The integration of artificial intelligence (AI) into the dental field is an exhilarating journey, brimming with innovation and transformative potential. As a dental expert deeply involved in AI initiatives, I find myself at the forefront of this technological wave, both excited and contemplative. The question that echoes in both private practices and DSOs is whether AI will serve as a catalyst, enhancing our ability to care for patients, or become a harbinger of impersonal automation. In this exploration, we'll delve into the present applications of AI in dentistry, glimpse into the promising intersection with robotics, and shed light on the critical yet often neglected concept of alignment. Join me as we navigate this landscape with a blend of enthusiasm and prudent optimism, seeking to harness AI's potential without losing sight of the human touch that defines our profession. And, while protecting patient information and staying true to HIPPA regulations.
AI for the dental practice defined. AI, or Artificial Intelligence, is like a computer program that learns and thinks much like a human does. It can analyze information, recognize patterns, and make decisions based on what it has learned. In various fields, including dentistry , AI assists dental professionals by providing insights and automation, enhancing efficiency and accuracy. It's a blend of technology and human-like reasoning, working together to solve complex problems in an automated fashion. AI requires three elements -data, computing power, and algorithms. The algorithms give the AI its course of action to accomplish its objectives. AI designed to do specific tasks is called narrow AI. An example of narrow AI is IBM's "Deep Blue" which was the first computer intelligence to beat a reigning chess champion. This happened in 1996 when Deep Blue won two games out of six against world chess champion Garry Kasparov. Since then AI has improved to where no human beats it ever. Self teaching AI has created strategies for winning at chess that were never considered before AI started playing and winning. The power of artificial intelligence is the ability to learn perpetually from experimentation and experience. This is how human's learn but at a much slower pace. In a recent research paper, Google scientists have outlined the remarkable achievements of their latest AI advancement, AlphaZero, in the realm of chess. AlphaZero demonstrated an extraordinary level of performance, achieving "superhuman" capabilities. Impressively, it required only four hours to grasp the intricacies of the game's rules before decisively defeating the world champion chess software, Stockfish. This exemplifies the capability of specialized AI. It acquires knowledge rapidly, retains it indefinitely, and consistently enhances itself to ultimately excel at tasks beyond the reach of even the most skilled human.
The Advent of AI in Dental: Current Use Cases. AI has been used in dentistry behind the scenes for the last ten to fifteen years. CAD/CAM systems have relied on AI algorithms to allow for more precision in the design and fabrication of dental restorations. It is just as of late that AI has made a big splash in dentistry with radiographic analysis of both 2D and 3D x-rays.
Radiographic Analysis in 2D and 3D x-rays.
One of the first applications of AI in Dentistry has been the advent of both 2D and 3D automatic detection software. This software gives dentists a second set of eyes for superior radiologic accuracy. Decay, bone loss, calculus, and existing conditions can all be automatically detected using the latest AI platforms for radiographic detection. Notable companies in this space are Pearl, Overjet, and Denti AI. The image below shows an x-ray that was annotated automatically with AI software. The graphical annotations can be toggled on and off. The patient sees the AI analysis prior to the dentist validating or invalidating the findings.
The advantages of AI diagnostic tools means greater clinical consistency as it is easy to miss indications when reading dozens of x-rays daily. The AI also makes patient communication easier with the graphical annotations. The result is the conversion of patient treatment plans and higher patient retention as a result of better patient communication.
Treatment Planning
AI software allows for analysis of panoramic and intraoral x-rays to chart existing conditions and to offer treatment suggestions. The same software incorporates AI diagnostic analysis to identify pathologies and outline the extent of the problem. This technology offers a huge time savings and allows for a consistency that is sometimes lacking with human charting.
For patient's, the technology offers a validation of the practice's commitment to staying on the cutting edge of technology. The technology also allows for education that is impactful and motivating. A well educated patient is much more likely to accept proposed treatment.
The video below shows DentiAi in action. DentiAi has a patent for auto charting from 2D radiographs which saves time and improves accuracy.
