Artificial intelligence: A gift to dentists

The media loves to make dentists the villain. AI has the potential to change the narrative

The May 2019 edition of The Atlantic magazine contained an article titled “The truth about dentistry”. In it, the author visualised dentists—not a particular dentist but dentists in the abstract—as sinister authority figures looming over the helpless patient’s recumbent form, drill in hand. Mistrust permeated the scene like swamp fog. “When he points at spectral smudges on an X-ray,” the author pleads, “how are we to know what’s true?”

Then there was the Dustin Hoffman movie Marathon Man with its Nazi dentist-cum-torturer, and the famous—or, if you’re a dentist, notorious—1997 Reader’s Digest article by a writer who visited 50 dentists in 28 states, picking them at random out of the Yellow Pages, and was given treatment plans ranging in cost from under US$500 to nearly US$30,000. That one really hit a nerve, so to speak.

The hidden inconsistency in dental diagnosis

Dentistry has long struggled with an uncomfortable truth: diagnostic interpretation varies far more than patients expect from a healthcare profession. While clinical judgment is shaped by training and experience, studies have repeatedly shown that dental diagnoses, especially those based on radiographs, lack consistent agreement across providers.

A widely cited Dental AI Council study made this variability difficult to ignore. The same full-mouth radiographic series was presented to more than 130 dentists, who were asked to diagnose each tooth and propose a treatment plan. Not once did a majority of participants agree on the diagnosis for any individual tooth. Treatment cost estimates for the same patient ranged from approximately $300 to $36,000, with no meaningful clustering around a typical plan.

Other research has echoed these findings. Studies examining radiographic interpretation show that estimates of cavity depth and recognition of radiolucencies are incorrect nearly as often as they are correct. In one large analysis, three dentists reviewing thousands of radiographs reached complete agreement only a small fraction of the time.

What the data reveals:

• No majority agreement on diagnosis for any single tooth
• Treatment plans spanning tens of thousands of dollars for the same case
• Radiographic interpretation accuracy hovering near chance in some scenarios
• Extremely low full agreement rates between multiple clinicians

These findings directly challenge the assumption that dental diagnosis is grounded in a shared, objective standard. For patients, this inconsistency helps explain persistent skepticism about treatment recommendations, even when dentists act in good faith.

How AI is solving dentistry’s diagnosis problem

Dentistry is uniquely positioned to benefit from artificial intelligence. Dental radiographs are already central to diagnosis and patient communication, and the range of pathologies visible on imaging is relatively focused compared to many other medical fields. These characteristics make dentistry an ideal application for computer vision systems trained to recognize subtle, repeatable patterns.

Modern dental AI systems are trained on millions of annotated radiographs. They analyze images pixel by pixel, detecting and quantifying features with a level of consistency that individual clinicians cannot realistically maintain across every case, every day. AI does not replace diagnostic reasoning, but it introduces something dentistry has historically lacked: repeatability.

Unlike humans, AI systems do not experience fatigue, distraction, or cognitive bias. They apply the same criteria to every image, creating a stable reference point across providers, locations, and time. That consistency is where AI’s real value lies.

What AI brings to the chair

An AI-powered second opinion offers practical value beyond simple confirmation. When AI findings align with a dentist’s assessment, they reinforce confidence. When they differ, they prompt closer examination that may uncover early pathology or confirm that conservative monitoring is appropriate.

For patients, the impact is equally significant. AI transforms radiographs from ambiguous grayscale images into clearer visual explanations, with highlighted areas, color-coded outlines, and structured findings. Diagnosis becomes easier to understand and easier to trust, supported by data rather than appearing as a purely subjective opinion.

Understanding AI's role: Assistant, not authority

Despite its accuracy, AI does not “understand” teeth the way clinicians do. It does not evaluate symptoms, consider patient preferences, or weigh clinical context. What it does exceptionally well is reflect how large populations of specialists have interpreted similar images.

In effect, AI represents a collective reference, summarizing the consensus patterns of thousands of expert interpretations. Dentists remain entirely free and responsible to disagree. The difference is that decisions are no longer made in isolation, but with visibility into what a broad peer group would likely conclude.

Addressing practitioner concerns about AI

Some dentists worry that AI could undermine their authority or challenge their judgment in front of patients. In practice, AI functions as a silent partner rather than a critic. It surfaces potential findings for review without dictating decisions or overruling clinical expertise.

Others question whether adopting AI signals a lack of confidence. The opposite is often true. Embracing AI reflects a commitment to consistency and evidence-based care. Just as clinicians seek peer input on complex cases, AI provides an always-available reference that helps counter fatigue, time pressure, and human variability.

Workflow disruption is another common concern. However, modern dental AI systems integrate directly into existing imaging environments and deliver results within seconds. For most practices, improved diagnostic clarity and stronger case presentation offset the minimal time and cost investment required to adopt the technology.

AI does not replace dentists. It supports them in delivering care that is more consistent, explainable, and trustworthy.

Revolutionizing dentistry: The transformative role of AI in diagnosis and beyond

The most significant impact of dental AI, however, is not that it necessarily brings a superhuman level of certainty to the data upon which diagnoses are based—although in most cases it may—but that it provides, for the first time, an objective and universally accessible standard of reference. Objective standards are precisely the thing that dentistry has lacked in the past, and their absence has given rise to suspicions about the candour and consistency of dental diagnoses. Look at the Reader’s Digest writer: guided only by a phone book, he collected a bewilderingly large variety of diagnoses. If he had visited only dental offices using an AI assistant, he would have been given a much smaller variety, and the differences would have been due to small variations among the radiographs made by different practices rather than to the whims of individual dentists or the immediate financial needs besetting them.

Consistency is not the only thing AI brings to dentistry. It also provides support for insurance claims and facilitates record-keeping, tracking of patients’ dental health and comparison of performance among multiple practices in an organisation. It trains dentists at the same time as dentists train it. In the future, it may reveal connections between dental health and general health that we do not now suspect.

Those are some of the collateral benefits. Above all, however, AI will give patients the reassurance of knowing that the condition of their teeth is not merely a matter of opinion.