Recognizing that artificial intelligence could lead to earlier diagnosis of oral diseases and put more tools in the hands of patients, the majority of dental practices, dental schools, oral health researchers, and policymakers are rapidly positioning themselves to evolve with the dawning AI movement in oral health care.
Experts shared these insights and more at the inaugural Global Symposium on AI and Dentistry, held Nov. 3-4 at the Harvard School of Dental Medicine (HSDM).
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“AI holds the promise of transforming the way we practice oral health care, pinpoint and treat diseases and conditions, and increase equitable access to care and treatment,” HSDM Dean William Giannobile said at the symposium.
The tangible energy around AI’s growing influence on dentistry is what prompted HSDM to gather more than 400 leading dental practitioners, researchers, students, AI scientists, ethicists, and policymakers from 30 countries. Attendees joined event workshops, keynotes, and thematic panel discussions both in person and virtually.
A poster session included more than 65 research projects featuring a range of device prototypes, patient-facing smartphone apps, and other technologies under development at the intersection of AI and dentistry. A panel of judges honored several presenters.
Harnessing AI to address barriers in oral health care
For more than 40 years, researchers have been experimenting with ways to apply AI to dentistry, said Florian Hillen, founder and CEO of VideaHealth, a dental imaging startup launched from AI research conducted at Harvard and MIT.
Within the last decade, he said, AI capabilities have finally reached critical mass.
“AI-powered tools are now helping dentists identify dental decay in patients up to five years earlier,” he said. “The tech revolution is happening.”
Beyond opportunities to improve outcomes for individual patients, researchers are seizing AI to help solve population-level health challenges. To do so effectively, academia and industry will have to dissolve boundaries between scientific discipines, said keynote speaker Dimitrias Bertsimas of MIT.
At Harvard, cross-disciplinary teams are leveraging machine learning to identify patients whose social determinants of health put them more directly in the path of climate change-related impacts and a bevy of other risks to oral health.
“Are exposures to wildfires impacting oral health? If they become more frequent, who’s most vulnerable and how do we act on this information?” asked Francesca Dominici, director of the Harvard Data Science Initiative at the Harvard T.H. Chan School of Public Health.
She and a team of researchers are using AI to analyze satellite data, atmospheric chemistry models, and other factors, revealing which communities are most affected by increasingly frequent wildfires, extreme heat waves, and destructive storms.
Reduced air quality from fires and higher temperatures from warming climate can cause mouths to be drier, making people more prone to oral disease and tooth decay. Increased psychological stress from extreme weather events can increase risk for teeth grinding and temporomandibular joint (TMJ) disorders.
What’s more, natural disasters can disrupt access to dental facilities and care, Dominici added.
Augmenting, not replacing, human knowledge
Biomedical researchers are also deploying AI to speed up and optimize experiments, therapeutic discovery, and pre-clinical validation.
“[AI is] generating, acquiring, harmonizing, and refining data, and it can generate hypotheses, as well as simulate experiments and downstream outcomes,” said Marinka Zitnik, assistant professor of biomedical informatics in the Blavatnik Institute at Harvard Medical School.
It will revolutionize the way therapies are matched individually to patients, she said, and help design entirely new drugs and therapeutics.
A survey of 1,600 biomedical researchers revealed that 25 percent of them feel AI will be essential to their studies within the decade, she added.
Zitnik specializes in building knowledge graph AI models, which help contextualize and capture relationships within diverse sets of biomedical data. Her team has developed a knowledge graph AI model called TxGNN that describes 17,000 diseases using all available clinical and biomedical data. Once trained, it could predict how well any given therapeutic might treat a patient’s unique disease and recommend new uses for FDA-approved medications.
On the industry side, two primary types of AI-assistive technologies are already making waves in dentists’ offices: platforms for patients, providers, and payers that focus on using AI to interpret and analyze imaging, and AI software that automates patient engagement, scheduling, and other time-consuming “back office” tasks for dental practices.
“AI [products] on the market today are not decision-makers, they are helpers,” said Phillippe Salah, co-founder and CEO of DentalMonitoring.
Dental AI tools include products that allow dentists to remotely analyze oral photos that patients submit via smartphone. Imaging tools use AI to guide patients as they capture images of their teeth and can then detect signs of declining oral health to flag for the dental care team.
AI-guided 3D simulations of patients’ mouths help orthodontists accelerate the fittings and transition between braces, aligners, and retainers. Some tools even enable patients to see AI-powered, life-like simulations of how their teeth, mouth, and face will look after dental work or braces.
“One of the biggest frustrations in my practice was knowing what my patients needed, but not having the tools or ability to communicate that in a way [that inspired my patients to] to prioritize their dental care,” said Edward Zuckerberg, who owns a private practice and is the chief dental officer at Keystone Bio and Viome.
Several FDA-cleared AI products on the market today use visual dashboards to show patients and their dental care teams precisely where areas of decay are detected in the mouth and to what degree — motivating patients to pursue care sooner.
When AI and high stakes collide
Experts at the intersection of AI and dentistry agreed that with progress must also come prudence.
“I’m excited about the abundance of AI solutions [we’re talking about] here,” said Mariya Filapova, chief technology officer at CareQuest Innovation Partners, but, she cautioned, AI is not good at empathy, creativity, or imagination – all uniquely human factors that are critical to solving problems ethically.
And, she continued, new technologies are often put into play before guidelines and policy have caught up.
While the FDA is clearing more AI dental platforms for commercial access, that process doesn’t regulate fairness and bias, said Hawazin Elani, assistant professor of oral health policy and epidemiology at HSDM.
“We have to own where our data [that’s training AI systems] is coming from,” he said.
Keynote speaker Fernanda Viégas, the Gordon McKay Professor of Computer Science at Harvard’s John A. Paulson School of Engineering and Applied Sciences and a principal scientist at Google, warned that health care providers should not have to put blind faith in AI decision-making.
Viégas and collaborators at Google have found that clinicians are more likely to adopt AI tools that don’t spit out automated results without sharing details about its analytic framework or the baseline data the system was trained on.
In high-stakes situations like making the correct diagnosis for a patient, Viégas said, the team found that being able to engage with AI systems at meaningful levels mattered a lot to health care providers.
“It touches upon the need for trust, confidence, transparency… and these are all really hard things to accomplish” in an AI system, she said. “As we start to deploy new [technologies], we will find these gaps [in user experience] that we need to design for.”
Giannobile agreed with the need for continued alliance among researchers, practitioners, and industry as AI further transforms dental medicine.
“We know things will change rapidly in this space — perhaps even within the next couple of weeks. So, stay tuned, because we’ll be inviting you back to meet again,” he said.
