External Validation of an AI mHealth Tool for Gingivitis Detection among Older Adults at Daycare Centers: A Pilot Study

Objectives: Periodontal disease is a significant public health concern among older adults due to its relationship with tooth loss and systemic health disease. However, there are numerous barriers that prevent older adults from receiving routine dental care, highlighting the need for innovative scree...

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Main Authors: Reinhard Chun Wang Chau, Andrew Chi Chung Cheng, Kaijing Mao, Khaing Myat Thu, Zhaoting Ling, In Meei Tew, Tien Hsin Chang, Hong Jin Tan, Colman McGrath, Wai-Lun Lo, Richard Tai-Chiu Hsung, Walter Yu Hang Lam
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:International Dental Journal
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Online Access:http://www.sciencedirect.com/science/article/pii/S0020653925000140
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author Reinhard Chun Wang Chau
Andrew Chi Chung Cheng
Kaijing Mao
Khaing Myat Thu
Zhaoting Ling
In Meei Tew
Tien Hsin Chang
Hong Jin Tan
Colman McGrath
Wai-Lun Lo
Richard Tai-Chiu Hsung
Walter Yu Hang Lam
author_facet Reinhard Chun Wang Chau
Andrew Chi Chung Cheng
Kaijing Mao
Khaing Myat Thu
Zhaoting Ling
In Meei Tew
Tien Hsin Chang
Hong Jin Tan
Colman McGrath
Wai-Lun Lo
Richard Tai-Chiu Hsung
Walter Yu Hang Lam
author_sort Reinhard Chun Wang Chau
collection DOAJ
description Objectives: Periodontal disease is a significant public health concern among older adults due to its relationship with tooth loss and systemic health disease. However, there are numerous barriers that prevent older adults from receiving routine dental care, highlighting the need for innovative screening tools at the community level. This pilot study aimed first, to evaluate the accuracy of GumAI, a new mHealth tool that uses AI and smartphones to detect gingivitis, and the user acceptance of personalized oral hygiene instructions provided through the new tool, among older adults in day-care community centers. Methods: Participants were invited from 3 day-care community centers. Intraoral photographs were captured and assessed by both GumAI (test) and a panel consisting of 2 calibrated periodontists and a dentist (benchmark). Mean sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, and F1 score were calculated to determine GumAI's diagnostic performance in comparison to the benchmark. User acceptance with this tool was assessed using 2 Rasch Theory-based 5-point Likert-type questions. Results: 44 participants were recruited out of 80 invited older adults. GumAI demonstrated a sensitivity of 0.93 and specificity of 0.50 compared to the panel‘s assessments, with a PPV of 0.90 and NPV of 0.56. The accuracy and F1 scores were 0.85 and 0.91, respectively. All participants expressed high acceptance of the process. Conclusion: GumAI demonstrates high sensitivity, PPV, accuracy, and F1 score compared to the panel's assessments but falls relatively short in specificity and NPV. Despite this, the tool was highly accepted by older adults, indicating its potential to enhance gingivitis detection and oral hygiene management in community settings. Further refinements are necessary to improve specificity and validate usability measures. Clinical Relevance: This study may pave the way for broader applications of mHealth systems in community settings, enabling greater health coverage and addressing oral health disparities.
