Smartphone-Based Teledentistry to Support Clinical Triage and Risk-Informed Dental Care in Patients With Inherited Bleeding and Haemoglobin Disorders: A Cross-Sectional Diagnostic Agreement Study.

INTRODUCTION

Patients with inherited bleeding and haemoglobin disorders face barriers to accessing timely dental care, increasing the risk of untreated oral disease and complications related to invasive procedures.

AIM: To evaluate the agreement between smartphone-based asynchronous teledentistry and face-to-face examination for oral conditions, and to assess its potential to support clinical triage in this population.

METHODS

A cross-sectional study was conducted including 71 individuals (2-70 years) attending a haematology referral centre. Dental caries was assessed using the Decayed, Missing and Filled Teeth index for permanent and primary dentitions (DMFT/dmft), the index of clinical consequences of untreated dental caries (PUFA/pufa), and the Modified Gingival Index (MGI). Standardised intraoral photographs were obtained using a smartphone. A blinded examiner performed remote assessments. Agreement was analysed using intraclass correlation coefficients (ICC) and Spearman's correlation.

RESULTS

Agreement was excellent for DMFT (ICC = 0.945) and dmft (ICC = 0.951), with similarly high values for most components and PUFA/pufa indices. Gingival assessment showed moderate correlation (r = 0.555, p < 0.001). Most cases were classified as moderate complexity, and remote assessment indicated that 73.2% could be managed at the primary care level.

CONCLUSION

Smartphone-based teledentistry demonstrated robust agreement for caries detection and meaningful capacity to support triage decisions. This approach may contribute to safer and more efficient care pathways for patients with inherited bleeding and haemoglobin disorders.