The use of AI in dentistry has been increasing as it can assist in diagnosis, treatment, prevention, and management of diseases. In the UK, where the dentistry is heavily skewed by high volume, low value NHS dental care, and there are currently resourcing issues (insufficient numbers of dentists and dental nurses), improvements in efficiency, created by AI, could significantly transform the public dental sector and add wider value to the private sector.
In this article, we explore how AI can be utilised in dentistry. We explore the opportunities and challenges of introducing AI into the UK dental sector, and the implications for dental professionals, patients, suppliers and regulators.
X-rays, intra oral scanning, and digital photography are all common forms of dental imaging. This is one of the easiest areas to apply AI technology within dentistry. These imaging methods are essential for planning dental treatments. They provide detailed data about the teeth and oral health of patients, which can be easily utilised by AI systems for training and then output creation.
Human interpretation of dental images can be time-consuming, subjective, and prone to errors, especially for complex cases, or with inexperienced clinicians. AI could help to overcome these limitations by providing rapid automated analysis, detection, and classification of dental images, using techniques such as computer vision, deep learning, and natural language processing. AI can also enhance the quality and accuracy of dental images, by reducing noise and distortions, improving contrast, resolution, and colour of images.
AI technology can help detect and assess cavities, gum disease, bone loss, cracks, and abnormalities shown in dental X-rays, scans and photographs and offer recommendations for treatment options, even before a dentist has needed to see a patient.
It is unlikely that technology will replace the intricate clinical skills of dentists in the near future. This will required advanced robotics. Trained imaging technicians can however improve the efficiency of the dental process by collecting the required data for diagnosis. This way, dentists can focus on the high value activity of providing treatment.
Scanning for a full mouth digital record
AI in dentistry can generate lifelike models of how different dental treatments, such as braces, dental implants, composite bonding, or veneers, would affect the appearance and function of a patient’s teeth, and help these patients to decide on the most suitable option for their needs. These models also help dental professionals to design and perform the best treatment for their patients, by giving them precise and realistic expectations of the outcomes. This can save time and money and may help prevent the failure of treatment.
3D milling, modelling and printing technologies can be managed by AI to create dental devices, such as implants, crowns, bridges, dentures, or aligners. AI technology could improve the materials and methods used for dental treatments, by looking at data from previous successful cases and scientific sources, and suggesting the best and most efficient solutions for each patient.
Personal mobile devices already have incredibly sophisticated imaging technology. People may soon be encouraged to take images of their own teeth and upload them to AI systems for analysis, feedback and advice from AI systems. Whilst it is unlikely that self x-rays will be possible, due to the cost and safety risk of radiography, aesthetic treatment planning to assist with teeth straightening and whitening, could easily be delivered by AI systems.
There are already intra-oral cameras that connect to iPhones for sale online for less cost than many electric toothbrushes. A potential patient could use their own mobile phone, in the comfort of their own home, to take images and video of their teeth, mouth and smile and upload them for AI analysis. The system could then help them find possible solutions and direct them to a suitable clinic, before a human has been involved.
Automated dental administration is possible with AI being utilised in practice management systems. This includes appointment booking, recalls, debt chasing, patient communication, treatment planning, billing, and marketing. These tasks are often tedious, repetitive, and time-consuming, and can distract the dental professionals from their core value adding clinical activities.
AI can automate and optimise these tasks, by using techniques such as natural language understanding, speech recognition, and chatbots. AI could enable online booking systems that understand and respond to natural language queries, and match the patients with the most suitable and accessible dental services and professionals.
These systems could improve patient communication, by delivering reminders, confirmations, feedback requests, and follow-ups, and by giving information and education on oral health and hygiene. These automated systems could also help in making billing and insurance claims faster, by automatically creating invoices and handling payments.
AI can assist in the creation of marketing plans, by examining patient data from the dental practice management systems, and using this data and comparable positive results from other patients, to make tailored campaigns to prompt new patient treatment journeys.
By providing guidance and information in the early stages of the patient journey, automated marketing systems could enhance the connection between the patient and the dental practice, and help convert interest into appointment bookings.
One of the biggest challenges of effectively utilising AI in dentistry is the lack of ‘big data’ to train AI systems. There is decades worth of dental data held within thousands of dental practice management systems, such as Carestream “R4” and Software of Excellence “Exact” . The problem is that this data is predominately held locally on individual dental practice sites, within different data structures, it is owned by many different people and is not accessible in an aggregate form. There has been innovation of recent years to cloud based practice management systems, but it is unlikely that these have sufficient data for training AI systems effectively.
For those practices with NHS contracts, data is transmitted to the NHS Business Service Authority and could in theory be used for some model training. However, by the nature of NHS dental services, this data will be biased to low value ‘check up, drill & fill dentistry” rather than the macro dental services being demanded by patients across the whole dental sector.
These wider services include teeth straightening, aesthetic composite bonding and professional teeth whitening. As these services are cosmetic rather than restorative, they are not provided under NHS contract. NHS dental data could therefore be seen as biased based on its historical (and restricted) treatment outcomes.
Could individual practices find a way to exchange local data that respects data protection laws such as GDPR? Could this data be ethically sold and aggregated? This possibility should be investigated, but withing the framework of effective AI Governance.
AI in dentistry, will require efficient AI Governance, which refers to the laws and rules that regulate dentistry. This oversight is essential to uphold the standards, security, and morality of dental care, and to protect both dental professionals and patients.
To ensure the proper use and adoption of dental AI, there will be some difficulties and risks in managing its governance. AI will bring up ethical, legal, and social issues, such as privacy, consent, accountability, liability, and trust, that will require the attention, action, and resolution from the current dental regulators, the General Dental Council (GDC), the Care Quality Commission (CQC) and the NHS in the UK.
These organisations, which are often inflexible and resistant to change, may have difficulty adapting to the fast-changing capabilities of AI technology. This could hinder innovation and delivery of the many benefits that AI offers the dental sector.
With data potentially coming from many sources, who would be responsible and accountable for the results and mistakes of AI systems in dentistry? Would it be the professionals who use them, or the AI dental system creators and providers? How can the quality and safety of AI in dentistry be guaranteed and checked? How can the data and algorithms that AI systems in dentistry use be clear and fair? How could bias and discrimination be prevented? These questions will need to be investigated and resolved if patients are to trust that AI is safe.
AI technology offers a lot of possibilities and many advantages for UK dentistry, a field that faces challenges such as high demand, low value public sector activity and limited human resources.
AI can make dental care more efficient, effective, and accessible, by improving diagnosis and treatment planning, streamlining and optimising administration, and providing personalised and engaging experiences for the patients.
The technology is not without challenges and risks. These have to be addressed and controlled by stakeholders within the dental sector. Dental professionals, technology providers and regulators, will need to make sure that the impact of AI on dental care is ethical, safe, and of high-quality for patients.
The biggest challenge will be the creation of ‘big dental data’ i.e. dental data sets that are large enough to train AI models and systems with less risk of bias. Data is available within the U.K., but this is fragmented, difficult to access and has many owners. The cost and challenges of aggregating this data may be prohibitive.
For the dental sector to have the chance of delivering impactful AI benefits, it will require a collaborative and multidisciplinary approach, that includes the stakeholders from the dental industry, AI developers, and the dental regulators.
Can the dental sector work together to deliver the benefits of AI? Time will tell.
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