Objectives: To assess caries prevalence in 12-60 month old children enrolled in six Early Head Start inner-city childcare centers by means of Teledentistry and to evaluate the use of Teledentistry as an oral examination screening tool. Methods: Images of the deciduous dentition were obtained by trained Telehealth Assistants using an intraoral camera. Images were entered into a web-based storage and retrieval program maintained by Health-e-Access, University of Rochester, Department of Pediatrics and the sponsor of the Teledentistry initiative. Images were transmitted to a secure remote-site computer and evaluated by a calibrated pediatric dentist. Results: Of 121 children screened, 55 (approximately 45%) were caries active. The mean dfs score was 2.34 (SD= 4.73) with a range of 0 to 32 carious surfaces. African-American children (n=78) had the highest mean dfs score of 3.05, followed by Caucasian children (n=3, dfs= 1.67) and Hispanic children (n=39, dfs= 1.03). Males had a higher mean dfs score (dfs=2.35, SD= 5.76) than females (dfs= 2.33, SD=4.10). 2.48% of children had diagnostically unacceptable images. These children were re-imaged until diagnostically acceptable images were obtained. Referrals for preventive or restorative care were provided for all children participating in the study. Conclusion: The results of this study suggest that (1) an intraoral camera can be used successfully for diagnostic purposes; (2) may reduce costs and enhance oral health screening programs; (3) images can be obtained as often as necessary to achieve an acceptable diagnostic standard or to follow-up on children referred for treatment and (4) very young children who often are not seen by a dentist can be screened and referred for care. Supported by NIH/NIDCR R21 DE08946 and the Aetna Foundation

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