Camila Huanca

[This corrects the article DOI: 10.2196/60590.].

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Background: Teledentistry is a field of activities that comprises information and communication technologies (ICTs) applied to dentistry, including the exchange of clinical information, patient care, and the use of educational strategies across remote distances. Its use has grown progressively over the past decades—intensified by the COVID-19 pandemic—and has been improving the provision of dental services and educational strategies ever since. Objective: This evidence gap map (EGM) study aims to present a collection of systematic reviews (SRs) with meta-analyses to answer the question “What are the applications of teledentistry in dental services and dental education?” by identifying gaps and current evidence on the improvement of health care and education. Methods: The EGM methodology has been developed by the Latin American and Caribbean Center on Health Sciences Information and is based on the concept created by the International Initiative for Impact Evaluation. Embase, PubMed, and Virtual Health Library databases were used for the literature research, using terms for teledentistry associated with eHealth, dental education, and oral health care. The data obtained from the included studies were then characterized in a Microsoft Excel spreadsheet, with a matrix containing 8 intervention groups (combined interventions, e-learning and tele-education, teleconsultation and teleservice, telemonitoring, telediagnosis, telescreening, ICTs, and artificial intelligence) and 8 outcome groups (diagnosis accuracy, education and professional training, user behavior, clinical practice, patient-centered outcomes, clinical outcomes, health services management, and access to health services). The quality of the studies was assessed using AMSTAR2 (A Measurement Tool to Assess Systematic Reviews). The visual analytics platform Tableau (Salesforce) was used to graphically display the confidence level, number of reviews, health outcomes, and intervention effects. Results: The confidence level obtained by the criteria applied was high for 28% (19/68) of the studies, moderate for 6% (4/68), low for 15% (10/68), and critically low for 51% (35/68). Among the interventions, the ICT group stood out with 182 (36.8%) out of 494 associations, followed by interventions with e-learning and tele-education (n=96, 19.4% of associations), telediagnosis (n=67, 13.6%), and combined interventions (n=53, 10.7%). Most of the outcomes were aimed at education and professional training (97/494, 19.6% of associations), patient-centered outcomes (74/494, 15%), and health services management (60/494, 12.1%). Conclusions: This EGM presents an overview of the contributions of teledentistry in patient care, health services, clinical practice, and education. The study results may help guide future research and policy decisions and serve as a convenient virtual tool for accessing valuable evidence-based information on teledentistry.

Esta pesquisa tem como objetivo determinar e analisar a usabilidade do Dental Case, um serious game de cuidados odontológicos na Atenção Primária, pelos jogadores. Cento e um estudantes de Odontologia foram submetidos a um caso clínico do Dental Case. O instrumento Questionário de Usabilidade do Sistema Pós-Estudo (PSSUQ) foi aplicado para avaliar a usabilidade do Dental Case e a satisfação dos jogadores. A qualidade das informações fornecidas pelos casos clínicos e a usabilidade foram avaliadas positivamente com pontuação Geral mediana de 6,11. Apesar do jogo digital não ser um hábito rotineiro, o Dental Case revelou-se útil para os jogadores, apresentando-se como uma abordagem criativa e eficaz.

BACKGROUND Teledentistry is a field of activities that comprises information and communication technologies (ICTs) applied to dentistry, including the exchange of clinical information, patient care, and the use of educational strategies across remote distances. Its use has grown progressively over the past decades—intensified by the COVID-19 pandemic—and has been improving the provision of dental services and educational strategies ever since. OBJECTIVE This evidence gap map (EGM) study aims to present a collection of systematic reviews (SRs) with meta-analyses to answer the question “What are the applications of teledentistry in dental services and dental education?” by identifying gaps and current evidence on the improvement of health care and education. METHODS The EGM methodology has been developed by the Latin American and Caribbean Center on Health Sciences Information and is based on the concept created by the International Initiative for Impact Evaluation. Embase, PubMed, and Virtual Health Library databases were used for the literature research, using terms for teledentistry associated with eHealth, dental education, and oral health care. The data obtained from the included studies were then characterized in a Microsoft Excel spreadsheet, with a matrix containing 8 intervention groups (combined interventions, e-learning and tele-education, teleconsultation and teleservice, telemonitoring, telediagnosis, telescreening, ICTs, and artificial intelligence) and 8 outcome groups (diagnosis accuracy, education and professional training, user behavior, clinical practice, patient-centered outcomes, clinical outcomes, health services management, and access to health services). The quality of the studies was assessed using AMSTAR2 (A Measurement Tool to Assess Systematic Reviews). The visual analytics platform Tableau (Salesforce) was used to graphically display the confidence level, number of reviews, health outcomes, and intervention effects. RESULTS The confidence level obtained by the criteria applied was high for 28% (19/68) of the studies, moderate for 6% (4/68), low for 15% (10/68), and critically low for 51% (35/68). Among the interventions, the ICT group stood out with 182 (36.8%) out of 494 associations, followed by interventions with e-learning and tele-education (n=96, 19.4% of associations), telediagnosis (n=67, 13.6%), and combined interventions (n=53, 10.7%). Most of the outcomes were aimed at education and professional training (97/494, 19.6% of associations), patient-centered outcomes (74/494, 15%), and health services management (60/494, 12.1%). CONCLUSIONS This EGM presents an overview of the contributions of teledentistry in patient care, health services, clinical practice, and education. The study results may help guide future research and policy decisions and serve as a convenient virtual tool for accessing valuable evidence-based information on teledentistry.