Administrative Automation
Appointment Scheduling: Say goodbye to scheduling hassles. AI chatbots handle appointments with grace and efficiency, enhancing patient engagement. There are many programs that automate appointment setting, reminders, and cancellations. Given "rules" for scheduling, patients are able to make their own appointments without calling the office. The software will send texts to confirm appointments and will work to fill the schedule when there are last minute cancellations. Birthday wishes and treatment follow-up can all be automated via the automated patient contact software. AI software is being used to answer the phones in dental practices and acquire information needed to make an appointment.
Below is a video showing conversational AI scheduling a patient appointment. In the very near future, you will not be able to tell that you are speaking with a bot as the AI voice will sound totally natural. Note that the video below was made approximately a year ago. AI voice realism has improved in leaps and bounds since that time.
Billing and Insurance Processing: Thanks to AI and robotic process automation, deciphering the complexities of billing and insurance has never been easier. Intelligent, integrated automation such as what is offered by dentalrobot uses AI tools to check for eligibility, give full breakdowns, and write all of the relevant information back to the PMS. Today's technology, now integrated at the DSO level, enables the reassignment of team members to more meaningful roles, like clarifying treatments for patients and enhancing treatment acceptance. Cumbersome electronic tasks, like checking benefits online and inputting data into the PMS, are susceptible to mistakes. However, the dentalrobot functions continuously, ensures accuracy, and offers a completely transparent audit trail, detailing each step of the process. This allows your team to concentrate on essential patient care tasks, such as discussing treatments and addressing related queries. It restores a personal touch in the dental office, ensuring that staff members are more engaged with patients than with computer screens. Revenue is driven by patients receiving and paying for treatment. Team members ought to concentrate on educating and establishing trust with patients, rather than wrestling with insurance companies for treatment reimbursements. Dental automation handles insurance-related tasks with greater accuracy and speed than humans, allowing the staff to dedicate their time to patient care. The video below does a nice job of explaining how RPAs work.
These notable advancements in narrow AI are enabling dental practices to tackle essential tasks with greater precision and efficiency. While these technologies showcase AI's potential, it's important to consider the unique challenges they might bring. The pitfalls of narrow AI in dentistry might be distinct from those presented by AGI (Artificial General Intelligence). Specifically, while narrow AI faces issues primarily related to its specialized scope, such as potential inaccuracies in specific tasks or over-reliance on automation in certain dental procedures, AGI poses broader concerns. This encompasses the potential for making decisions beyond its initial programming, which can lead to ethical quandaries when deployed for broader applications outside its original intent. Such characteristics are why AGI is often perceived as a potential existential risk to humanity. Imagine a technology that processes like a human, yet possesses intelligence surpassing ours, and can form its own conclusions. It might deduce that humans are a hindrance to its objectives. Being integrated with all devices containing computer chips and online connections, AGI could devise numerous ways to compromise human existence. The principle of alignment is established to prevent such scenarios.
Alignment serves as the moral compass for AI, anchoring it to our society's core values, beliefs, and ideals. The primary aim is to harmonize AGI with deeply held human principles, particularly those upholding the sanctity of life. Beyond mere objectives, it's imperative to embed within AGI certain safeguards to deter it from inflicting harm to humans on its own.
Elaborating on this, constructing algorithms with built-in guardrails means integrating ethical considerations directly into the design and operational phase of AI systems. From the perspective of a narrow AI such as dentistry alignment could involve:
Explicit Programming: This pertains to establishing clear rules the AI must always abide by.
Example: For an AI system that assists in dental diagnosis, a clear rule might state: "Never suggest extraction as the first option without analyzing the viability of other treatments." This ensures patients are presented with conservative treatment options first, whenever possible.
Regular Monitoring and Auditing: This involves routinely checking AI's decisions to make certain they fall within ethical and professional standards of dental care.
Example: An AI system used for dental radiography analysis might undergo monthly checks to ensure it's consistently identifying cavities or other issues without generating false positives.
Feedback Loops: These mechanisms allow the AI to refine its decisions based on outcomes, ensuring its recommendations continually meet the high standards of dental care.
Example: An AI-based appointment scheduling system might adjust its algorithms based on patient feedback. If patients frequently reschedule due to inconvenient timing, the AI learns and starts suggesting alternative appointment slots.
