The Latest in AI

  • by Joe Dysart
  • Apr 18, 2022
Artificial Intelligence and Dentistry: Mostly Blue Skies Ahead 

Unlike many professions where the burgeoning use of artificial intelligence (AI) is projected to leave a wholesale loss of jobs in its wake, the outlook for dentistry and AI is sunny. 

AI’s wonders are poised to remake the way dentistry is done. And, after the AI storm sweeps over the profession, not only will dentists still have their jobs, they’ll be more efficient and more profitable. 

“The bottom line is not whether dentists will adopt AI, but rather how and/or when they will adopt AI,” said Jeffery B. Price, DDS, MS, MAGD, clinical associate professor, University of Maryland School of Dentistry. 

“The average dental consumer today appreciates practices that maintain up-to-date technology that provides meaningful improvements in care when used in the proper manner — and AI will do that for dentistry,” Price added. 

Already, dentists who are early adopters of AI find the tech helps them read radiographs more accurately and analyze changes in the mouth over time more precisely. Many of these same dentists are also discovering a number of new AI tools that are helping usher in the era of teledentistry. 

Early adopters of other AI dentistry tools are finding they can better run the business side of their practices with new apps, such as auto-transcription of spoken notes, AI-enhanced security of their practice data and the auto-writing of their business reports. 

Many solo practitioners and dental service organizations (DSOs) are viewing AI as a powerful new tool they can use to compete with one another. Some solo practitioners see AI second opinions as a potential edge over DSOs. Meanwhile, many DSOs, with their treasure troves of patient data, believe they’re best suited to leverage the tech most effectively. 

AI Tools Custom-Designed for Dentistry 

While definitions of AI vary, most agree that, broadly defined, AI is the concept of software executing tasks that previously were the exclusive purview of intelligent beings. 

Current applications in AI, for example, enable software to find patterns, discover meaning, form generalities and/or learn from past experiences.

 In dentistry, AI is currently being used to rapidly sift through thousands — or even millions — of data points to analyze and issue diagnoses or second opinions on patient radiographs, verify insurance claims, offer business projections on a practice’s future performance and more. 

In addition, some AI applications also include a subgenre, machine learning, to continually assess their own performance. This machine learning enables the software to auto-refine its own processes to ideally grow more adept and proficient at its task over time. 

While the need for FDA approval has delayed the rollout of many AI tools specifically designed for dentistry, many of the generalized tools are starting to crop up on the market. 

Dentists can now seek another opinion on a diagnosis with tools like Second Opinion® from Pearl, a software that uses AI to analyze patient radiographs and detect a wide array of pathologies and existing restorations. 

“Second Opinion allows dentists to optimize their work as radiologists, enabling them to consistently deliver need-based care of the highest standard,” said Ophir Tanz, founder and CEO of Pearl. Similar automated diagnostic systems are available from Videa Health and Denti.AI.

Meanwhile, dentists looking to automate their claims processes may want to check out the NovoHealth Dental platform. It’s an AI-driven system that is designed to save dentists time and money by automatically analyzing dental insurance claims. 

David Rock, CEO, NovoDynamics, said dentists opting for the service will be treated to accurate, objective clinical assessments and, ultimately, accelerated reimbursements. 

Ideally, use of the system will also result in fewer mistakes. 

Meanwhile, dentists looking for AI help in dental design will want to evaluate 3Shape. 3Shape offers software solutions for automating the design and printing of nightguards, clear aligners, surgical guides, crowns, veneers, bridges and more. 

Still other industry-specific apps include Diagnocat, a dental imaging, data and analysis system; Yomi by Neocis, an AI-powered robot that helps with dental surgeries; and Beam Dental, an insurance company that offers AI-based underwriting and includes a smart toothbrush. 

AI Help for the Teledentist in the Age of COVID-19 

There’s been a lot of talk about how AI is going to help dentists usher in the practice of teledentistry — especially in the age of the continuing COVID-19 pandemic. 

And, in truth, dentists will find there are a number of AI tech firms making good on that promise — offering them tools that are designed to help them expand into teledentistry in an easy and profitable way. 

“The pandemic has gotten people in a lot of professions to realize how much can be done remotely. Dentistry is no exception,” said Kyle Stanley, chief clinical officer of Pearl. “Remote monitoring, remote diagnosis, remote triage — there is a lot we can already do. I don’t see any fundamental technical obstacle to eventually adding some form of at least superficial visualization to that. Then, if you combine that with a layer of AI, not only can you improve accuracy and predictability, but you can greatly expand service to people who live in remote areas.” 

However, University of Maryland’s Price offered some caveats to how far the profession can take teledentistry and remote medicine. “Teledentistry may be limited due to the fact that every state controls the practice of dentistry within its own borders,” he said. “Dentists are of course free to engage in teledentistry activities involving patients of record during activities within their own states or licensure boundaries.” 

