to train and validate the tooth detection and tooth numbering modules. 90% of OPG images were used for training, and the remaining 10% were used for validation. 10-folds cross-validation was performed for measuring the performance. The intersection over union (IoU), F1 score, precision, and recall (i.e. sensitivity) were used as metrics to evaluate the performance of resultant CNNs. The ROI detection module had an IoU of 0.70. The tooth detection module achieved a recall of 0.99 and a precision of 0.99. The tooth numbering module had a recall, precision and F1 score of 0.98. The resultant automated method achieved high performance for automated tooth detection and numbering from OPG images. Deep learning can be helpful in the automatic filing of dental charts in general dentistry and forensic medicine.
Publisher: Informa UK Limited
Date: 03-08-2023
Publisher: Elsevier BV
Date: 08-2022
DOI: 10.1016/J.OOOO.2022.03.008
Abstract: This study aimed to evaluate a deep learning (DL) system using convolutional neural networks (CNNs) for automatic detection of caries on bitewing radiographs. In total, 2468 bitewings were labeled by 3 dentists to create the reference standard. Of these images, 1257 had caries and 1211 were sound. The Faster region-based CNN was applied to detect the regions of interest (ROIs) with potential lesions. A total of 13,246 ROIs were generated from all 'sound' images, and 50% of 'caries' images (selected randomly) were used to train the ROI detection module. The remaining 50% of 'caries' images were used to validate the ROI detection module. Caries detection was then performed using Inception-ResNet-v2. A set of 3297 'caries' and 5321 'sound' ROIs cropped from the 2468 images was used to train and validate the caries detection module. Data sets were randomly ided into training (90%) and validation (10%) data sets. Recall, precision, specificity, accuracy, and F1 score were used as metrics to assess performance. The caries detection module achieved recall, precision, specificity, accuracy, and F1 scores of 0.89, 0.86, 0.86, 0.87, and 0.87, respectively. The proposed DL system demonstrated promising performance for detecting proximal surface caries on bitewings.
Publisher: Public Library of Science (PLoS)
Date: 08-11-2012
Publisher: SAGE Publications
Date: 19-07-2016
Publisher: SAGE Publications
Date: 10-08-2022
DOI: 10.1177/07334648221120082
Abstract: We undertook a qualitative assessment of aged care technology needs from the perspective of consumers and providers using a cross-sectional survey that assumed a largely open-response format. We recruited a convenience s le of in iduals aged 18 years or older, lived in Australia, and self-identified as either an older adult ( n = 133), an informal caregiver of an older adult ( n = 27), and/or clinician, healthcare practitioner, and aged care provider ( n = 148). Survey responses were analyzed using a descriptive qualitative content analysis approach to interpret meaning from written survey responses. We identified seven themes reporting that technologies used in aged care do not appear to be meeting end-user needs. Supporting the Technology Acceptance Model, consumers and providers perceive usefulness of the technology and its actual ease of use as drivers of acceptance toward gerontechnology. Ten recommendations are proposed to support technology use and the quality of aged care.
Publisher: SAGE Publications
Date: 08-07-2016
Abstract: This study aimed to evaluate users’ acceptance of a teledentistry model utilizing a smartphone camera used for dental caries screening and to identify a number of areas for improvement of the system. A store-and-forward telemedicine platform “Remote-I” was developed to assist in the screening of oral diseases using an image acquisition Android app operated by 17 teledental assistants. A total of 485 images (five images per case) were directly transmitted from the Android app to the server. A panel of five dental practitioners (graders) assessed the images and reported their diagnosis. A user acceptance survey was sent to the graders and smartphone users following completion of the screening program. Of the 22 surveys sent out, 20 (91%) were completed. Generally, users showed optimism towards the use of the teledentistry system, and strongly positively assessed items on content and service quality. The majority of graders took less than 15 min to read the images while phone users took 5–10 min to complete the dental photography using the Android app. This study identified a number of factors that are essential for improving the current system, such as optimization of smartphone camera features, the format of the server, and the orientation of images and using oral retractors during photography. Users appear to be generally satisfied with the proposed teledentistry model. However, they have specific concerns to address, many of which could be resolved through more effective training, coordination between sites and upgrading the current system.
