Children's Acceptance of Intraoral Cameras and Smartphones for Caries Detection: A Randomized Controlled Clinical Trial

Abstract

Background: Teledentistry can improve access to care, but children's acceptance of different imaging techniques is underexplored. Aim: The aim of this study was to assess children's acceptance of intraoral cameras and smartphones for caries detection. Design: A randomized controlled trial was conducted in rural Egyptian nurseries, with children aged ≤ 6 years randomized into intraoral camera or smartphone groups. Behavior during imaging was assessed using four indicators: fear, mouth-opening difficulty, opposition, and cooperation, with a total score calculated from their sum. Imaging time was recorded, and mood was assessed using the Positive and Negative Affect Scale. Linear regression assessed associations between behavior and time with technique and mood, adjusting for confounders. Results: The study included 508 children, mean (SD) = age 4.54 [1.04] years. Children in the intraoral group showed higher fear and difficulty keeping their mouths open, with lower overall behavior scores (mean [SD] = 16.64 [2.95] vs. 17.18 [3.06], B = −1.05, p < 0.001). The intraoral camera required less time (mean [SD] = 3.62 [1.49] vs. 5.33 [2.82] minutes, B = −1.56, p < 0.001). Positive mood improved behavior (B = 0.25, p < 0.001), while negative mood increased time (B = 0.30, p < 0.001) and worsened behavior (B = −0.64, p < 0.001). Conclusion: Smartphones improved behavior, while intraoral cameras were more time-efficient. Device choice should balance efficiency with child comfort. Trial Registration: ClinicalTrials.gov identifier: NCT06019884.