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Telecommunication: An Approach in Optimising Paediatic Oral Health – A Review
*Corresponding author: Dr. Manju Raman Nair, Department of Pediatric and Preventive Dentistry, A B Shetty Memorial Institute of Dental Sciences, NITTE (Deemed to be University), Deralakatte, Mangaluru 575018, Karnataka, India. drmanjupedo@gmail.com
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Received: ,
Accepted: ,
How to cite this article: Kumar N, Nair MR, Nayak PP. Telecommunication: An Approach in Optimising Paediatric Oral Health – A Review. J Health Allied Sci NU. 2026;16:1-7. doi: 10.25259/JHASNU_14_2025
Abstract
Teledentistry, which leverages telecommunication technology for dental care and education, has gained traction, especially in paediatric dentistry. This review evaluates its current applications, various tools, benefits, challenges, and prospects. It highlights how teledentistry improves access to dental services for children, particularly in underserved and rural areas, by enabling remote consultations, diagnosis, and treatment planning. Additionally, it promotes oral health education and preventive care for children and their caregivers through the inclusion of child-friendly applications and games. While teledentistry offers advantages such as improved access, cost-effectiveness, and convenience, significant efforts are needed to overcome certain challenges. Future research and policy initiatives are crucial for integrating teledentistry into paediatric dental practice, showcasing its potential to enhance accessibility and efficiency, ultimately leading to better oral health outcomes for children.
Keywords
Dental caries
Oral health
Paediatric dentistry
Technology
Telecommunication
INTRODUCTION
Teledentistry, a subfield of telehealth, focuses on dentistry by utilising information technology to provide remote dental care, advice, education, and treatment, rather than face-to-face interactions. The first study was conducted in 1994 by the US Army as part of the Total Dental Access Project.[1] “Teledentistry was defined as the practice of diagnosing and providing treatment advice over a distance using video-conferencing technology”.[1] Teledentistry offers numerous benefits, reducing barriers to oral healthcare access. Virtual appointments improve access to specialty care in rural areas and enable providers to collaborate for multidisciplinary care, such as with cleft teams.[2]
Types of teledentistry
Two-way interactive or real-time consultation (synchronous) and real-time video conferencing between a dentist and patient allows for the immediate exchange of information and diagnosis, facilitating prompt sharing with specialists.[3]
Store-and-Forward Teledentistry (asynchronous): X-rays, photos, and scanned images are collected, stored, and forwarded to consultants elsewhere. This is useful for specialist consultations and educational purposes with consent.[4]
Remote Monitoring of Patients' Health and medical data are transmitted electronically for healthcare and supportive management.
Mobile health (mHealth), mobile devices like cell phones, tablets, and Personal digital assistant (PDAs) support public health practices and education.[5]
Telehealthcare model
Teletriaging implies sorting patients based on how critical their dental needs are, and it works well with phones or computers. The dental group or office staff can decide whether a patient needs prompt care or on the off chance that they can wait. In case it's pressing, they'll attempt to assist right away. In case it's not pressing, they can set up a conversation afterward and schedule a visit at a more convenient time.
The concept of "forward triage" is utilised to reduce the caregiver's workload by tending to non-emergent cases. Sometimes patients physically visit a clinic or a dental clinic. By proactively recognising potential emergencies and avoiding pointless developments, forward triage makes a difference by overseeing patient flow amid times of widespread crisis.
Teleconsultation alludes to the method of connecting in interactive consultations with healthcare experts through phone or video conferencing, which serves as a key component within the telehealth show. Also, in case the computer program supports different members, it can moreover encourage meetings with mentors.
In a teleconsultation, individuals converse over the internet or by phone. They share things like what's off-base, their restorative history, later tests, pictures of their teeth interior and out, X-rays, and in some cases a virtual check-up. They do this at an arranged time.
Telediagnosis implies looking at all the data from a conversation online to figure out what's off-base. After that, the specialist tells the patient what's going on and what to do. A few analysts made a framework called 'Mobile Mouth Screening Anywhere (MeMoSA®)' to discover verbal cancer. Also, since not everybody can see a master effectively, they made a little microscope you can utilise with a tablet called the Cellscope Gadget to check for oral cancer.
