The Journal of Contemporary Dental Practice

Register      Login



Volume / Issue

Online First

Related articles

VOLUME 22 , ISSUE 4 ( April, 2021 ) > List of Articles


Teledentistry-based Program to Improve Oral Hygiene Indicators in Rural Pakistan—A Protocol

Syed Sarosh Mahdi, Raheel Allana, Francesco Amenta

Citation Information :

DOI: 10.5005/jp-journals-10024-3074

License: CC BY-NC 4.0

Published Online: 00-04-2021

Copyright Statement:  Copyright © 2021; The Author(s).


Aim: The primary aim of this research protocol is to secure funding to initiate a teledentistry pilot project in order to improve the oral hygiene conditions of the most vulnerable population of rural Sindh in Pakistan, through hands-on training of 1,000 lady health workers by dentists and community dentistry specialists of other colleges led by Jinnah Medical and Dental College. Materials and methods: Training courses on digital health consultation would be given to participating healthcare workers. The trainees would be trained on all aspects of dental hygiene including precautions, tooth brushing techniques, and oral care. During the 2-day-long course, lady health workers will be taught various tooth brushing techniques, as well as basic instructions about oral hygiene and how to address queries of people regarding oral health. They will also get guidance about the various multimedia softwares in the phone and how to use them. The study would also include teledentistry consultation as a real-time patient learning tool for patients, healthcare workers, and trainees. Results: Results will be made available when the trial has been completed in 2021. The program will be evaluated by assessing its usability, acceptability, knowledge, and satisfaction of users. Conclusion: The protocol is designed to illustrate the underlying concept that a more reliable and robust model can be built through creating interactive communities of practice for consumers of telehealth in dental education. The Telehealth Skills Coaching and Delivery Initiative would incorporate and test a technically oriented paradigm of Internet-based medical education for vertically incorporated, community-based learning environments. Clinical significance: Teledentistry has the ability to expand access to oral health care, increase the provision of oral health care, and decrease costs. In view of the immense advances made in this field, teledentistry can continue to promote specialized health care in the remotest corners of the world. Many countries have already embraced virtual health care (telemedicine) in the face of an increase in cases of COVID-19; however, teledentistry has yet to play its role in this pandemic by enhancing the accuracy and efficiency of dental treatment. In the case of LMICs such as Pakistan, which lack advanced technologies such as teledentistry within their national healthcare network, the COVID-19 pandemic is a challenge to introduce the requisite legislative changes to promote the widespread use of teledentistry.