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spelling doaj-art-a44faba8b34d4a19bbe04ebd403a53702025-08-20T01:49:08ZengElsevierInternational Dental Journal0020-65392025-06-017531970197810.1016/j.identj.2025.01.008External Validation of an AI mHealth Tool for Gingivitis Detection among Older Adults at Daycare Centers: A Pilot StudyReinhard Chun Wang Chau0Andrew Chi Chung Cheng1Kaijing Mao2Khaing Myat Thu3Zhaoting Ling4In Meei Tew5Tien Hsin Chang6Hong Jin Tan7Colman McGrath8Wai-Lun Lo9Richard Tai-Chiu Hsung10Walter Yu Hang Lam11Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region, ChinaDepartment of Computer Science, Hong Kong Chu Hai College, Hong Kong Special Administrative Region, ChinaFaculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region, ChinaFaculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region, ChinaFaculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region, ChinaFaculty of Dentistry, The National University of Malaysia, Kuala Lumpur, MalaysiaSchool of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USEastman Dental Institute, University College London, London, UKFaculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region, ChinaDepartment of Computer Science, Hong Kong Chu Hai College, Hong Kong Special Administrative Region, ChinaFaculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region, China; Department of Computer Science, Hong Kong Chu Hai College, Hong Kong Special Administrative Region, China; Corresponding author: Department of Computer Science, Hong Kong Chu Hai College, 80 Castle Peak Road, Tuen Mun, New Territories, Hong Kong Special Administrative Region, China.Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region, China; Musketeers Foundation Institute of Data Science, The University of Hong Kong, Hong Kong Special Administrative Region, China; Corresponding author: Faculty of Dentistry, The University of Hong Kong, 3/F, Prince Phillip Dental Hospital, 34 Hospital Road, Sai Ying Pun, Hong Kong, Hong Kong Special Administrative Region, China.Objectives: Periodontal disease is a significant public health concern among older adults due to its relationship with tooth loss and systemic health disease. However, there are numerous barriers that prevent older adults from receiving routine dental care, highlighting the need for innovative screening tools at the community level. This pilot study aimed first, to evaluate the accuracy of GumAI, a new mHealth tool that uses AI and smartphones to detect gingivitis, and the user acceptance of personalized oral hygiene instructions provided through the new tool, among older adults in day-care community centers. Methods: Participants were invited from 3 day-care community centers. Intraoral photographs were captured and assessed by both GumAI (test) and a panel consisting of 2 calibrated periodontists and a dentist (benchmark). Mean sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, and F1 score were calculated to determine GumAI's diagnostic performance in comparison to the benchmark. User acceptance with this tool was assessed using 2 Rasch Theory-based 5-point Likert-type questions. Results: 44 participants were recruited out of 80 invited older adults. GumAI demonstrated a sensitivity of 0.93 and specificity of 0.50 compared to the panel‘s assessments, with a PPV of 0.90 and NPV of 0.56. The accuracy and F1 scores were 0.85 and 0.91, respectively. All participants expressed high acceptance of the process. Conclusion: GumAI demonstrates high sensitivity, PPV, accuracy, and F1 score compared to the panel's assessments but falls relatively short in specificity and NPV. Despite this, the tool was highly accepted by older adults, indicating its potential to enhance gingivitis detection and oral hygiene management in community settings. Further refinements are necessary to improve specificity and validate usability measures. Clinical Relevance: This study may pave the way for broader applications of mHealth systems in community settings, enabling greater health coverage and addressing oral health disparities.http://www.sciencedirect.com/science/article/pii/S0020653925000140Community dentistryGingivitisMachine learningMobile healthPeriodontal diseasesTelemedicine
spellingShingle Reinhard Chun Wang Chau
Andrew Chi Chung Cheng
Kaijing Mao
Khaing Myat Thu
Zhaoting Ling
In Meei Tew
Tien Hsin Chang
Hong Jin Tan
Colman McGrath
Wai-Lun Lo
Richard Tai-Chiu Hsung
Walter Yu Hang Lam
External Validation of an AI mHealth Tool for Gingivitis Detection among Older Adults at Daycare Centers: A Pilot Study
International Dental Journal
Community dentistry
Gingivitis
Machine learning
Mobile health
Periodontal diseases
Telemedicine
title External Validation of an AI mHealth Tool for Gingivitis Detection among Older Adults at Daycare Centers: A Pilot Study
title_full External Validation of an AI mHealth Tool for Gingivitis Detection among Older Adults at Daycare Centers: A Pilot Study
title_fullStr External Validation of an AI mHealth Tool for Gingivitis Detection among Older Adults at Daycare Centers: A Pilot Study
title_full_unstemmed External Validation of an AI mHealth Tool for Gingivitis Detection among Older Adults at Daycare Centers: A Pilot Study
title_short External Validation of an AI mHealth Tool for Gingivitis Detection among Older Adults at Daycare Centers: A Pilot Study
title_sort external validation of an ai mhealth tool for gingivitis detection among older adults at daycare centers a pilot study
topic Community dentistry
Gingivitis
Machine learning
Mobile health
Periodontal diseases
Telemedicine
url http://www.sciencedirect.com/science/article/pii/S0020653925000140
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