Could telescreening be an alternative for referring urgent dental cases in children? A before-and-after study.

Teledentistry has emerged as a promising strategy to improve access to urgent dental care for pediatric populations, particularly in underserved areas; however, evidence regarding the agreement between telescreening and in-person assessment for pediatric dental emergencies remains limited. This before-and-after study, nested within a randomized controlled clinical trial, evaluated the level of agreement between diagnoses and risk classifications obtained through telescreening and in-person consultation in children aged 3 to 13 years presenting with dental pain. All participants underwent synchronous telescreening using a standardized questionnaire and were randomized into two groups; the present analysis included 130 children allocated to telescreening followed by an in-person consultation, which was performed by a blinded examiner unaware of the telescreening results. Agreement between treatment decisions (urgent vs. elective) was assessed, and pain outcomes were monitored at baseline, 7 and 15 days using the Wong–Baker Faces Pain Scale. Agreement between telescreening and in-person evaluation was observed in 49.2% of elective cases and 26.9% of urgent cases, with infrequent changes in treatment decisions, including 6.9% of cases reclassified from urgent to elective and 0.8% from elective to urgent. Pain scores showed a significant reduction over time (p < 0.001), with median values decreasing to zero at both follow-up assessments. These findings indicate that telescreening demonstrates good agreement with in-person evaluation for the identification and management of pediatric dental appears to be a viable and effective alternative for initial screening and referral, although adherence to subsequent in-person care remains an important consideration. Trial registration: Brazilian Clinical Trials Registry (ReBEC): RBR-523hrsx.