Teledentistry Assessment of the Accuracy of Dental Photographs Taken by Elementary School Teachers

Objective: This study aimed to evaluate the effectiveness of oral health education and smartphone-based dental photography training for elementary school teachers in improving their knowledge, the quality of teacher-acquired dental photographs, and the diagnostic accuracy of these photographs compared with dentists' clinical examinations.Materials and Methods: This quantitative study employed a preexperimental one group pretest–posttest design involving 30 elementary school teachers. Sixty students aged 9–12 years underwent dental photography and clinical examination, producing 360 intraoral and extraoral photographs. Diagnostic accuracy analysis included 60 primary teeth and 54 permanent teeth that were clearly visible in the photographs. Data were collected using questionnaires and dental photographs and analyzed using the Wilcoxon signed-rank test, Spearman's rank correlation, diagnostic accuracy analysis, and Cohen's kappa coefficient with SPSS version 25.Results: Teachers' knowledge and dental photography quality improved significantly after the intervention. The sensitivity for caries detection was 84.21%–85.00%; specificity, 86.36%–90.00%; positive predictive value, 91.43%–93.54%; and negative predictive value, 76.00%–78.00%. Agreement between teacher-acquired photographs and clinical examination was substantial, with k = 0.69 for primary teeth and κ = 0.714 for permanent teeth.Conclusion: Oral health education and smartphone-based dental photography training improved teachers' knowledge and their ability to obtain diagnostic-quality dental photographs. Teacher-acquired photographs demonstrated acceptable diagnostic accuracy and may support early caries detection through school-based teledentistry, particularly in areas with limited access to dental professionals.