Whilst unlikely to replace you clinically, how can AI currently be used to help dentists run their practices?

The pith of human existence is fundamentally flawed and immutable. The Sartean claim that “existence precedes essence” is built on the principle that as human beings, we choose to engage with specific values through our unique consciousness, instead of being predisposed to a precise purpose. The absurdity of existentialism has been discussed many times with numerous propositions stemming from woven stories of what is and what could be. And, as swiftly learned, some stories look better in hindsight. We as humans are anecdotal researchers; experience plays just as important a role in decision-making as intelligence. Things as simple as trust in one another or as vast and meaningful as the mysteries about our universe have all arisen from abstruse inquiry and learning. And what do we do when our intelligence gains an undefeated rivalry?

 

About a century ago, futurists or new-age “dreamers” made predictions about the future, otherwise known to you and me as the present. These included fascinating innovations like flying taxis, levitating trains, space hotels or some form of machine-human hybrid. And even if Sci-fi imagines of a post-apocalyptic world ruled by sentient robots aren’t as gospel today, technology has been taking an incredible stride in satisfying humans’ insatiable curiosity. Without getting lost in the technical jargon, we can admit that artificial intelligence has been a critical driver in our technological advancement. Without realizing it, we have been successful in creating a silent truce between the innately dextrous “robots” and the pitifully hard-working humans.

Why is artificial intelligence popularizing?

Artificial Intelligence (AI) refers to machine-displayed intelligence that mimics or simulates human behaviour or human cognitive activity to create something that resembles a “thinking machine”. Data that fuels these systems help them learn, making them prevalent in everything from cloud-based applications to consumer apps and firmware.

AI trailblazers like Google and Apple have long embraced AI to elevate their products and services, thereby bettering business outcomes as well as improving the human experience as a whole. Although coined more than 60 years ago, artificial intelligence has seeped into mainstream consumerism only in the last few years. Widespread familiarity with applications like ChatGPT and virtual assistants the likes of Siri and Alexa have allowed a good chunk of the global population to begin embracing technology and machine learning.

The function and popularity of AI are soaring by the day. According to a report by Grand View Research, by 2023, it is theorized that the AI market size would reach $1,811.8 billion, up from $136.6 billion in 2022 with a 38.1% CAGR. With as many as 37% of organizations getting on board with implementing AI in some form, reports suggest that the percentage of enterprises employing AI grew 270% over the past four years. These industries range from financial and e-commerce sectors to cybersecurity and telecommunications.

The healthcare sector has also not shied away from welcoming AI into its systems. AI is currently being applied in the healthcare service plan for identifying patterns, carrying out accurate diagnoses, medical imaging, drug discovery and development, robotic surgery, and improving patient outcomes. And, surprising to no one, dentistry has taken its own dip into the cognizant robotic pool.

AI in dentistry

Dentistry has had a long and intimate history with technology, and so the interpolation of digital development in dentistry isn’t anything new. Compure-assisted design (CAD), computer-assisted manufacturing (CAM) and computer-aided surgery have allowed experts to conceptualize a time when dentistry would fully be automatic.

However, recent advances in diagnostic testing and treatment mapping have heralded a new era, catching speed to potentially complete automation of dentistry. Several dental fields are currently flourishing with the widespread application of innovation, for instance, nanotechnology, navigational dentistry, and robotics. This guise of novel AI has been ushered into numerous applications such as the diagnosis and repair of oral lesions, implant treatment, and independent dental surgeries.  As AI fully evolves, it can revolutionize the way dental care is delivered, pivoting to a better-equipped patient personalization plan, improved patient outcomes, and generally enhanced patient care.

Dentistry has employed numerous manual robotic systems to manually manage dental assignments via the control interface of the computer. While manual robots have been a mainstay in dentistry, experts are working towards creating autonomous robots to achieve a step further.

• Dental Implantology

The outcome of a dental implant treatment is heavily reliant on the precision of implant placement. Several concerns regarding implant surgery like perforation of the maxillary sinus, inferior border, lingual plate, or inferior alveolar canal; nerve injury; tissue necrosis; and dehiscence¹ become deterring factors for public persuasion. Implant failure is also a huge risk typically arising from the nefarious amalgamation of poor clinician experience, improper implant location, and patient-related medical complications. A combination of technology and dental expertise can be crucial in eliminating frequent surgical errors. Therefore, dentists have begun to use surgical template guidance and navigation systems to obviate such complications.

AI is extensively utilized in dentistry to improve the reliability, precision, efficiency, and safety of dental procedures. So does this mean that we have a robot dentist on our hands? Well, that premise may be more real than originally implied!

• In 2017, an autonomous robot performed two dental implants on a woman in China entirely without human intervention or assistance. The doctors involved supervised the dental procedure but did not participate. This robot dentist was a joint venture between the Fourth Military Medical University affiliated with Stomatology Hospital and Beihand University. In an hour-long procedure, the robot successfully fitted two dental implants with a margin of error of 0.2 to 0.3 mm. If that doesn’t embellish the future of dentistry for you, we don’t know what will!