Telemonitoring alludes to the method of remotely checking patients' health and conducting schedule checkups, which has truly been given lower priority in dentistry.[5]
Utilising media transmission strategies such as planned phone calls, video conferencing, or electronic forms to assemble data on side effect determination allows for effective observation of postoperative cases. This approach advances great dental health and empowers early detection of any potential treatment disappointments.
Teledentistry driven remedies
Dental trauma
Immediate dental visits are ideal for trauma-related injuries; however, teledentistry tools (e.g., phone consultations, video calls, messaging, and image sharing) provide effective remote management when otherwise impossible. Mobile apps also aid in handling such cases [Table 1].
| Dental trauma | |
|---|---|
| ToothSOS |
|
| Accident |
|
| Dental trauma first aid app |
|
| Tooth emergency app |
|
| Injured tooth app |
|
| Knocked out app |
|
|
|
| Broken tooth no pain guide app |
|
| Chipped tooth solution, Dental crown repair, Fixing cracked tooth, Repairing the front tooth, and solution to broken tooth |
|
| Caries prevention | |
| AICaries |
|
| Cambra-kids |
|
| My smile buddy |
|
|
|
| Brush DJ |
|
| Time2 Brush |
|
| Behaviour management | |
| Crazy dentist app |
|
| Little lovely dentist |
|
ToothSOS, developed by the International Association of Dental Traumatology (IADT), provides accessible, step-by-step guidance for both patients and professionals during dental emergencies. A survey assessing parental awareness of ToothSOS and the IADT’s "Save Your Tooth" revealed that parents had insufficient knowledge of traumatic dental injuries (TDIs), suggesting a need for greater emphasis on TDI education by dental health providers using these tools.[6]
AcciDent functions without an internet connection, making it particularly useful in remote areas. Additionally, the Dental Trauma First Aid app offers crucial on-the-spot guidance for dental accidents. For Android users, apps like Chipped Tooth Solution, Dental Crown Repair, and Fixing Cracked Tooth provide further resources for managing common dental trauma scenarios.[7]
Another valuable resource is the electronic book Traumatic Dental Injuries to Children’s Permanent Teeth, a 10-page digital guide with images and text covering the causes, consequences, prevention, and first aid for children’s permanent tooth injuries, accessible on various digital devices.[8]
Dental caries
Dental caries are highly prevalent, requiring early prevention and management. Teledentistry, through video consultations and smartphone photography, facilitates early detection and prevention. The YOLOv3-enhanced deep learning model has demonstrated promising results in accurately detecting primary caries, with image enhancement improving model performance.[9]
Applications such as AICarie aid in the early detection of early childhood caries (ECC) and provide education on reducing caries risk.[10] The CAMBRA-Kids app is an Information and communication technology (ICT)-based caries management system that evaluates children’s caries risk by considering risk factors, protective factors, and disease indicators. A study showed that CAMBRA-Kids significantly reduced dental plaque, mineral loss, and cariogenic bacteria, especially in high-risk groups, after conducting caries management by parents using an app-based protocol for 1 year in 119 preschool children.[11]
The My Smile Buddy app assesses ECC risk based on dietary habits and has proven to be user-friendly for community health workers and parents.[12] The Brush DJ app, designed to promote oral hygiene routines, showed positive results in motivating and educating children aged 7-12.[13] Apps like Your Child's Smile.[14] Increased parents’ knowledge of dental caries prevention, and Time2Brush and Little Monsters Toothbrush Time helped improve oral hygiene and reduce plaque and caries incidence in children.[15]
Remote caries management through teledentistry includes non-restorative cavity control (NRCC) for early-stage cavities, emphasising proper brushing with fluoridated toothpaste, dietary changes, and the use of fluoride products. Asymptomatic cavities can be managed at home with a thorough cleaning, and deeper cavities may be temporarily addressed with clove oil and analgesics until a dental visit is possible. For severe pain and swelling, teleconsultations can guide antibiotic and pain relief medication, and advise if an emergency visit is necessary.[5]
Behaviour management
Patil et al.[16] evaluated the "My Little Dentist" app in children aged 8 to 12 during dental visits. The pilot study found that the app, allowing children to perform virtual dental procedures, significantly reduced anxiety and improved behaviour in subsequent visits. Meshki et al.[17] assessed the "Crazy Dentist" app, a dental simulation game for children aged 4 to 7, before dental procedures. The trial showed that the app effectively reduced anxiety during anaesthetic injections and drilling through its engaging, reward-based design. Elichelra et al.[18] Evaluated the "Little Lovely Dentist" app in children aged 7 to 11 during their first dental visit. The study found the app to be more effective than traditional tell-show-do (TSD) methods in reducing anxiety, due to its interactive features addressing psychological and emotional aspects of fear.[18] A recent study compared a mobile dental game, tell-show-play-doh, and traditional TSD methods for reducing anxiety in children aged 4 to 8. The study found the mobile game and tell-show-play-doh significantly more effective than conventional methods due to their interactive nature.[19] The table summarizes mobile applications, primarily focused on dental trauma,[20] with additional coverage of caries prevention and behavior management.