Publisher: Springer Science and Business Media LLC
Date: 31-07-2018
Publisher: The Journal of Rheumatology
Date: 04-2012
Abstract: To examine fine specificity of anticitrullinated peptide antibodies (ACPA) in relation to responsiveness to anti-tumor necrosis factor (anti-TNF) agents in rheumatoid arthritis (RA). S les from 450 patients with RA treated with anti-TNF agents were analyzed for antibodies to citrullinated α-enolase, vimentin, and fibrinogen peptides. The Disease Activity Score-28 was measured at baseline and 6 months. Both anti-cFib antibodies and the number of citrullinated peptides recognized were associated with a poorer response. These findings were not significant following stratification for anti-cyclic citrullinated peptide 2 antibodies. The presence of any ACPA rather than in idual ACPA specificities was associated with a poorer response to anti-TNF agents. We suggest that this reflects distinctive differences in the pathogenesis of ACPA-positive and negative RA.
Publisher: Rural and Remote Health
Date: 28-11-2016
DOI: 10.22605/RRH3915
Publisher: Springer Science and Business Media LLC
Date: 30-11-2021
DOI: 10.1186/S12875-021-01586-7
Abstract: Despite recent incentives through Medicare (Australia’s universal health insurance scheme) to increase retinal screening rates in primary care, comprehensive diabetic retinopathy (DR) screening has not been reached in Australia. The current study aimed to identify key factors affecting the delivery of diabetic retinopathy (DR) screening in Australian general practices. A descriptive qualitative study involving in-depth interviews was carried out from November 2019 to March 2020. Using purposive snowballing s ling, 15 general practitioners (GPs) were recruited from urban and rural general practices in New South Wales and Western Australia. A semi-structured interview guide was used to collect data from participants. All interviews were conducted over the phone by one facilitator, and each interview lasted up to 45 min. The Socio-Ecological Model was used to inform the content of the interview topic guides and subsequent data analysis. Recorded data were transcribed verbatim, and thematic analysis was conducted to identify and classify recurrent themes. Of 15 GPs interviewed, 13 were male doctors, and the mean age was 54.7 ± 15.5 years. Seven participants were practising in urban areas, while eight were practising in regional or remote areas. All participants had access to a direct ophthalmoscope, but none owned retinal cameras. None of the participants reported performing DR screening. Only three participants were aware of the Medicare Benefits Schedule (MBS) items 12,325 and 12,326 that allow GPs to bill for retinal screening. Seven themes, a combination of facilitators and barriers, emerged from interviews with the GPs. Despite the strong belief in their role in managing chronic diseases, barriers such as costs of retinal cameras, time constraints, lack of skills to make DR diagnosis, and unawareness of Medicare incentives for non-mydriatic retinal photography made it difficult to conduct DR screening in general practice. However, several enabling strategies to deliver DR screening within primary care include increasing GPs’ access to continuing professional development, subsidising the cost of retinal cameras, and the need for a ch ion ace to take the responsibility of retinal photography. This study identified essential areas at the system level that require addressing to promote the broader implementation of DR screening, in particular, a nationwide awareness c aign to maximise the use of MBS items, improve GPs’ competency, and subsidise costs of the retinal cameras for small and rural general practices.
