More than meets the eye: Digital fraud in dentistry

Introduction: Digital photographs play a substantial role in the presentation and validation of clinical cases for documentation and research purposes in esthetically oriented professions such as dentistry. The introduction of sophisticated cameras and "easy to use" computer software readily available on today′s market has enabled digital fraud to emerge as a common and widely used practice. Hence, it is essential that both dentists and editorial circles are aware and cautious with regard to the possibility of digital fraud. Materials and Methods: A set of 10 routine "pre-" and "post" treatment dental procedure photographs were taken and randomly manipulated using standard desktop software. A team of 10 dental professionals were selected and each one of them was individually requested to review and evaluate the authenticity of the photographs. Results: An assessment of expert opinion revealed an overall sensitivity of 60% and a sensitivity of 15% in correctly identifying a manipulated photograph, which is considered low. Furthermore, there was poor interobserver agreement. Conclusion: Advanced technology that is easily available has resulted in adept digital fraud that is difficult to detect. There is a need for awareness among both dental practitioners and the editorial circle regarding misrepresentation due to image manipulation. It is therefore necessary to follow a skeptical approach in the assessment of digitalized photos used in research and as a part of clinical dentistry.