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As Artificial Intelligence (AI) transforms healthcare around the world, should people be worried about its impact on the dentist-patient relationship? By Rashida Tayabali
Artificial intelligence (AI) is no longer a vague idea set somewhere in the future. It’s rapidly transforming dentistry services around the world and patient care. For example, a new AI platform being developed in the UK could allow dentists and dental students to read dental X-rays with higher accuracy to better detect tooth decay and gum disease in patients. In Australia, an in-mouth robot is being developed to allow city dentists to ‘visit’ remote communities. Dentists in the US are already using AI-powered X-ray imaging technology to help manage regular procedures like cavities and gum disease, and to diagnose more serious conditions like periodontal disease, and bone loss within the mouth linked to non-oral health diseases.
As AI transforms dentistry, practices will need to incorporate it to stay competitive. While patients are seeing the advantages of their dentist using AI to deliver better care, they are also worried about how it will affect the dentist-patient relationship. Indeed, a study published in Head & Face Medicine found that while patients saw a distinct advantage to using AI in dentistry, 36 per cent of those surveyed were concerned about its impact on the provider-patient relationship.
How can dentists use AI in their clinics and still reassure their patients they are receiving a high quality of care?
According to Professor Heiko Spallek, head of School and dean at The University of Sydney School of Dentistry, it’s not all bad news. “I believe AI will positively impact dentistry, especially in patient care because privacy is handled much more strictly in healthcare than in other industries. No healthcare professional will submit identifiable patient data records to the free version of Open AI’s ChatGPT-4. AI can be used effectively within a HIPAA-compliant environment, such as provided by Microsoft.”
A HIPAA-compliant system secures patient data by following infrastructure, network and process security measures. The dentist can safely input identifiable patient health information, find patterns of disease to track health outcomes or use AI for clinical decision support. A HIPAA-compliant AI system can still fall prey to human error and therefore needs to be governed by solid policies and procedures, staff training and security protocols.
While patient information is secured with a HIPAA-compliant system, how can AI help to improve patient care?
Personalised patient care
Dentists are obliged to keep accurate and up-to-date records each time they treat a patient. Patient notes need to be typed up, and the provider is under pressure to do it quickly and without error. Presently, not much is being done with patient notes and AI could help to change that.
“Using AI to make sense of unstructured data like patient notes, find patterns of infections and diseases and provide a big-picture view will allow dentists to focus on high-quality care instead of various admin tasks in the dental office. It helps bridge the gap between the dentist and other medical professionals, find meaning behind the data and improve the quality of patient care,” says Professor Spallek.
“Today, people are taking more medications and presenting with different health-related problems. Having AI fill in the gaps means the dentist is more aware of how these other factors can impact on the dental treatment planned, and can then plan and deliver more customised and holistic patient care.”
How can dentists tie in their expertise with AI to explain diagnosis and treatments to patients in a way they understand? According to Professor Spallek, AI can add value for dentists and providers in translating ‘medical speak’ into different languages and reading levels to improve health literacy and understanding in patients.
“For example, every dentist gives out an information pamphlet when they send patients home after a tooth extraction. Patients whose first language isn’t English could find it difficult to read and follow the post-care instructions correctly. A dentist could easily translate their various pamphlets into the most suitable reading levels and languages for their typical patients using ChatGPT-4 or another large language model (LLM).”
How much human involvement is needed to ensure AI doesn’t cause issues with patient care? “It’s still the responsibility of the dentist to check everything thoroughly before they pass it on to the patient. However, if AI is being used only to translate approved information into different languages and reading levels, the risk of what’s often referred to as ‘hallucination’ is low. But, everything needs to be checked by a human so there isn’t over-reliance on AI,” says Professor Spallek.
Aside from the patient’s capacity to understand how AI systems work, often they lack sufficient levels of awareness to give free and informed consent for suggested treatments. They rely on their dentist to help with decision-making. How does this fit in with the dentist using AI as a diagnostic tool?
“The provider is always responsible no matter what system they’re using. In fact, dentists have always used external sources of knowledge, like guidelines from a reputable source or information regarding medications from pharmaceutical companies. It’s the dentist’s responsibility to make sure they are providing accurate, up-to-date information taken from evidence-led sources,” says Professor Spallek.
“AI might allow dentists in the future to spend more time with their patient and on clinical tasks, because it’s freed up their time from administrative tasks, which are also necessary for running an efficient practice, but not necessarily the best use of the dentist’s time. On the plus side, I don’t think AI will be replacing dentists anytime soon!”