Publisher: Wiley
Date: 26-07-2016
DOI: 10.1111/IDH.12240
Publisher: Springer Science and Business Media LLC
Date: 09-10-2018
DOI: 10.1007/S00784-018-2700-Y
Abstract: To determine the detectability of the intra-oral photographic method in comparison to the baseline, comprehensive dental examination (CDE), in children when performed by different levels of dental practitioners. As part of a quality assurance program, intra-oral photographs were obtained from 77 patients (2-18 years) as part of a CDE before undertaking dental treatment under general anaesthesia. A DSLR camera was utilised to acquire images which were subsequently uploaded to a cloud-based server. The baseline for each participant was established during the CDE, utilising both visual and radiographic examination, which was then compared to the assessment made by a mid-level dental practitioners (MLDP). The evaluation was based on utilising an odontogram where the teeth were charted either as decayed or filled. Specificity (95%) was higher than sensitivity (61.5%) when comparing the photographic assessment with the benchmark CDE assessment. The inter-rater reliability between the two methods of assessment was substantial, with a kappa score of 0.62. The photographic assessment method underestimated the decayed and filled teeth, as observed by the caries experience (dft/DFT scores) (CDE = 7.01 vs. photographic assessment = 5.22). There were lower levels of diagnostic detection in the posterior teeth as compared to the anterior teeth assessments. Although the CDE is still considered to be the gold-standard, this study found that the photographic caries assessment by MLDP produced an acceptable diagnostic level of detection particularly for the anterior teeth. The photographic method could offer a potential cost-saving and user-friendly screening.
Publisher: Springer Science and Business Media LLC
Date: 04-11-2016
Publisher: Springer Science and Business Media LLC
Date: 07-10-2016
Abstract: Objective This study was conducted to evaluate the validity and reliability of intraoral photographic assessments by different members of a dental team as a means for dental screening in children.Methods The intraoral photographic records of 126 children (2 to 18 years old) were obtained from routine clinical records taken before dental treatment. Intraoral photographs were obtained using a DSLR camera and then uploaded to a cloud-based server using store-and-forward telehealth technology. Images were reviewed by an expert panel to formulate a benchmark screening baseline, to which the screeners' data were compared. The photographic assessments conducted by a mid-level dental practitioner (MLDP) and dentist, were compared to the benchmark expert panel assessment.Results The screeners' assessments by means of intraoral photography, when compared to the expert panel assessment had a sensitivity value of 82-89% and specificity value of 97%. The inter-examiner agreement between the expert panel assessment and photographic method (assessed by a dentist and MLDP), was almost perfect, with a kappa score ranging from 0.82 to 0.88. The mean DFT/dft score for the children as determined by the expert panel's review and photographic assessment ranging from 5.41 to 5.79, with mean scores between the two assessment methods not significantly different (P = 0.746).Conclusion Our results suggested that oral health professionals (other than dentists) have the potential to screen for caries from intraoral photographs with the same diagnostic accuracy and reliability as dentists. This strategy has implications for supporting the use of MLDPs such as dental therapists or hygienists to screen for oral disease using telehealth.
Publisher: CSIRO Publishing
Date: 15-08-2023
DOI: 10.1071/AH23110
Publisher: Elsevier BV
Date: 08-2016
DOI: 10.1111/IDJ.12217
Publisher: Academic Journals
Date: 31-12-2011
DOI: 10.5897/JMPRX11.006
Publisher: Wiley
Date: 09-2017
DOI: 10.1111/ADJ.12527
Publisher: SAGE Publications
Date: 08-07-2016
Abstract: 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. 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. 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. 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.
Publisher: MDPI AG
Date: 02-08-2021
Abstract: The purpose of this study was to learn about mothers’ experiences with food choices for their pre-school children in underprivileged communities in Greater Western Sydney (GWS). A total of 20 mother-child dyads living in GWS were recruited to a qualitative study from an ongoing birth cohort study. Participants’ houses were visited for semi-structured interviews, which were recorded, transcribed verbatim, and analysed thematically. The interviews yielded five main themes: (i) food choices, nutrition, and health (ii) accessibility and availability of foods (iii) buying time for parents (iv) child’s age and their preference on food choices (v) conditioning certain behaviours by family and cultural factors. Nutrition literacy, child’s preferences, unhealthy food intake by family members, child’s demand, advertising and availability of harmful foods, and time constraints were all mentioned as hurdles to mothers making appropriate meal choices for their children. However, some identified facilitators were promoting parents’ knowledge, increasing access to health educational materials, upskilling mothers to providing healthier alternatives, regulating the marketing of unhealth foods. Although, the present study identified critical factors that influence mothers’ food choices for their young children, making healthy food choices is a complex practice as it is shaped by in idual, social and environmental influences.
