Teleorthodontics & Artificial Intelligence in Orthodontic Triaging

INTERVENTION: Part 1: Orthodontic eligibility and screening Patients in the intervention group will be assessed for eligibility using teleorthodontics by sumitting intra‐oral and extra‐oral photographs using the Dental Monitoring(TM) platform. This system uses a smartphone application that allows patients to take accurate intraoral photos, software that measures individual tooth movements and an internet‐based interface where the clinician can monitor patient records and correspond with the patient. The process of taking photographs and completing the patient questionnaire will take between 30‐45 minutes, which is comparable to the time taken for a face‐to‐face screening appointment. The researchers (orthodontic registrars) will review the submitted photographs and if any images are non‐diagnostic, participants will be asked to perform a new "scan" using the DM system. This trial is a randomized crossover trial, whereby all participants are screen for eligibility using the teleorthodontic AND conventional face‐to‐face method. Participants randomised to Group 1 will undergo teleorthodontic assessment first, followed by conventional assessment. Group 2 will undergo conventional assessment first, followed by teleorthodontic assessment. There will be a minimum washout period of 2 months between the two assessment methods. CONDITION: Malocclusion; ; Malocclusion Oral and Gastrointestinal ‐ Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon PRIMARY OUTCOME: Outcome 1. Eligibility status assigned via teleorthodontic assessment compared with status assigned via conventional assessment method. Following the assessment (conventional or teleorthdontic), eligibility status will be recorded. For the conventonal method, this will be based on the findings from the patient examinaton and review of patient history and radiographs. For the teleorthdontic method, this will be based on intra‐oral and extra‐oral photographs, patient history form and available radiographs submitted electronically. The two outcomes will be compared for agreement.[Following teleorthodontic and conventional assessment] Outcome 2. Index of Orthodontic Treatment Need (IOTN) score assigned with teleorthodontics compared with conventional assessment method. For the teleorthodontic method, this will be based on the intraoral photographs submitted with the DM system. For the conventional assessment, this will be based on the clinical examination intra‐oral findings.[Following teleorthodontic and conventional assessment] INCLUSION CRITERIA: • Sex: Male, female, non‐binary, unspecified • Access to smartphone: Routine access to smartphone capable of running the DM™ application with camera functionality • Access to email account • Consent: Willingness to provide informed consent (or parental consent) and to participate and comply with the study requirements • Age range: equal to or older than 6 to 29 years of age • Referral status: Due for orthodontic eligibility assessment in 2023 SECONDARY OUTCOME: Change in eligibility assessment wait time. Time of each face‐to‐face eligibility assessment appointment recorded and average calculated. Time of each teleorthodontics eligibility assessment recorded and average calculated. Reduction in wait time calculated based on reduction in number of unnecessary face‐to‐face screening appointments. ; [Following teleorthodontic and conventional assessment] Gingival health status assigned via teleorthodontic assessment compared with status assigned via conventional assessment method. Status will be assigned as "gingivitis" or "none" by the DM system for the teleorthodontic method and by the researcher (orthodontics registrar) for the conventional assessment method.[Following teleorthodontic and conventional assessment.] Oral hygiene status assigned via teleorthodontic assessment compared with status assigned via conventional assessment method. Status will be assigned as "noticeably insufficient", "slightly insufficient" or "good" by the DM system for the teleorthodontic method and by the researcher (orthodontics registrar) for the conventional assessment method.[Following teleorthodontic and conventional assessment] Patient satisfaction with teleorthodontic screening compared with conventional eligibility assessment. 5‐point Likert scale, questionnaire designed specifically for this study. Participants/carers will also provide data on time off work/school and method of transport for travel.[Following teleorthodontic and conventional assessment]