317 - Diagnostic Outcomes of Digital Images in Pediatric Dentistry: an Intra-examiner Agreement Assessment

Purpose: To Assess intra-examiner diagnoses obtained via traditional oral clinical examination (TCE) versus digital oral examination (DOE) completed from digital video images of pediatric patients.

Methods: Fifty pediatric patients 5 to 10 years of age, who attend the Pediatric Dentistry Clinic at the University of Alabama at Birmingham (UAB) for initial consultations or regular visits were included in this study. Individual oral comprehensive examinations were done by five second-year pediatric dentistry residents. A trained dental hygienist recorded a full mouth intraoral video for each patient via MouthWatch intraoral camera and stored using existing Information and Communication Technology (ICT) infrastructure. After a one-month wash-out period, videos were assessed by the same examiner for comprehensive evaluations. Intra-examiner consistency (percent) and examiner agreement was determined using the kappa coefficient (95% confidence interval [CI]).

Results: The overall findings indicated 93.5% intra-examiner consistency (C) and a moderate to almost perfect agreement between DOE and TCE with a kappa coefficient of 0.85 (0.73-0.95). The highest agreement was on dental caries detection (k=0.89) and assessment of hard tissues (k=0.93) The lowest agreement was on the assessment of dental occlusion (k=0.64), followed by the assessment of oral hygiene (k=0.82).

Conclusions: Dentists make similar diagnoses via DOE and TCE when examining school-age children. Within the limitations of the current study, the oral video record was found to be comparable to traditional visual clinical examination for the diagnosis of dental problems among school children, with both producing good and reproducible diagnostic outcomes. These findings support the use of the DOE as an alternative method of providing oral examination, assessment, and diagnosis for school-aged children.