Use of smartphone photos to document the oral care status of nursing home residents

Abstract

Objective: Investigate whether clinically assessed oral care status by an external dentist can be replicated using smartphone photographs. Background: Many people with care needs have poor oral hygiene. To help maintain oral health, caregivers require a simple way of communicating oral care status to the dental team. Materials and Methods: Cross-sectional study in which smartphone photographs of the oral and prosthetic care situation of N = 50 nursing-home patients (mean age 85.6 [SD 6] years, 74% women) were assessed by two blinded, external examiners (D1/D2) and compared with clinical assessments made by the onsite dentist who also took the photographs (D0). Intraoral care status was clinically evaluated using the modified Plaque Index for Long-Term Care (PI-LTC) and Denture Hygiene Index (DHI). The intraclass correlation coefficient (ICC) determined correlations between clinical and photographic findings. Results: The ICC was assessed for the PI-LTC (upper jaw, n = 41; lower jaw, n = 49) and DHI (upper jaw, n = 25; lower jaw, n = 18). The DHI showed excellent reliability between clinical assessment and smartphone evaluation for the determination of positive surfaces (ICC: upper 0.91 [95% confidence interval (CI) 0.83–0.96], P < 0.001; lower 0.95 [95% CI 0.89–0.98], P < 0.001). The PI-LTC showed good reliability between clinical assessment (D0) and D1/D2 for determination of vestibular plaque (ICC: upper 0.84 [95% CI 0.74–0.91], P < 0.001; lower 0.87 [95% CI 0.79–0.92], P < 0.001). Conclusions: Although limited, this pilot study demonstrated that standardised smartphone photographs can simply communicate the intraoral care status of patients who have difficulties accessing their dentist. This should be considered when planning improved communication between dentists, care recipients, and their support network.