Publisher: Wiley
Date: 27-08-2021
DOI: 10.1111/JSR.13179
Publisher: Elsevier BV
Date: 08-2018
DOI: 10.1111/IDJ.12379
Abstract: To estimate the scale of resource transfer that could be achieved by screening low-risk schoolchildren using teledentistry rather than using traditional visual dental examination. This study was based on a previous cost-minimisation study that compared the costs of two dental-screening approaches (visual and teledentistry). The data for the population of children 5-14 years of age was obtained from the Australian Bureau of Statistics and was ided across Australia according to statistical local area (SA2). The cost models (for teledentistry and visual screening) for each SA2 relative to the state, Remoteness Area (RA) and Socio-Economic Index for Area (SEIFA) indexes were estimated. The geographical information system was used to superimpose modelled cost data on the geographical map to provide a visual presentation of the data. Resource transfer scenarios, based on risk minimisation, were then developed and analysed. This study demonstrated a suboptimal allocation of dental-care resources, such that children living in high socio-economic areas (major cities) with low disease burdens consuming half of the estimated resources of a universal visual dental screening system. The findings suggest that utilising teledentistry screening for low-risk children has the potential to free up $40 million per annum. Such resources can be reallocated to increase care access and improve the quality of dental services for vulnerable children. To reduce inequalities in dental health within a community, scarce health-care resources should be targeted at the population at most risk. These findings can be used to inform policymakers, guide the appropriate distribution of scarce resources and target dental services to benefit high-need children.
Publisher: SAGE Publications
Date: 24-01-2017
Abstract: This review is designed to inform future decisions about the benefits of integrating teledentistry into routine health services, by presenting an overview of the evidence for the effectiveness and economic impact of teledentistry. Two reviewers searched PubMed, EMBASE and CINAHL databases through November 2016 to identify published peer-reviewed studies in English. Teledentistry studies were included if they were (a) controlled (randomised or non-randomised) assessment studies and (b) compared outcomes of a teledentistry intervention in terms of clinical or economic evaluation with the outcomes of traditional clinical alternatives. The quality of the studies was evaluated using a quality appraisal tool that considered study performance and design. This review identified 385 publications, of which 217 full-text articles were retrieved for further inspection. Of these, only 11 articles met the inclusion criteria. Nine of the included articles showed some clinical outcomes the other two were primarily economic analyses. The balance of these studies assesed the efficacy of teledentistry interventions rather than their effectiveness. Four studies (36%) achieved higher quality scores and have greater potential to influence health-care decision-making. To date, the most convincing published evidence regarding the efficacy of teledentistry was provided by studies on paediatric dentistry, orthodontics and oral medicine. The economic analysis referred only to cost-minimisation, suggesting that the use of teleconsultation in dentistry can be cost-saving when compared to a conventional consultation. However, high-quality economic studies on teledentistry are rare. There is emerging evidence supporting the efficacy of teledentistry. However, there is not yet enough conclusive evidence, particularly for its effectiveness, cost-effectiveness and long-term use, to make evidence-based policy decisions on teledentistry.
Publisher: Elsevier BV
Date: 09-2016
DOI: 10.1016/J.JEBDP.2016.08.003
Abstract: This study sought to systematically review the literature for research evidence for the diagnostic accuracy of teledentistry in the detection of dental caries. Two reviewers searched PubMed, EMBASE, and Scopus databases through January 2016 for comparative studies that examined the diagnostic accuracy of teledentistry for detecting caries compared with nontelemedicine alternatives. Retrieved studies were screened for inclusion criteria and were evaluated for methodological quality using the quality assessment of diagnostic accuracy studies (QUADAS-2) checklist. Of 287 citations identified, 10 met the preset inclusion criteria. Sensitivity and specificity were the most common measures of diagnostic accuracy used in 10 studies. Despite very limited published evidence on the diagnostic accuracy of teledentistry, the reviewed teledentistry studies showed comparable diagnostic performance compared with nontelemedicine alternatives. The average methodological quality of the selected articles is low, since none of the selected studies satisfied all 4 QUADAS-2 domains. Only 6 articles were scored as having a low risk of bias in 3 of 4 of QUADAS-2 domains. All the selected studies had low concerns regarding applicability. The main shortcoming was that in most of the selected studies, the methodology, in particular patient selection and index tests, was insufficiently described. Teledentistry has an acceptable diagnostic performance in the detection of dental caries. However, due to the heterogeneity of the reviewed studies, the generalization of results may be difficult. Further well-designed research to investigate the effectiveness of the teledentistry approach to caries detection is needed to determine the capability of this technology in epidemiologic oral surveys.
