How AI and AR-powered technology is finally replacing 150-year-old dental examinations

Three forward-thinking dental experts explain how digital technologies are changing how they practice, informing patient treatment journeys and creating better outcomes for patients. 

“The mirror and probe method of examining teeth is 150 years old and that’s how some dentists still look around the mouth.” says Dr Sheena Tanna incredulously.  

As the founder of Billericay Dental Care and a practitioner who was recently named Next Top Digital Dentist by the influential Dentistry magazine, Dr. Tanna is one of a new guard of forward-thinking practitioners adopting digital innovations as they land – from diagnostics to treatment planning, and from patient monitoring and communication. The result is more accurate diagnosis, personalised patient treatment plans, greater trust from patients, and a more efficient practice. 

“I think there was a time in which dentists thought digital technology was only for elite clinicians, but now it’s clear that the tools work for everyone, and they are completely revolutionising how we examine, how we diagnose and how we treat our patients,” she says. 

Making a better impression 

Central to Dr. Tanna’s patient consultations is the iTero 3D intraoral digital scanner by Align Technology. It replaces traditional orthodontic impressions which involve uncomfortable trays filled with a putty-like material, which can trigger gagging, particularly in younger patients.  

The scanner’s slim wand is simply swiped around the mouth to capture thousands of images; the resulting 3D video and still images – produced almost simultaneously – of the patient’s teeth and gums can be shared on a large TV screen, allowing the patient to see exactly what their dentist sees – no more uncomfortable mirror and probe dental examinations. The digital scans incorporate artificial intelligence (AI) which helps dentists quickly and accurately identify early-stage issues with teeth or gums. “Gone are the days when a dentist just tells you what you need. They can now show you your teeth and gums and discuss the future of your mouth with you,” adds Dr. Tanna. 

For patients needing or wanting orthodontics, complementary software – Invisalign Smile Architect, allows clinicians to model and compare different treatment approaches – including tooth movements and restorations – to find the solution that best suits the patient.  The software also allows the clinician to plan a staged approach completely bespoke to patients’ anatomy and their orthodontic and restorative needs. This creates exceptional precision with a level of detail that means fewer surprises and more predictable outcomes. 

No more guestimates 

To help orthodontic patients arrive at their treatment choice, practitioners have the option of another Align Technology programme – Outcome Simulator Pro. Powered by augmented reality(AR,) it helps patients visualise what their aligned and restored smile might look like from every angle, using videos and photographs of their own face; talking, laughing and turning from side to side. 

Says Dr. Tanna: “Not only can we show patients their tooth decay or gum calculus, in the case of orthodontic or cosmetic work we can also show them exactly what we’re expecting to achieve. This creates fantastic trust between us and our patients.  This level of care is so much more powerful than anything the industry has ever had before.” 

“Knowledge is power and our patients leave the clinic with that power. They’re able to take ownership of their own mouths and for me that is fundamental to everything we do.”  

Seeing is believing 

The power of AI, machine learning and computer vision are at the heart of one of the first AI solutions legally authorised to assist dentists in interpreting dental x-rays.  Developed by a team of technologists and dental professionals based in the tech sweet spot on the US West Coast, Hello Pearl – a global leader in dental AI solutions, is the first and only dental AI company with FDA-cleared solutions for both 2D and 3D dental radiologic image analysis. 

The Second Opinion software uses AI capabilities to cone beam computed tomography (CBCT) imaging, enabling automated identification of critical anatomical structures – effectively acting like a second set of eyes, scanning dental x-rays to detect a wide range of causes of dental disease, including cavities, bone loss and calculus.  

The software shows significant advantages over human clinicians in detecting dental pathologies from radiographs.  A landmark studyi involving more than 8,700 dental x-rays revealed that it has consistently outperformed human dentists in identifying tooth decay.  While human dentists showed moderate agreement (79%) in identifying the absence of decay, they unanimously agreed on the presence of decay in only 4.2% of cases.  By contrast, Second Opinion exhibited greater consistency and accuracy, identifying lesions that human clinicians often missed.  Further clinical trials reinforce these findings: In studies with more than 2,000 dental x-rays and 86 dental professional participants the software identified 36% more anomalies compared with those without AI assistance.  

The software’s success comes from its ability to detect the subtlest dental lesions that may elude the human eye. In fact, the human eye can detect approximately 40-70 shades of grey, while AI can detect up to 800 – an ability fundamental to identifying early stage caries and other dental anomalies.  

Dr. Alan Clarke, Founder and Clinical Director at Paste Dental in Belfast, says AI in diagnosis is a game-changer in helping his patients to see and understand the status of their mouths. “Diagnosis can be hard to explain without visual support. 75% of patients are visual learners, so how do we convey the information they need to help them make decisions about their own health? Presenting information on the screen, with all the issues highlighted in different colours, we become co-diagnosers with our patients, and they completely understand our treatment recommendations. By detecting potential issues earlier and more accurately, the AI supports preventative care, which reduces the need for more invasive and costly procedures down the line. Moreover, patients gain greater trust in their diagnoses: When they see clear, AI-supported visuals, explaining a cavity or a gum issues, they are more likely to follow-through with recommended treatments.” 

Long distance care 

While digital tools are helping dental professionals to improve their diagnosis and communications with patients and plan treatments for them, they’re also setting new benchmarks for check-ups and treatment monitoring.  Complex orthodontic treatment can mean a dental professional needs to see their patient every four to six weeks – a challenge for people who live some distance away, have busy careers or are at school.  However, virtual monitoring using an AI-powered technology allows dentists to supervise patients’ progress and track their treatment remotely. 

Dr Alex Seijas, Founder at the London Orthodontic Clinic says patients simply upload photographs into their Invisalign Virtual Care app weekly for the clinical team to make an AI-assisted assessment which can flag up any potential issues.  “If everything is progressing well, there’s no need to come into the clinic. If something needs attention – perhaps an aligner isn’t fitting correctly or a tooth isn’t moving as expected, an appointment is scheduled,” he says. 

Experience, expertise and the personal touch still reign 

Despite the numerous advantages of using AI-driven technology, all three doctors stress that it does not – and will not – replace face-to-face care.  

Concludes Dr. Seijas: “The technology doesn’t make decisions; it supports the orthodontist’s clinical judgement. There’s a balance to strike with digital orthodontics. Technology can streamline workflows and improve precision, but it doesn’t replace the experience and judgement of a trained clinician.