Can teledentistry be used as an alternative to in-person examinations for the detection of dental caries in pandemic?

A COMMENTARY ON: Casas K, DiPede L, Toema S, Ogwo C. Assessing Teledentistry versus In-Person Examinations to Detect Dental Caries: A Systematic Review and Meta-analysis. JDR Clinical & Translational Research. 2025;11(1):4-15. https://doi.org/10.1177/23800844251320974 DESIGN: A systematic review and meta-analysis focusing on the diagnostic accuracy of teledentistry compared to in-person examinations for detecting dental caries in primary and permanent dentition. The authors conducted a search in PubMed and CINAHL via EBSCOhost and followed the PRISMA-DTA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Diagnostic Test Accuracy) guidelines. STUDY SELECTION: Comparative studies, including randomized and non-randomized clinical trials, that used DMFT/S or ICDAS indices and reported sensitivity and specificity as diagnostic parameters were considered eligible. Only studies published in English between January 2013 and December 2021 were included. Studies that did not meet these criteria were excluded. DATA ANALYSIS: QUADAS-2 and JBI checklists were used for risk of bias and critical appraisal. A DerSimonian-Laird random-effects approach was applied to conduct the univariate meta-analysis. Forest plots were generated for included studies, and sensitivity, specificity, diagnostic odds ratio (DOR), and confidence intervals were calculated. Heterogeneity was assessed using Cochran's Q and Higgins's I² to evaluate the variation across studies and the consistency of the results. RESULTS: Twelve studies reported sensitivity of 45.6-88.3% and specificity of 55.2-98.3% for teledentistry in caries detection. Accuracy ranged from 70% to 96%, and PPV/NPV were 79-92% and 48-97%, respectively. Heterogeneity was low (I² = 24%), and the DerSimonian-Laird random-effects model estimated a diagnostic odds ratio of 35.14, indicating high diagnostic performance. CONCLUSIONS: Teledentistry can be considered a method comparable to in-person examinations for diagnosing dental caries.