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

purposeThis 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.

methodsEleven 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.

resultsNo 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.

conclusionsIn 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