Other considerations
Teledentistry enables sharing teething advice via video consultations or messaging. Dentists guide parents on gum cleaning, recommend teething products, and offer personalised advice. Remote monitoring helps assess gum health and progress in teething.[21]
Home-based tooth extraction can be assisted with a topical anaesthetic, gentle twisting, and post-care instructions (gauze pressure, food/activity precautions). Teledentistry tools offer real-time guidance to parents for safe and effective care.[22]
Assess the object and breathing in swallowing incidents. Teledentistry aids with small objects that may pass naturally while choking and need urgent care. For swallowed restorations, maintain hygiene and pack the cavity with Teflon tape or clove oil until a dental visit.[5]
Teledentistry supports paediatric orthodontics by managing issues like broken brackets or appliance fit through video consults, messaging, and remote monitoring. Parents can cover sharp wires with wax or reseat loose bands. Teleconsultation guides replacing elastic modules at home until a dentist visit.[5]
In all paediatric concerns, immediate teleconsultation is the first and foremost step to managing the situation in the right manner and avoiding harmful consequences.
DIGITAL DEVICES AND SOCIAL NETWORKS
In recent years, several digital devices have gained importance. Torres-Pereira et al.[23] evaluated the use of smartphone cameras for capturing intra-oral images for cloud-based screening by mid-level practitioners and dentists. The study found that 18-megapixel DSLR images provided adequate diagnostic accuracy, improving referral speed, reducing treatment delays, and increasing patient inflow. Kopycka-Kedzierawski et al.[24] compared conventional and teledentistry-assisted examinations for detecting ECC in children aged 12 to 60 months. Both methods were equally effective, but coloured images of carious teeth were particularly effective in motivating parents to seek dental evaluations for their children. Estai et al.[25] compared the cost-effectiveness of conventional dental examination with teledentistry using the 'Remote-I' system for Android phones. The study found that teledentistry, through a cloud-based review of recorded dental photographs, is a cost-effective method for mass dental screening in remote areas. De Almeida Geraldino et al.[26] assessed the use of mobile phone cameras for remote examination of traumatised teeth in patients aged 3 to 39. The study found that remote diagnoses using the camera were as accurate as in-person assessments, demonstrating its utility for diagnosing TDIs remotely. Kale et al.[27] evaluated mothers' ability to diagnose dental caries in children aged 3 to 5 using a smartphone camera and WhatsApp for photo sharing after health education. The method demonstrated high sensitivity, specificity, and accuracy. Additionally, children were more cooperative during smartphone-based exams compared to conventional ones due to their familiarity with the device. AlShaya et al.[28] assessed the reliability of intra-oral images taken with a smartphone for diagnosing dental caries in children aged 6 to 12 using Google Drive and WhatsApp Messenger for teledentistry. The study found that while teledentistry provided acceptable reliability for initial diagnoses, it was less reliable than traditional methods, likely due to the lack of radiographs. Marino et al.[29] evaluated the effectiveness of teledentistry using intra-oral and web cameras for transmitting audio and video. In a non-randomised field trial, community dentists sent recorded images of children (mean age 8.6 years) to paediatric dentists for consultations on cleft lip/palate, dental trauma, and orthodontics. The study found that teledentistry effectively provided accurate diagnoses, reduced screening time, and facilitated appropriate referrals. A recent study evaluated the effectiveness and parental satisfaction of teleconsultations by paediatric dentists for children aged 2 to 16 during the COVID-19 pandemic. The study found that telephone consultations reduced the need for in-person visits and achieved high patient satisfaction.[30]