BACKGROUND Games are present in society, representing the most diverse activities. A brief conceptual approach to gaming is necessary to the broadening of its understanding within the social and educational context. With the use of digital games in education, known as serious game, the education of dentistry students and dentists may include new complementary approaches. OBJECTIVE To report the project and the development criteria of a serious game in clinical decision-making cases, in the sphere of Dentistry, as a complementary teaching tool. METHODS Case study of the development of the content and narrative of a serious game decision-making process in the dental clinic. In Dental Case, players assume the role of a dentist in consultation, whose mission goes through the stages of Medical history, clinical examination, complementary examination, diagnosis, and treatment. The situations presented in the game were designed to be similar to situations of decision making in the dental clinic in the context of primary health care. The content developed was reviewed and validated by specialists, both from a technical and pedagogical point of view, to be later inserted into the game software by the IT team. RESULTS We developed Dental Case, a serious game with a set of clinical cases for professionals and Dentistry students to support teaching in decision making at different stages of the clinic. The game is available for free on the web and in the Play Store and Apple Store mobile app stores. CONCLUSIONS New complementary pedagogical approaches in the field of Dentistry are necessary. The resources provided by Dental Case are presented as a potential tool in educational technologies aimed at Dentistry and may contribute to expanding the scale and scope of educational activities. Subsequent to this, learning effectiveness tests will be carried out.

BACKGROUND The technology-mediated education has been increasingly used in the global scope of continuous education. In the health area, it has been applied for professional development. In Brazil, the Ministry of Health created, as of 2010, the Open University of the Brazilian Public Health System (UNASUS), starting to promote the continuous education of the health teams, by means of a network of public universities, making an open access educational repository, with a wide range of course offers. Considering that, as of 2016, the Ministry of Health included the dental visit in the prenatal care of the pregnant women being followed-up. The SUS’ Open University-Federal University of Maranhão (UNASUS-UFMA), in partnership with the Faculty of Dentistry of the University of São Paulo (FOUSP), developed and launched the “Oral Health Care for Pregnant and Postpartum Women” course in the massive open online course (MOOC) format. OBJECTIVE The purpose of this study is to present a descriptive analysis, resulting from the offer of such course, considering its program content, the participants’ profile, their development and the observed dropout rate. METHODS The MOOC on “Oral Health Care for Pregnant and Postpartum Women” designed to support dental surgeons and Dentistry students, as well as other health professionals. Educational objectives, target public, program content, workload were established and it counted with a development multidisciplinary team, including content developers expert on the subject, educators, professionals specialized in instructional design and information technology professionals. The course open for a 6-month period was presented in two units. At the end of the course, an evaluation activity with a cut-off grade of 70% for certification was available to the participants. For this study, the data collected in the Arouca platform and in the Moodle virtual learning environment from the period of April 10th to October 10th, 2018 was analyzed evaluating the students of the course. RESULTS The registrations reached the number of 15,461 people and, of these, 11,854 participants interacted with the course by accessing the multimedia book and 4,683 (30.30%) received the certificate of completion. Most of the participants (79,30%) were female and from a broad age group, from 21 to 40 years old. All the Brazilian federation units had registrants 5,434 registrations were from the Southeast region. 70.33% or the enrolled individuals were dental surgeons and 11.38%, classified as others, included Dentistry students, and there were also other health professionals registered. The completion rate was higher than the average of courses in the MOOC fashion registered in the literature. CONCLUSIONS The analyzed data indicated the wide capillarity of the offered course, overcoming geographic distance, and even connectivity, barriers given the technology and innovative delivery model, based on mobile technology.

The Brazilian public healthcare system (SUS - Brazilian Healthcare System) provides free dental care, covering almost half of the Brazilian population. Providing continuing education to thousands of professionals is a difficult and expensive task given the country’s large size. SUS' Open University in partnership with public universities provides ongoing education to thousands of healthcare professionals using technological resources for distance learning. A distance learning course, in the MOOC (Massive Open Online Course) modality, was developed to provide continuing medical education for dental surgeons to assist patients with chronic diseases. The course is free and has registered 13,089 participants. Aim: The purpose of this study is to present the profile of the MOOC course participants. Methods: Secondary data were obtained from Federal Council of Dentistry, the National Registry of Health Facilities, the National Institute for Educational Studies and Research Anísio Teixeira and the Registry of Higher Education Institutions and Courses (e-MEC). Data of the MOOC course were collected in the Arouca Platform. Results: Dentists in Brazil are predominantly female. However, in some specialties there are more men than women. The majority of participants on the course were female 73.5% and in the age group of 21-40 years. Conclusion: This phenomenon is similar to other countries, and needs to be better investigated in Brazil, so that public policies of continuing education of healthcare professionals by means of distance learning, may take the profession's feminisation into consideration.