COMPARISON OF INTRAORAL CAMERAS AND SMARTPHONES IN EARLY CHILDHOOD CARIES DETECTION: A DIAGNOSTIC ACCURACY STUDY

Objectives

Early Childhood Caries (ECC) is a major public health problem affecting children worldwide. Teledentistry offers innovative approaches for ECC detection, particularly in areas with limited access to care. This study compared the accuracy of intraoral cameras and smartphones in relation to visual clinical examination in detecting ECC.

Methods

A prospective diagnostic accuracy study was conducted in a rural area near Alexandria, Egypt, involving children under 6 years old. An intraoral camera (C50 Full HD with fluorescence) or a smartphone (Samsung Galaxy A24) captured intraoral structures after randomizing the children into 2 groups. The reference standard was visual clinical examination under daylight without magnification or drying. Teeth were categorized using the Caries Assessment Spectrum and Treatment (CAST) index criteria based on clinical examination, intraoral camera videos and smartphone photos. Sensitivity, specificity, and accuracy were calculated for the 2 methods at 3 thresholds: enamel caries, dentin caries and enamel/dentin caries combined.

Results

The study included 116 children, mean (SD) age = 4.3 (1.0) years, 83.6% with untreated decay and mean (SD) number of decayed teeth = 4.03 (3.50). Both the intraoral camera and the smartphone had high specificity and accuracy at the 3 thresholds (≥90%). The lowest sensitivity was in the case of detecting enamel lesion (intraoral camera = 77.5% and smartphone = 68.5%).

Conclusion

Enamel caries was detected by the intraoral camera more accurately than the smartphone. Despite this, both devices exhibited high specificity and accuracy at all diagnostic thresholds. Smartphones present a good alternative for intraoral cameras in underserved areas, improving ECC detection and care.