Oral Health Monitoring of Homebound Older Adults Using Teledentistry in Primary Health Care: A Pilot Pragmatic Randomized Feasibility Trial

Population aging increases demand for home-based dental care, but access remains limited for homebound older adults. Although teledentistry can help overcome mobility barriers, its feasibility within routine Primary Health Care (PHC) requires further investigation. This pragmatic pilot trial evaluated a teledentistry protocol for monitoring homebound older adults. Six homebound older adults in the Brazilian PHC system were assigned to receive either one remote monitoring visit via a telehealth platform or one conventional home visit over three weeks. Feasibility was assessed using the Acceptability, Adequacy, and Feasibility measures of the intervention (scale 1 to 5), along with diagnostic instruments (OFI-8, OHIP-14, Kihon Checklist). In this small pilot sample, descriptive trends of adequacy (3.5), feasibility (3.3), and acceptability (3.0) were presented, with the acceptability score sitting exactly at the predefined 3.0 progression threshold. Digital literacy barriers may have influenced participation and frequently required caregiver mediation. Remote data collection appeared stable in this pilot setting. The intervention group showed a descriptive worsening of OHIP-14 scores, which future studies can examine. In conclusion, while preliminary observations suggest that remote monitoring could be delivered in this small pilot sample, digital literacy challenges indicate that a hybrid model—combining teledentistry with targeted in-person visits—should be examined in larger, future trials as a potentially more equitable approach.