He has a different idea of how teledentistry could be widely applied for patient and clinician benefit. “As a dentist in academia, I think a more far-reaching aspect of teledentistry would be ‘grand rounds’ with the patient, the referring dentist and the treating dentist. Such rounds would enable all three parties to go over a working diagnosis and provisional treatment plan so that not only does the patient more fully understand the upcoming care or treatment plan, but the referring dentist knows that their patient is being well cared for.” 

But other industry experts — including Pearl’s Tanz — are less convinced that teledentistry will take hold in any meaningful way, even with help from AI.

“While I think AI will increasingly enable more productive teledental patient-doctor interaction and contribute to new tools that facilitate certain kinds of remote examination and diagnostics, I don’t see teledentistry becoming a truly reliable stand-in for in-person care any time soon,” said Tanz. “Radiographs are just too important to dental diagnostics. Interproximal caries, periapical radiolucency, widened periodontal ligaments — these kinds of issues can only be detected via radiographic imaging. Without a major breakthrough in radiographic technology to make at-home radiography systems not only compact but also safe and cheap enough that patients can own and operate them at home, I don’t see teledentistry becoming a truly reliable stand-in for in-person care.” 

Thomas T. Nguyen, DMD, MSc, FRCD(C), faculty of dentistry, McGill University, shared a similar view. “With all the advancements in AI, there will always be one major obstacle to remote dentistry: visualization,” he said. “The mouth is a restricted, dark and humid cavity. Without clear 3D visualization of the mouth — and a possibility to see underneath the surface — AI won’t be used to its full potential, and teledentistry applications will remain limited and unreliable.” 

Despite these obstacles, AI apps designed to advance teledentistry are flooding the market. DentalMonitoring, for example, offers an entire AI-powered software suite designed for dentists looking to make a move into remote dentistry. The software works by enabling patients to scan their smiles with their smartphones and then send images of their teeth to a dentist for monitoring and analysis. There is also an in-app messaging system that the dentist can use to communicate with each patient. Patients can also use a DentalMonitoring photomorphing tool to visualize how their smile will look after they opt for recommended treatment. 

Pearlii is a similar remote monitoring app that relies on five images, which patients take using their smartphones, to potentially diagnose what’s going on with their teeth. It also recommends a trip to the dentist if trouble is detected. The AI-powered monitoring system is a much more informal app than DentalMonitoring in that use of the software is not linked to a particular dentist. Instead, after Pearlii alerts users that they need to consult with a dentist, patients can use the app to book an appointment with any one of thousands of dentists linked to the system. 

Attent, yet another remote imaging app, takes a different approach to teeth imaging. It uses a pen camera, which patients use by pressing the tip of the camera to each tooth and then taking a picture. Each image takes about a second to shoot. Attent’s AI software then analyzes the images and issues a prognosis that the company says is 99% accurate. The tool is also designed to become even more accurate over time, thanks to its machine learning algorithm. 

Even More AI for the Business Side of Practices 

While many dentists may be less enthusiastic and more cautious about adopting the plethora of increasingly medical AI apps, there is also a torrent of new general-use, AI-powered business apps in the marketplace for the administrative side of dentistry. 

“I do think dentists will embrace AI apps to help with the business side of their practice,” said Erick Cutler, partner at EisnerAmper, an accounting, tax and business advisory firm. According to him, AI business apps will help dentists “be more efficient and allow them to focus on the healthcare service part of their work rather than getting tied up running a business.” 

For example, the popular video meeting provider Zoom recently added an AI-powered auto-transcription app to its services. Dubbed Fathom, the tool is designed to automatically take written notes on Zoom meetings — including annotations. Plus, Fathom generates a comprehensive written summary of a video meeting, including key insights and action items. 

Meanwhile, dentists troubled by the growing scourge of ransomware now have a number of AI-powered cybersecurity packages that can help defeat would-be hackers. 

Bitdefender Antivirus Plus, for example, uses AI to watch for unexpected behaviors in your dental office computer system — such as sudden, wholesale changes to file names. Similar AI-powered anti-ransomware solutions are available from ZoneAlarm by Checkpoint, Kaspersky Security Cloud – Free, Sophos Home Premium and NeuShield Data Sentinel. 

There are also a number of firms, including Microsoft, that have come up with AI solutions designed to auto-write business reports directly from a business’s database. Microsoft’s Smart Narrative tool, for example — included in the company’s business analytics software, Microsoft Power BI — enables dentists to autogenerate short, written business reports from their data, which offer analysis on a dentist’s current sales, a forecast of future performance and more. 

Meanwhile, dental marketing teams looking for AI to help automate the writing of short ads, emails and social media posts have a slew of auto-writing apps they can subscribe to. 

Anyword, for example, can be used to auto-generate a marketing message optimized for the gender, age, shopping preferences and other demographics a dentist is looking to attract. AISEO, Scalenut and WordLift all specialize in auto-generating website and other copy that is optimized for high returns via search engines due to search engine optimization (SEO). 