• Also in 2017, YOMI^TM (Neocis, Miami, FL, USA) became the world’s first computerized navigation system to be approved by the FDA. It was developed to provide surgeons with robotic guidance of the drill’s depth, orientation, and position during surgery thereby overcoming the need for custom fabrication of surgical guides. The YOMI system delivers high predictability and precision during dental implant surgery.

• Oral and Maxillofacial Surgery

An increased volume of dentists is now bidding on the modern-day computer’s proficiency to practice complex surgical procedures. Computer-assisted surgery or transoral robotic surgery has got on well with clinicians and has often been used alongside cone-beam computed tomography (CBCT) to manufacture a stereoscopic view of the intraoral tissues. AI in the form of robot-assisted surgery has also been used to provide superior local control in the treatment of low-risk oral squamous cell carcinoma.²

• Oral Pathology

Oral cancers are some of the leading causes of death in the world. It is stipulated that one in every three mouth cancers (33%) are found on the tongue and almost one in every four (23%) are discovered on the tonsil. It was reported that in 2021 alone, a whopping 3,034 Brits lost their lives to some form of oral cancer. This figure has risen by almost 20% in the last five years³.

 

Therefore, dental practices must detect and diagnose oral lesions early to significantly improve prognosis. Dental experts such as Warin et al. make use of a system known as deep convolutional neural network  (CNN) algorithms for the classification and detection of oral potentially malignant disorders (OPMDs) and oral squamous cell carcinoma (OSCC) in intraoral optical images. CNN is a subset of artificial intelligence that has been exhibiting a promising route for the overall diagnosis of head and neck cancer lesions with an accuracy of 80 to 83.3%. It has also been used in identifying and classifying benign and malignant lesions in the oral mucosa.

• Endodontics

AI models like CNN have not only been successful in diagnosing cancer but also in the detection and diagnosis of dental caries. They are used to minimize treatment failures related to endodontic therapy owing to the different morphologies of teeth. AI software is now an ally to dentists for detecting cavities in their earliest stages so that patients need not look out for more expensive and invasive treatment procedures in the future.

• Periodontics

Similar to endodontic enhancement by AI, it has also substantially improved the detection of gum disease, especially alveolar bone loss. Other early detections of vertical root fractures, apical lesions, salivary gland diseases, maxillary sinusitis, maxillofacial cysts, cervical lymph node metastasis, and osteoporosis⁴ can now be successful with AI technology.

• Prosthetics and Orthodontics

Deep-programmed robots today are geared towards manufacturing partial or complete dentures with the experience and skill of well-trained dental personnel incorporated into the software. Additionally, artificial intelligence has become a cornerstone for orthodontic treatment planning and prediction of treatment results. This is done by simulating the changes in the appearance of pre-and post-treatment photographs. Nanotechnology-integrated software like SureSmile® is also able to make use of microrobots to design and alter the archwire of braces. The company claims that this robot-assisted orthodontics generates results almost 34% quicker than conventional braces.

• Administration

One of the most exciting ways AI can be engrossed in the dental sector is through the streamlining of tedious and time-consuming everyday tasks that take up valuable doctor-patient consultation time. These services can include scheduling appointments, reviewing the literature, or submitting insurance claims, all of which can be easily completed by AI software.

• For example, a dental software firm called Pearl™ uses AI to flag fraudulent insurance claims that use an X-ray or intraoral scan. During the pilot project, Pearl™’s AI was able to identify up to $6 billion in insurance.

The  integration of virtual consultations has also been a monumental step towards an automated future. With advanced software, patients can avail of teledentistry services with their dentist online, reducing the need for in-person visits and limiting chair time.

The Future of AI in Dentistry

AI has the potential to revolutionize the dental industry which creates concern for dentists about their job security. Will AI ultimately replace dentists? Organizations like the American Dental Association acknowledge the impact of AI on the dental sector and firmly believe that AI “will not outright replace dentists, but help them instead”.

And indeed, there is very little to fear for the complete coup of dentistry by robots. While AI bridges the gap between patient management systems and insurance data, they also help you save time and invest in more comprehensive patient care, exactly what you ought to be doing. And even though artificial intelligence is designed to spot the most microscopic of errors and identify easy-to-miss pathologies, without experienced and sagacious operators, they are only scattered pieces of useless data.

AI is only as good as the data it is fed with and is purely intended to satisfy your every whim. It is capable of creativity and innovation but it cannot think outside the box or secure original ideas without the help of a trained professional. Lastly, while AI can mimic or analyse emotions, it cannot truly understand them which is why AI is a valuable tool for augmenting human ingenuity but it can never truly replace the “human touch.” So, instead of having a myopic view of the future and dreading a hauntingly monotonous digital cesspool where we are alienated by our own technologies, it is time to embrace AI for the progression of dentistry.