JADA+: Artificial Intelligence in Dentistry

Artificial intelligence (AI) once seemed to be the stuff of far-flung science fiction. But today, in an era of self-driving cars and instant answers from Alexa or Siri, AI has become a staple in our daily lives. Many of the conveniences we’ve come to count on—fraud alerts on our bank accounts, up-to-the-minute traffic updates, and e-mail spam filters—are driven by AI technologies such as machine learning and cognitive computing. It’s likely that in the coming years, AI will also be integral to clinical care and practice management in dentistry.

The rising prominence of AI in health care is a hot topic among scholars and futurists, adding a fresh dimension to how our profession could enhance its knowledge base and improve patient outcomes. The conversation now comes to JADA+ in a three-part series exploring AI’s use in the dental profession.

Some clinicians may hear “AI” and immediately picture robots scurrying through a dental office. In truth, like all technologies, AI reaches its highest capabilities when applied in tandem with human expertise and well-honed instincts.

AI could streamline routine processes and allow providers more one-on-one time with their patients. It does what dentists can’t do (like synthesize and aggregate raw data quickly or annotate a radiograph in seconds) and frees us to do what only we can—meet the nuanced challenges of patient care with thoughtful decision making and personal connection. In fact, some prefer the concept of “augmented intelligence,” which emphasizes technology’s adjunctive role to human pursuits.

However you choose to expand its acronym, AI could help dentistry broaden its potential both in and out of the operatory. AI in dental laboratories could yield greater accuracy in computer-aided design restorations. Beyond this, what would an era of digitized dentistry mean for evaluating clinical trends, integrating a patient’s medical and dental health information, and even adjudicating insurance claims?

Along with its possibilities, the use of AI in dentistry also has its share of controversies, among them concerns about ethics, errors, and patient privacy. Reaping its benefits requires us to balance its risks. Over the next three issues, this special JADA+ supplement will explore these topics and more.

As technology becomes more intricately woven into everyday life, here’s a chance to see what it could mean for our work. Who knows what this new tide of digital innovation might do for our profession and patients? Whatever side you’re on in the AI in dentistry debate, the articles in this series will help inform your perspective.

Guest editor's note: Navigating this new resource on AI

R. Faiella, D.M.D., M.M.Sc., M.B.A.

Dentistry is currently experiencing significant changes in the management and delivery of treatment due to the extensive introduction and expansion...

Overview of Artificial Intelligence in Dentistry

M. Jurkovich, D.D.S., G. Zeller, D.D.S.

We always overestimate the change that will occur in the next two years and underestimate the change that will occur in the next ten. Don’t let...

The Future of Dental Practice Management: Insights Beyond Human Cognition (Why AI?)

C. Smiley, D.D.S.

Augmented intelligence (AI) is commonplace in everyday life, with predictive metrics that push content and advertisements to our social media...

Methods for Advancing Oral and Maxillofacial Radiology using AI and Eye Tracking

K. Panetta, Ph.D., R. Rajendran, Ph.D., A. Ramesh, D.M.D.

Introduction Computer vision is an interdisciplinary field that focuses on automating and replicating tasks by processing, analyzing, and...

How AI Will Transform Dental Practice Transitions

S. Ebert, D.M.D.

Back in 1994, Kiss.com launched as the very first modern dating website, creating an entirely new type of experience. Today, just about everyone...

Leveraging Artificial Intelligence to Improve Clinical Success

Glidewell Dental

Four leading experts offer their perspective about the impact of AI on digital dentistry. Glidewell experts include Sergei Azernikov, Mike Selberis,...

This photo depicts a machine learning image. Because the AI algorithm can identify disease, the pink region highlights enamel and the green shading is a segmented identification that shows the clinician the extent of the decay. Some models will use a bounding box so the clinician can easily visualize decay. This AI algorithm can also help the clinician calculate decayed, missing and filled surfaces.

Panoramic image of machine learning tooth identification

This panoramic image depicts machine learning identification of each tooth to help the clinician identify the teeth, anatomy and tooth number. With AI technology, the computer has been trained through neural network applications and millions of X-rays to aid the clinician with this kind of identification and color enhancements.

The first image in this sequence shows a standard X-ray, while the second shows the same radiograph with AI enhanced, color-coded information. The AI-enhanced image offers the clinician clear views of the enamel mask, tooth numbers, measurement from the cementoenamel junction to the crestal bone (measured to the 10th of a millimeter). Note that restorations can also be identified.

Similar to how certain tools can look at the world in infrared, UV, heat-mapping, AI algorithms have the ability to look at images in ways we as humans are unable to. These are only 4 examples of many possible AI models.

This photo depicts a sample dashboard. Not only does the AI algorithm identify images relevant for the clinician, but enhancements including bounding boxes and shading will help identify bone loss, decay or compressed margin. CEJ and crestal bone measurements also offer clinical decision support to aid diagnostic and treatment planning.

The first image shows the radiograph of a root canal, and the second AI-enhanced image identifies residual infection around the root.

To determine whether or not the root canal is well obturated, this AI-enhanced image shows the root canal fill in green and helps the clinician measure the working length (fill to the tip of the root).

This AI-enhanced radiograph identifies the crowns (dark blue), restorations (purple) and implants (far right). This image also shows tooth numbers and bone loss measurements. The AI software is flexible enough to let the clinician toggle on/off the color-enhanced functionality to aid in the diagnostic evaluation of a patient.

This image shows assessment of marginal seal around crowns, pre-cementation. Obtruation assessment and tracking of potential pathology over time is one AI benefit. We also see recurrent decay around crown margins and direct restorations. We can track incipient lesions over time following fluoride treatment and hygiene regimen.

In this radiograph, the AI-enhancements clearly show decay (green) under the enamel (pink) and through the dentin. The algorithm can also identify decay that is has not yet broken through the enamel to help the clinician decide whether remineralization is a treatment option.

ADA White Paper offers comprehensive overview of AI

The ADA Standards Committee on Dental Informatics recently released a white paper offering dentists a comprehensive overview of artificial intelligence/augmented intelligence in dentistry.

Disruptive Innovation in Dentistry: What It Is and What Could be Next

As a developing technology, artificial intelligence remains at the center of personalized dentistry which also includes dental health data, care applications, and services and operations.

AI in Dentistry: Chances and Challenges

This article reviews artificial intelligence (AI) clinical and business applications and offers readers a glimpse at the possible future for diagnostics, image analysis, predictive modeling, records, and more.

The Emergence of AI in Dental Care Delivery

This article outlines the promise and challenges associated with the development of artificial intelligence (AI) and machine learning to help clinicians keep pace with ever-expanding medical knowledge and improve clinical intelligence in the delivery of dental care.