“I think it is only a question of time until the use of AI becomes widespread in dental offices,” said McGill’s Nguyen. “AI technologies will improve our efficacy, make our lives easier and give us more time to focus on patient care and the human aspects of dentistry.” 

The AI Shoot-Out: Solo Practitioners Versus DSOs 

As AI begins to pervade virtually every aspect of dentistry, many wonder if the technology will ultimately be leveraged by DSOs to make it tougher for solo practitioners to compete in the markets where they have a strong footprint — or even make it tougher for solo practitioners to simply survive. The oft-voiced axiom, “Data is the new oil,” originally said by British mathematician Clive Humby, appears to naturally favor DSOs. Essentially, with many of these apps, the more data they’re fed, the more accomplished and precise they become. And one thing DSOs have a lot of is data. 

“My impression at this time is that DSOs are more interested in AI than individual dentists,” said Donald A. Tyndall, DDS, MSPH, PhD, FICD, professor of diagnostic sciences, University of North Chapel, Adams School of Dentistry. Tyndall added that AI offers greater opportunities to benefit from automation to organizations that employ numerous practitioners across a wide network of offices. 

Should that scenario play out, DSOs stand to gain even more ground with the advent of AI if an increasing number of solo dental practices — beaten by the COVID-19 pandemic — are folded into regional DSOs. 

“Because their business models are geared toward productivity and efficiency — and access to huge amounts of data — DSOs will have the upper hand if they can rapidly adapt and embrace this new technology,” said Nguyen. 

Others envision more of a win-win scenario. 

“Initially, DSOs will benefit more since, in general, DSOs are interested in investing time, effort and money in quality control efforts in their practices to improve their ROI,” said University of Maryland’s Price. “But, over time, dental AI will be a winner for both the solo practitioners who adopt AI and for DSOs.” 

“I think it’s a tide that’s going to lift all boats,” said Pearl’s Stanley.

The great aspect of web-based AI tools is that the individual doctor or DSO network doesn’t actually need a huge amount of data to utilize the tools, according to Stanley. Everyone — including both solo practitioners and DSO doctors — will be able to consult built-in AI second opinions instantly. 

“It will increase trust in all aspects of dentistry,” said Stanley. “Since the advent of digital dentistry, practitioners have been accruing huge volumes of data within their practice management systems and their radiology databases. Until now, they haven’t been able to do much other than store it. AI vendors can take that data and find opportunities that bring growth, efficiency and better patient outcomes to practices.” 

“Simply put— [DSOs and private practitioners] both benefit,” said Pearl’s Tanz. “AI is an equalizer. It raises the standard of care. It increases production. It facilitates efficiency. It builds patient trust. If you’re a DSO using AI correctly, you benefit. If you’re a solo practice using AI correctly, you benefit. There are ways that a DSO can use AI that differ from ways solos can use AI, but that’s because they operate differently as businesses. DSOs have more patient data overall. But on a per-practitioner basis, they have the same amount of data.” 

Ahead on AI’s Misty Horizon 

When making predictions about AI’s future, many experts agree that, at the very least, one of AI’s core promises — freeing staff and dentists from mundane chores so they can focus more on treatment and the personal touch — will ultimately be realized. 

“In the near future, I believe that most dentists will be leveraging AI to eliminate the need for repetitive daily tasks like charting, inventory management and patient recall,” said Tanz. “This will allow everyone — from the hygienist to the front office staff to the dentist — to spend more time building meaningful relationships with the patient and focusing on improving practice efficiency.” 

Price sees special promise in AI’s coming use to detect smaller carious troubles. “The future of AI for caries detection will be to integrate clinically oriented AI results with the remainder of the patient’s demographic history, dietary and oral care habits, and existing restorative history to then assist with treatment decision-making,” he said. “This will allow dentists to develop the final treatment plan for caries management in a more comprehensive and holistic manner.” 

Long term, Tanz also sees AI being used to predict and get a jump on a patient’s likely dental problems — enabling dentists to devise plans to evade those problems before they have a chance to take root. “For example, AI may soon be able to analyze a patient’s medical records and understand which individuals are at higher risk of gum disease — allowing the patient and dentist to develop a preventive care plan to drive better outcomes,” he said. “Further down the line, I’d like to see AI helping to bridge the gap between oral and systemic health, bringing dentistry out of its silo and making it part of the conversation when it comes to holistic care.” 

“There will be ups and downs in these early years of the adoption of AI due to the unpredictable performances of the early AI programs,” said Price. “In other words, there will be a lot of hype. And dentists will expect these programs to solve a lot of problems. Dentists tend to buy a lot of gadgets and things to try to boost production and increase their sales of dentistry to their patients. If they approach AI in this manner, then dental AI will be one more failure in their practices. 

“On the other hand, if dentists approach dental AI with the concept of how this will enhance the overall improvement of their patients’ dental health, then there is a greater likelihood that dental AI will actually have a positive effect on their patients’ oral health — and in their practice’s health and performance.” 

Joe Dysart is an internet speaker and business consultant based in Manhattan. To comment on this article, email impact@agd.org.