The use of various social networking sites has also been implicated. Scheerman et al.[31] conducted a randomised controlled trial using a theory-based program delivered via the Telegram app to promote regular tooth brushing among children aged 12 to 17 and their mothers. It found significantly improved brushing behaviour and reduced plaque scores, with increased effectiveness when mothers were involved. A randomised controlled trial was conducted to evaluate the impact of educational text messages about ECC delivered via WhatsApp to parents and their children aged 36 to 60 months. The study found that the intervention effectively reduced ECC severity in low socioeconomic preschoolers, improved parental eHealth literacy, and positively influenced children's dietary habits.[32]
Benefits and limitations
Teledentistry can expand child oral healthcare access at lower costs, addressing the shortage of paediatric dental specialists in remote areas.[33] Virtual appointments save travel time, making it convenient for children and parents without taking time away from school or work.[34] It helps dentists triage urgent cases and provide follow-up advice, reducing patient load in busy practices.[35] Video consultations allow for clearer explanations of treatment plans to parents using intraoral photos.[35] An initial virtual appointment can reduce dental visit anxiety and give parents more time to consider treatment options before the clinic visit.[36] It enables better interdisciplinary interactions, improving treatment outcomes.[36] Teledentistry faces issues like lack of awareness, equipment costs, reimbursement clarity, and data security, similar to telemedicine.[37] Dentists face challenges like poor internet access, hardware shortages, system incompatibility, financial constraints, remote centre cooperation, unclear directives, and installation costs.[38] While overcoming these challenges will take time, surveys indicate that both patients and healthcare providers are increasingly accepting TD and telemedicine.[39] Without overcoming these limitations and barriers, the adoption of teledentistry in dental practice will remain slow and inconsistent.[40]
Future scope
Further research on teledentistry's cost-effectiveness for paediatric patients is needed. Clear government policies on reimbursement, licensure, taxation, and legal issues are essential for global adoption. A 2020 study detailed Italy's first remote intervention using a 5G-connected robot.[41] The procedure involved transoral laser microsurgery on a cadaver located 15 km from the anatomy lab. The surgeon remotely removed a polyp grafted onto the vocal cords, with two-way data transmission enabled by an experimental 5G network.[42] Teledentistry is just beginning to show its potential, with more dental treatments likely to be performed remotely soon. While numerous studies have demonstrated teledentistry's effectiveness in diagnosing oral malignancies,[43] orofacial pain, medication-related osteonecrosis of jaw-MRONJ,[44] temporomandibular disorders,[45] and oral surgery follow-up,[46] further advancements are expected. Dentistry lacks advanced remote practice tools, unlike general surgery, requiring technological innovation and a mindset shift among practitioners. Future dentists will use information networks and simulations for remote skill transfer, shaping digital healthcare through widespread adoption in education.[47] Patient acceptance is crucial for the success of teledentistry, as the absence of face-to-face interaction may raise concerns about effective communication.[48] Teledentistry research is largely from developed countries, with uncertain effectiveness in developing, rural, and remote areas.
CONCLUSION
Teledentistry offers key advantages in paediatric dentistry, particularly in underserved areas, by reducing travel, minimising anxiety, and enabling timely consultations. It also enhances interdisciplinary care and improves treatment outcomes. However, challenges such as technological limitations, financial constraints, and regulatory issues hinder its full potential. Addressing these barriers through research, clear guidelines, and robust support systems is crucial for widespread adoption.
Ethical approval
Institutional Review Board approval is not required.
Declaration of patient consent
Patient's consent not required as there are no patients in this study.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
Use of artificial intelligence (AI)-assisted technology for manuscript preparation
The authors confirm that there was no use of artificial intelligence (AI)-assisted technology for assisting in the writing or editing of the manuscript and no images were manipulated using AI.
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