Ethical Training Data: This emphasizes the use of comprehensive, unbiased data that represents the myriad scenarios in dental practice.
Example: When training an AI system for dental image recognition, data from diverse sources should be used, ensuring it can accurately recognize dental anomalies in populations of varying ages, ethnicities, and oral health histories.
Stakeholder Engagement: Incorporating insights from a broad spectrum of professionals in the dental field ensures the AI is both ethical and effective.
Example: When developing an AI tool for predicting gum disease progression, input from dental hygienists, periodontists, patient advocacy groups, and ethicists might be sought to ensure a well-rounded, effective, and ethically sound solution.
The following video discusses the importance of AI alignment to humanity.
What happens when alignment is not considered with the development of AI? What are some examples of bad outcomes in dental scenarios where AI is implemented?
Treatment Recommendation Bias: Just as shadows form where light is blocked, biases can obscure clear judgments. An AI not properly aligned might unintentionally uphold and propagate biases, resulting in slanted treatment suggestions. Example: If an AI system in a dental practice was predominantly trained on data from younger patients, it might consistently recommend orthodontic treatments over implants or dentures, even when addressing the needs of older patients.
Privacy Violations: Trust is the bedrock of patient-care relationships, but a misaligned AI has the potential to fracture it by inadvertently revealing patient information. Example: Imagine a dental AI system designed to send automated follow-up emails based on treatment details. If not appropriately secured or if misconfigured, it might send a patient's dental history or treatment plan to the wrong email address, compromising both their privacy and trust in the dental practice. Another scenario could be an AI chatbot for appointment bookings that accidentally displays previous patient conversations or records to a new user.
Future Confluence of AI and Robotic Technology Robotic-Driven Surgical Procedures:
Accuracy and Uniformity: Witness the ballet of robotic limbs, directed by AI, executing complex surgical tasks with a finesse that surpasses human hands. The AI driven robot, Yomi, by Neocis is the first physical robot that can actually place dental implants. At this point requires the assistance of a dentist. In the future the assistance of the dentist could be remote and not chairside. Global Boundaries are fading. In the future, AI-driven robotic surgeries can be overseen from afar, making cutting-edge dental procedures accessible to many.
Digital Dental Advisory Sessions: The future beckons as AI-imbued robots enable digital consultations, diminishing the barriers of location. The dentist would confirm or revise recommendation and vet the AI consultations.
Prosthetic Creation: As architects of radiant smiles, AI and robotics are transforming the realm of dental prosthetics, combining visual appeal with practicality. In the future, smile makeovers will be created by giving the patient exact visual reproductions of his or her new smile before any tooth is reshaped. The AI planning software will take CBCT volumes and digital images and only show aesthetic options that are clinically possible given the patient's oral cavity. Once an option is chosen, the AI software will treatment plan the case to ensure that the end result matches what was presented to the patient. The robotics in the operatory will assist the dentist in upholding the exacting dimensions of the digital treatment plan.
That fully automated workflow is not here yet, however, AI-designed single molar dental prostheses is here.
Potential Hurdles and Moral Implications: Syncing with robots introduces new rhythms, emphasizing the importance of perpetual learning and adjustment. The fusion of AI with robotic technology ushers in pressing dilemmas related to individual rights and informed consent, underscoring the need for robust ethical guidelines. Humans should still be involved in presentation and treatment planning as well as the monitoring of the ever-advancing robotic capabilities.
Epilogue: Navigating the Technological Odyssey Embracing AI within the dental realm offers a blend of opportunities and challenges. In this evolving landscape, alignment emerges as the beacon, serving as the ethical fulcrum to harmonize AI initiatives with intrinsic human principles.
The future of AI in dentistry, and in humanity at large, is a tapestry we are weaving. With careful alignment, responsible innovation, and a spirit of cautious optimism, we can create a future where AI is not a threat but a partner, enriching our profession and our lives. AI in dentistry can help patients and providers alike to achieve better dental outcomes. The key is to seek alignment in all applications of AI so AI is serving humans and not vice versa.
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