Teleassistance in dentistry enables the support of dentists in areas without access
to specialists. The aim of this study was to assess the feasibility and accuracy of
synchronous teleconsultation in oral medicine.
Patients referred for specialized care owing to oral lesions were evaluated in person
by a general dentist who obtained photographs of the lesions with a smartphone. The
images were sent via a mobile application to an oral medicine specialist, with whom
a video call was initiated on the same instant messaging application. After interviewing
the patient, the specialist formulated a diagnostic hypothesis and suggestions for
case management. Then a second specialist, blinded to the first evaluation, assessed
the oral lesion in person and defined a diagnosis, which was considered as the reference
standard. Diagnoses from the remote and the face-to-face consultations were compared
in percentage levels of agreement and κ coefficient.
Thirty-three patients, 25 through 83 years old, had 41 oral lesions. The average teleconsultation
length was approximately 10 minutes. In 92.7% of the cases, there was concordance
between the telediagnosis and the reference standard (κ = 0.922).
Synchronous teleconsultation can provide reliable remote diagnosis through the support
to primary care health care professionals in management of oral lesions.
Earlier diagnosis of malignancies, improvement of access for unassisted populations,
and reduction of unnecessary referrals are possible practical implications of remote
support of a specialist in the management and diagnosis of oral lesions.