Smartphone-based patient-driven teledentistry for postoperative monitoring: a pilot study.

PURPOSE: This pilot study evaluated whether the use of an intraoral camera improves the accuracy of remote postoperative wound-healing assessment after oral surgery compared to a phone consultation alone. The primary outcome was the correct identification of cases requiring further intervention such as a medication change or an in-person visit. METHODS: Eleven patients undergoing oral surgery were assessed 4–6 days postoperatively using four remote modalities: phone consultation (PC), patient-generated snapshots (SS), patient-generated video footage (VF) and clinician-guided live video call (LC). For each method, assessments were performed independently by the operating clinician and by a second independent dentist, who had no prior knowledge of the patient, using standardized questionnaires developed for this study. A physical visit (PV) served as the reference standard. Accuracy, rates of non-assessable outcomes and inter-examiner agreement (Cohen’s kappa, or prevalence-adjusted bias-adjusted κ when required) were calculated. Performance across modalities was compared using McNemar tests. Clinicians also rated the perceived usefulness and preference and image quality was assessed for smartphone-based intraoral camera (IOC) modalities. RESULTS: No patient required an intervention at the PV. Remote assessments incorrectly suggested the need for intervention in three instances, all occurring during phone-based or live video call evaluations. Accuracy varied across modalities. Correct identification of cases needing intervention was highest for SS and VF (21/22; 95.5%), followed by PC and LC (19/22; 86.4%). Snapshots showed the lowest overall accuracy across wound-healing parameters, largely due to poor image quality (47% diagnostically sufficient). Live video calls yielded the highest proportion of diagnostically adequate images (72.7%) and were the most preferred modality among clinicians. Across all modalities, assessments by the operating clinician more closely matched PV findings than those made by the independent dentist. CONCLUSIONS: In this pilot study, smartphone-based intraoral camera methods did not outperform simple phone consultations in identifying postoperative cases requiring intervention after oral surgery. This finding likely reflects the limited statistical power rather than a true absence of differences between methods. However, live video calls were preferred by clinicians and provided the most clinically useful images. CLINICAL RELEVANCE: Remote postoperative assessment in oral surgery is feasible but reliability depends largely on image quality and clinician’s familiarity with the patient. Live video-guided assessements may offer practical advantages and represent a promising approach for future teledentistry applications