Publisher: Springer Science and Business Media LLC
Date: 03-2017
Publisher: BMJ
Date: 31-01-2012
Publisher: OMICS Publishing Group
Date: 2016
Publisher: Wiley
Date: 27-05-2016
DOI: 10.1111/ADJ.12423
Publisher: Elsevier BV
Date: 11-2016
DOI: 10.1016/J.AANAT.2016.02.010
Abstract: In this report we review the range of teaching resources and strategies used in anatomy education with the aim of coming up with suggestions about the best teaching practices in this area. There is much debate about suitable methods of delivering anatomical knowledge. Competent clinicians, particularly surgeons, need a deep understanding of anatomy for safe clinical procedures. However, because students have had very limited exposure to anatomy during clinical training, there is a concern that medical students are ill-prepared in anatomy when entering clerkships and residency programs. Therefore, developing effective modalities for teaching anatomy is essential to safe medical practice. Cadaver-based instruction has survived as the main instructional tool for hundreds of years, however, there are differing views on whether full cadaver dissection is still appropriate for a modern undergraduate training. The limitations on curricular time, trained anatomy faculty and resources for gross anatomy courses in integrated or/and system-based curricula, have led many medical schools to abandon costly and time-consuming dissection-based instruction in favour of alternative methods of instruction including prosection, medical imaging, living anatomy and multimedia resources. To date, no single teaching tool has been found to meet curriculum requirements. The best way to teach modern anatomy is by combining multiple pedagogical resources to complement one another, students appear to learn more effectively when multimodal and system-based approaches are integrated. Our review suggests that certain professions would have more benefit from certain educational methods or strategies than others. Full body dissection would be best reserved for medical students, especially those with surgical career intentions, while teaching based on prosections and plastination is more suitable for dental, pharmacy and allied health science students. There is a need to direct future research towards evaluation of the suitability of the new teaching methodologies in new curricula and student perceptions of integrated and multimodal teaching paradigms, and the ability of these to satisfy learning outcomes.
Publisher: Elsevier BV
Date: 12-2011
Publisher: Elsevier BV
Date: 10-2023
Publisher: Wiley
Date: 13-02-2023
DOI: 10.1111/IPD.13054
Abstract: Tele‐dentistry can be useful to facilitate screening of children, especially those living in rural and remote communities, and during the COVID‐19 pandemic. This study evaluated the feasibility of tele‐dental screening for the identification of early childhood caries (ECC) in preschoolers using an app operated by their parents with remote review by oral‐health therapists. This cross‐sectional study was a sub‐project nested in ORIGINS Project, a longitudinal birth cohort study in Western Australia. Initially, children were visually examined by a paediatric dentist (gold standard). Subsequently, dental photographs were taken by parents using a smartphone camera. Two trained oral health professionals asynchronously evaluated dental photographs. The presence of dental caries was recorded as per the International Caries Detection and Assessment System‐II classification. The diagnostic accuracy and reliability of the tele‐dental screening and the gold standard dental examinations were then compared. Forty‐two children aged years were enrolled in the study. Twenty‐five per cent of examined children had dental caries (mean dmfs = 0.7). A total of 370 dental photographs were obtained. Parents were able to take good‐quality photographs, with 90% of photographs rated as good to fair quality. Tele‐dental screening demonstrated high specificity ( =95.5%) for both reviewers compared to the gold standard dental examination. However, the sensitivity scores for the two reviewers varied, ranging from 44% to 88.4%. Tele‐dental screening for ECC was shown to be a feasible approach following a brief training for primary caregivers. This approach can offer a potential low‐cost and sustainable alternative for visual dental examinations for young children, particularly in times of COVID‐19‐related restrictions.
