Digital Cameras Aid in Early ID of Tooth Decay

A new study finds that digital images could be helpful as a tool to screen for cavities in toddlers.

Putting a baby to bed with a bottle, especially a bottle filled with sweet liquid, is a recipe for serious tooth decay. Parents may overlook resulting cavities until the childs pain prompts a trip to the emergency room. By that time, the teeth may be so decayed that the toddlers may need to have their teeth extracted.

But some workers at child care centers are using digital cameras to identify the cavities early, before they cause pain and require surgery. Using a specially outfitted digital camera, telemedicine assistants at inner-city child care facilities can take pictures of childrens teeth and then send them over the Internet to pediatric dentists. The dentists can then identify toddlers with early childhood dental cavities, or "baby bottle tooth decay."

In a study, "Teledentistry in inner-city child-care centers," published in the Journal of Telemedicine and Telecare, dentists at the University of Rochester Medical Center found that nearly 40 percent of 162 one- to four-year-olds in inner-city child care centers had childhood cavities. Most children averaged about two cavities, but one child had 20 decayed teeth.

Most of these children had not been to the dentist, according to the researchers. And while early tooth decay is widely recognized as a problem in poor urban communities, large screening programs have not been implemented because of labor costs.

But this study showed that on-site health assistants could take pictures that were clear enough for accurate diagnoses.

"The quality of the images was such that we could spot decay that was not visible to the human eye," said Dr. Dorota Kopycka-Kedzierawski, one of the authors of the study and an assistant professor at the University of Rochester Medical Center. "And, we could use the photos to help educate the parents about the disease, and in some cases, gently prod them into seeking the care of a dentist."

According to the study, the current cost of baby bottle tooth decay in Rochester, N.Y., is estimated at about $1 million, a tab almost entirely picked up by Medicaid.

The study was a collaboration between Health-e-Access, one the nations largest telemedicine networks, and the Eastman Dental Center. Digital photographs of childrens mouths were taken by Health-e-Access assistants, who are already involved in facilitating virtual doctor visits for sick children. Digital files of childrens mouths were then electronically delivered to Eastman Dental Center, where they were reviewed by pediatric dentists.

If disease was identified, parents and guardians were sent letters warning about the cavities and referring the children to a dentist.

Three months later, all children were re-screened to determine how many actually had seen a dentist to correct the problem. About 25 percent of children had received dental services. The researchers said this study was too small to draw generalized conclusions.

The researchers are now looking for grants to cover childrens dental care.


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