Saudi Electronic Caries Assessment Tool (SECAT) Development: Mixed Methods Feasibility Study

Background: Dental caries is a significant public health challenge globally, particularly acute in Saudi Arabia's remote areas with limited healthcare access. Traditional paper-based methods for recording epidemiological data have limitations in data collection, storage, and sharing, highlighting the need for mobile solutions to enhance dental surveillance in resource-limited settings. Objective: To develop and evaluate the Saudi Electronic Caries Assessment Tool (SECAT), a mobile application designed for collecting dental caries data in remote locations, following a user-centered design approach. Methods: This mixed-methods feasibility study was conducted in three stages: (1) requirement gathering through semi-structured interviews with 12 dental professionals to explore experiences and needs; (2) development of the SECAT application using Flutter frontend and Supabase backend; and (3) evaluation through usability testing with 18 clinicians and heuristic study with five domain experts. Results: The usability study revealed an 82% overall satisfaction rate among clinicians, with 78% strongly endorsing the application's user-friendly features. Expert evaluation highlighted the application's utility for remote areas and offline functionality. Key improvements implemented based on feedback included an automated tooth recognition system, enhanced visualization protocol, and integration of clinical metrics. Primary limitations identified included the need for improved color contrast and individual-level calculations of dental indices. Conclusions: The SECAT application demonstrated high satisfaction and acceptability among dental health providers for collecting examination data in remote locations. The preliminary evaluation identified both limitations and positive aspects, particularly regarding utility in areas with limited internet connectivity. The SECAT mobile application could be valuable aid for caries assessment in remote places and also in school and community-based dental health programs.