Think back to the last time you were in the dentist’s chair and were told you have a cavity. The scenario probably went something like this: The dentist pulled up your X-ray, pointed to a gray smudge on your radiograph, and said, “This should probably be filled before it gets any bigger.”
If you’re like most patients, you probably had trouble distinguishing the monochrome gradations on your X-ray. Is that a cavity or just a stain on your tooth, you might have wondered. Maybe you asked for further clarification, or maybe you bit your tongue, accepted the diagnosis, and scheduled the filling.
This uncertainty is likely something we’ve all experienced at the dentist. And accounts like that of the well-known Reader’s Digest reporter who went to 50 different dentists and received 50 different diagnoses certainly don’t make the experience any easier to swallow.
The vast majority of dental professionals are reputable and honest, but understanding and trusting a diagnosis remains a challenge. The patient experience in the dentist’s chair is changing, however, and the patient trust deficit may soon shrink—thanks to artificial intelligence.
Recently cleared by the U.S. Food and Drug Administration, AI algorithms can now help your dentist detect and track oral health issues with sensitivity and precision that is equal to—and often better than—that of the human eye. The technology is a win-win for patients and dentists alike, promising to bring greater accuracy, consistency, and transparency to a field of medicine that has long been beset by patient mistrust.
Why Now, and Why Dentistry?
Over the last 10 years, the use of AI in healthcare has taken off. According to Deloitte, 75% of large healthcare organizations felt strongly enough about the technology’s future to invest $50 million or more of their R&D budget in AI-related projects in 2019 alone.
Currently, AI plays a behind-the-scenes role in most medical fields, where it’s applied to understand and classify clinical documentation and organize administrative workflows. Increasingly, it is also being used to perform various radiologic functions, including detection of diseases and other medical abnormalities.
There are a number of reasons, however, that AI will have an outsize impact on the field of dentistry.
Unlike other healthcare fields, where X-rays are captured only to diagnose the cause of a specific ailment, most dental patients receive X-rays annually to track their oral health and inform care. As a result, there are more X-rays of healthy and unhealthy teeth than there are any other kind of X-ray. This massive volume of available imagery enables training of highly accurate machine learning (ML) algorithms.
Just as ML algorithms are trained to recognize humans through exposure to numerous images of faces, ML algorithms exposed to millions of dental X-rays can detect oral ailments more accurately than the human eye. For the first time, this ability of AI/ML software to distinguish healthy from unhealthy teeth allows for diagnostic consistency to be established across dental providers. And because X-rays are used more frequently in everyday dental care than they are in general medicine, the technology’s impact can be greater than in other areas of healthcare.
The dentist’s role in reading X-rays is also different than in other medical fields. Fields like pulmonology, orthopedics, and urology typically have dedicated radiologists who work alongside a specialist to complete and analyze recommended imaging.
In dentistry, however, dentists themselves play that role, often in addition to acting as entrepreneur and business owner, not to mention surgeon and dental provider. As such, AI is becoming another tool on the dental tray, helping to improve diagnostic accuracy. Additionally, unlike other fields of medical radiology, dentists need not fear that their jobs will be replaced—while diagnosis may be computer augmented, delivery of care remains in the dentist’s hands.
AI can also virtually eliminate the patient trust problem. With the ability to measure and detect things like tooth decay, calculus, and root abscesses down to the millimeter—and track disease progression over time—AI can help ensure that no common conditions are missed or misdiagnosed. By annotating dental X-rays, it can also help patients better understand exactly what their radiograph is showing them, helping to relieve dental anxiety and instantly provide a real-time second opinion validating what their dentist is telling them.
Thinking back to that last time you were in the dentist’s chair, imagine how much easier it would have been to understand your dentist’s diagnosis with this visual aid, not to mention your level of confidence in knowing that a computer is involved in verifying it.
Forward-thinking dental practices are already rolling out this technology, and it has been met with enthusiasm. Sage Dental, for example, a dental service organization operating in Florida and Georgia, has been using AI-aided technology to ensure quality and consistency among providers across its 82 practices.
As it turns out, AI-aided exams encourage patients to treat dental issues earlier than they might otherwise, which is critical since dentistry only becomes more expensive and more extensive if left untreated. And while the driver to adopt AI was consistency across dentists and offices, the result has been a dramatic improvement in patient satisfaction and ultimately in patient care.
Clearly, patient trust will be improved in the long run by AI’s impact on diagnostics. By establishing higher universal standards of care, AI can ensure consistent quality outcomes. When that happens, patient trust becomes intrinsic to dentistry. A patient may not like the diagnosis and may not elect to treat the diagnosis, but he or she should trust the diagnosis.
Paving the Road for Patient-Facing AI in General Healthcare
Consumers are already comfortable with the use of AI in many of the technologies we use daily. At one time or another, who hasn’t been impressed by AI’s ability to build a playlist of new music based on your favorite songs, or identify that hard-to-distinguish face in the photo you uploaded to social media?
For the larger medical industry, dentistry is poised to play a similar role, helping patients to develop that same level of familiarity and comfort with AI-aided diagnostics.
We are nearing a time—possibly sooner than we might expect—when AI technologies in the dental office will not only identify immediate dental concerns but also anticipate, through analysis of medical records, how these concerns may impact a patient’s overall health.
Ophir Tanz is the founder and CEO of Pearl. Dr. Cindy Roark is the SVP and chief clinical officer at Sage Dental.