Publisher: Springer Science and Business Media LLC
Date: 2016
Abstract: Objective This study aimed to explore Australian dental practitioners' perceptions of the usefulness of teledentistry in improving dental practice and patient outcomes.Methods A descriptive cross-sectional study involving an anonymous electronic survey of a s le of 169 Australian dental practitioners. We designed a 24-item, 5-point Likert-scale questionnaire assessing perceptions of dentists in four domains: usefulness of teledentistry for patients usefulness of teledentistry for dental practice capability of teledentistry to improve practice and perceived concerns about the use of teledentistry.Results Of the 144 respondents (response rate 85%), 135 completed responses that were suitable for analysis. More than 80% of respondents agreed or strongly agreed that teledentistry would improve dental practice through enhancing communication with peers, guidance and referral of new patients. The majority also felt that teledentistry is quite useful in improving patient management, and increasing patient satisfaction. A substantial proportion of respondents expressed uncertainty with technical reliability, privacy, practice expenses, the cost of setting up teledentistry, surgery time and diagnostic accuracy.Conclusion Dental practitioners generally reported optimism and support to the concept of teledentistry and its integration into current dental practices. Addressing how teledentistry can benefit specific practice issues, would encourage more dentists to use telemedicine in routine practice.
Publisher: CSIRO Publishing
Date: 2018
DOI: 10.1071/AH16119
Abstract: Objective The aim of the present study was to compare the costs of teledentistry and traditional dental screening approaches in Australian school children. Methods A cost-minimisation analysis was performed from the perspective of the oral health system, comparing the cost of dental screening in school children using a traditional visual examination approach with the cost of mid-level dental practitioners (MLDPs), such as dental therapists, screening the same cohort of children remotely using teledentistry. A model was developed to simulate the costs (over a 12-month period) of the two models of dental screening for all school children (2.7 million children) aged 5–14 years across all Australian states and territories. The fixed costs and the variable costs, including staff salary, travel and accommodation costs, and cost of supply were calculated. All costs are given in Australian dollars. Results The total estimated cost of the teledentistry model was $50 million. The fixed cost of teledentistry was $1 million and that of staff salaries (tele-assistants, charters and their supervisors, as well as information technology support was estimated to be $49 million. The estimated staff salary saved with the teledentistry model was $56 million, and the estimated travel allowance and supply expenses avoided were $16 million and $14 million respectively an annual reduction of $85 million in total. Conclusions The present study shows that the teledentistry model of dental screening can minimise costs. The estimated savings were due primarily to the low salaries of dental therapists and the avoidance of travel and accommodation costs. Such savings could be redistributed to improve infrastructure and oral health services in rural or other underserved areas. What is known about the topic? Caries is a preventable disease, which, if it remains untreated, can cause significant morbidity requiring costly treatment. Regular dental screening and oral health education have the great potential to improve oral health and save significant resources. The use of role substitution, such as using MLDPs to provide oral care has been well acknowledged worldwide because of their ability to provide safe and effective care. The teledentistry approach for dental screening offers a comparable diagnostic performance to the traditional visual approach. What does this paper add? The results of the present study suggest that teledentistry is a practical and economically viable approach for mass dental screening not only for isolated communities, but also for underserved urban communities. The costs of the teledentistry model were substantially lower than the costs associated with a conventional, face-to-face approach to dental screening in both remote and urban areas. The primary driver of net savings is the low salary of MLDPs and avoidance of travel and overnight accommodation by MLDPs. What are the implications for practitioners? The use of lower-cost MLDPs and a teledentistry model for dental screening has the potential to save significant economic and human resources that can be redirected to improve infrastructure and oral care services in underserved regions. In the absence of evidence of the economic usefulness of teledentistry, studies such as the present one can increase the acceptance of this technology among dental care providers and guide future decisions on whether or not to implement teledentistry services.
Location: Australia
No related grants have been discovered for Mohamed Estai.