  1. Pakistan has world's 6th largest population [Internet]. The Nation. 2020 [cited 3 November 2020]. Available from: pk/06-Jan-2017/pakistan-has-world-s-6th-largest-population.
  2. [Internet]. 2020 [cited 3 November 2020]. Available from:
  3. Pakistan Bureau of Statistics. Available from: 2017-0.
  4. Pakistan economic survey 2018-19. Chapter 10: education (PDF). Economic survey of Pakistan; 2019 [Retrieved August 07, 2020].
  5. Global economic prospects. World Bank; 2020. p. 98 [Retrieved June 24, 2020].
  6. Economic indicators 2019 (PDF). Pakistan Finance Division [Retrieved August 29, 2020].
  7. Mahsud-Dornan S. Pakistan, population programmes and progress. Ulster Med J 2007;76(3):122–123. PMID: 17853634; PMCID: PMC2075591.
  8. Meghani ST, Sehar S, Punjani NS. Comparison and analysis of health care delivery system: Pakistan versus China. IJEHSR 2014;2(1):46–50. DOI: 10.29052/IJEHSR.v2.i1.2014.46-50.
  9. Bille K, Aslam M. Oral health in Pakistan: a situation analysis. Islamabad: Government of Pakistan-Ministry of Health D WHOPakistan; 2003.
  10. Siddiqui IA, Farooq MU, Siddiqui RA, et al. Role of toluidine blue in early detection of oral cancer. Pak J Med Sci 2006;22(2):184.
  11. Shah SM, Merchant AT, Luby SP, et al. Addicted schoolchildren: Prevalence and characteristics of areca nut chewers among primary school children in Karachi, Pakistan. J Paediatr Child Health 2002;38(5):507–510. DOI: 10.1046/j.1440-1754.2002.00040.x.
  12. [Retrieved on May 29, 2016].
  13. Roine R, Ohinmaa A, Hailey D. Assessing telemedicine: a systematic review of the literature. CMAJ 2001;165(6):765–771. DOI: 10.1136/bmj.323.7312.557.
  14. Sanchez Dils E, Lefebvre C, Abeyta K. Teledentistry in the United States: a new horizon of dental care. Int J Dent Hyg 2004;2(4):161–164. DOI: 10.1111/j.1601-5037.2004.00093.x.
  15. Chen JW, Hobdell MH, Dunn K, et al. Teledentistry and its use in dental education. J Am Dent Assoc 2003;134(3):342–346. DOI: 10.14219/jada. archive.2003.0164.
  16. Yoshinaga L. The use of teledentistry for remote learning applications. Pract Proced Aesthet Dent 2001;13(4):327. PMID: 11402774.
  17. Chen H, Fricton J. Teledentistry: seeing the doctor from a distance. Northwest Dent 2007;86(2):27. PMID: 11402774.
  18. Ignatius E, Mäkelä K, Happonen RP, et al. Teledentistry in dental specialist education in Finland. J Telemed Telecare 2006;12(3_ suppl):46–49. DOI: 10.1258/135763306779379996.
  19. Kim T, Zuckerman JE. Realizing the potential of telemedicine in global health. J Glob Health 2019;9(2):020307. DOI: 10.7189/jogh.09.020307.
  20. Scuffham PA, Steed M. An economic evaluation of the Highlands and Islands teledentistry project. J Telemed Telecare 2002;8(3):165–177. DOI: 10.1177/1357633X0200800307.
  22. html.
  23. Touger-Decker R, Mobley CC; American Dietetic Association. Position of the American Dietetic Association: oral health and nutrition. J Am Diet Assoc 2003;103(5):615–625. DOI: 10.1053/jada.2003.50130. PMID: 12728223.
  27. player-youre-not-using-0156339/.
  29. Holttinen T, Murtomaa H, Saarni H, et al. Utilization of dental services by Finnish seamen. Acta Odontol Scand 1994;52(2):77–81. DOI: 10.3109/00016359409029058. PMID: 8048325.
  30. Centers for Disease Control and Prevention. Division of Oral Health (US). Oral health: preventing cavities, gum disease, and tooth loss [cited June 3, 2009]; 2012. Available from: URL:
  31. Maher R, Lee AJ, Warnakulasuriya KA, et al. Role of areca nut in the causation of oral submucous fibrosis: a case-control study in Pakistan. J Oral Pathol Med 1994;23(2):65–69. DOI: 10.1111/j.1600-0714.1994. tb00258.x.
  32. Gupta PC, Warnakulasuriya S. Global epidemiology of areca nut usage. Addict Biol 2002;7(1):77–83. DOI: 10.1080/13556210020091437.
  33. Gajendra S, Cruz GD, Kumar JV. Oral cancer prevention and early detection: knowledge, practices, and opinions of oral health care providers in New York State. J Cancer Educ 2006;21(3):157–162. DOI: 10.1207/s15430154jce2103_14.
  34. Fjeldsoe BS, Marshall AL, Miller YD. Behavior change interventions delivered by mobile telephone short-message service. Am J Prevent Med 2009;36(2):165–173. DOI: 10.1016/j.amepre.2008.09.040.
  35. Lamb R. Portable mission dentistry. 4th ed. Broken Arrow, Oklahoma: World Dental Relief; 2008.
  36. Kopycka-Kedzierawski DT, Billings RJ. Prevalence of dental caries and dental care utilisation in preschool urban children enrolled in a comparative-effectiveness study. Eur Arch Paediatr Dent 2011;12(3):133–138. DOI: 10.1007/BF03262794.
  37. Wheeler T. Smile for the camera: telemedicine comes to your local dentist's office. Telemedicine Today 1999;7(1):14–15. PMID: 10350936.
  38. Chumbler NR, Cohen DM, Bhattacharyya I, et al. University of Florida College of Dentistry's “case of the month”: evaluating a web-based continuing dental education course for clinical oral pathology. J Dent Educ 2007;71(2):260–268.
  39. Reynolds PA, Mason R. On-line video media for continuing professional development in dentistry. Comput Educ 2002;39(1):65–98. DOI: 10.1016/S0360-1315(02)00026-X.
  40. Lester R, Karanja S. Mobile phones: exceptional tools for HIV/AIDS, health, and crisis management. Lancet Infect Dis 2008;8(12):738. DOI: 10.1016/S1473-3099(08)70265-2.
  41. Walton G, Childs S, Blenkinsopp E. Using mobile technologies to give health students access to learning resources in the UK community setting. Health Info Libr J 2005;22(Suppl. 2):51–65. DOI: 10.1111/j.1470- 3327.2005.00615.x.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.