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Achieving a consensus regarding the future of artificial intelligence (AI) in dentistry is proving to be difficult if not impossible. When it comes to the specific applications of AI in dental training programmes, there are a few prominent voices in research and education who are urging the dental academic community to integrate AI into their teaching—with caution. Dental Tribune International spoke with Prof. Falk Schwendicke and Dr Sergio E. Uribe, associate professor, regarding their recent research into the role AI and large language models (LLMs) may play in supporting the next generation of dental practitioners.
Prof. Schwendicke, what specific gaps or challenges in current dental education motivated you to explore the integration of artificial intelligence AI chatbots and large language models?
Prof. Schwendicke: Even with existing guidelines for using information technology (IT) in dental education, dental institutions were largely unprepared when the COVID-19 pandemic struck. Although some of us had previously been involved in developing recommendations for integrating IT into dental education, most of these suggestions had not been widely adopted. However, less than a month after the pandemic hit, almost all dental institutions were forced to rely heavily on IT for education.
A similar situation is happening now with generative AI, which came to the fore in November 2022. Once again, dental institutions find themselves unprepared. This motivated us to explore the expectations and opinions of dental educators regarding generative AI. While we anticipate limited impact from generative AI on the practical side of dental education, which involves developing the manual skills needed to practise dentistry, we expect it to influence the theoretical side of dental education significantly. Our research aimed to assess the opinions of dental educators worldwide on the potential role of generative AI in reshaping dental education.
Dr Uribe, the study you and Prof. Schwendicke conducted highlights both the potential benefits (e.g. enhancing knowledge acquisition, research and decision-making) and concerns (e.g. lack of human interaction and misuse) regarding AI in dental education. What were the most surprising survey findings in terms of benefits and challenges?
Dr Uribe: Most of the dental educators felt that there was a lack of clear guidance and training on using generative AI in their institutions. For example, it remains unclear what is and is not allowed. Is it permissible for a dental student to upload a patient’s clinical record to ChatGPT and ask for a possible diagnosis and treatment plan? When is it appropriate for a student to use ChatGPT and when not? Can a lecturer use ChatGPT to create a presentation? What steps should a lecturer take if he or she suspects ChatGPT has been used to create a paper or seminar? Institutions need to address these types of questions by providing clear guidance to the dental academic community.
Several findings surprised us. Firstly, nearly one-third of dental educators do not have a clear sense of the impact generative AI will have on dental education. While the majority believe that generative AI could be useful for grading and providing feedback, most also acknowledge that its use will likely lead to less student–faculty interaction. What struck us most, however, is that only 26% of dental educators believe that using generative AI will improve students’ critical thinking skills. This is interesting because we consider the ability to distinguish between fact and opinion to be one of the most important skills for today’s healthcare professionals. This suggests a significant opportunity to use the rise of generative AI to rethink what theoretical knowledge we teach in dentistry, as well as why and how.
Your results show differing perceptions of AI’s potential impact on dental education across regions, such as a more positive view in Africa, Asia and the Americas compared with Europe. What do you believe accounts for these regional differences, and do you think that they might influence future implementation strategies?
Dr Uribe: This is definitely an area that needs more research because, at this point, we don’t have a clear understanding of the reasons for these regional differences.
Why do dental educators in Turkey and Estonia strongly believe that generative AI will improve dental education, whereas those in Italy and Norway do not? Even within culturally similar regions such as the Nordic countries, there are differences, such as between Norway and Finland.
We tested several possible explanations, such as whether the age of the respondents influenced their answers, but this was not the case. After adjusting for age, the results hold. So, other explanations warrant further research. For example, in some countries, people have adopted other technologies and, having seen no change, have become sceptics. Or is the lack of belief related to more traditional institutions constraining a lot of bureaucracy to adapt the curriculum? We do not know, and we hope that more researchers will look into this area and the questions we have uncovered.
Given the cautious, yet optimistic view of integrating AI tools in dental curricula, what practical steps or recommendations would you suggest for dental educators who are considering incorporating these technologies into their teaching methods?
Dr Uribe: We recommend that dental educators integrate AI tools like ChatGPT into their teaching as much as possible and encourage students to do the same. The sooner they begin using these tools, the sooner they will understand their potential and limitations.
One significant potential is the ability to summarise and adapt content for different learning contexts. For instance, a dental educator could ask ChatGPT to generate simplified explanations of complex topics, ensuring that every technical term is clarified and accompanied by practical examples. Similarly, students could use AI to generate questions from their lecture notes to help them assess their understanding. The key is for educators and students to explore these tools early and often to realise their full potential while being aware of their limitations.
For example, for a dentistry lecturer, the following would be a useful prompt that explains the context and the role ChatGPT must play and the expected outcome:
For a dental student, a useful prompt might look something like this:
Regarding limitations, students must realise how often these large language models tend to “hallucinate”, producing plausible content that is incorrect or made up. For example, this is the output of ChatGPT when asked to write an essay about the latest research on amelogenesis and begin to link amelogenesis to political activities:
As you can see, although the text sounds coherent, it erroneously attempts to make a connection between two completely unrelated topics: the biological process of enamel formation and political activities. For health educators, this highlights the importance of equipping students with the skills to evaluate health-related content critically. With the increasing likelihood that ChatGPT-generated content will appear in news articles, blogs, social media and even scientific journals, the ability to assess the accuracy and reliability of information will become an essential part of dental education.
Based on your findings, what are the key areas for future research to better understand the role of AI chatbots in dental education?
Dr Uribe: Future studies should focus on explaining why differences exist between countries in their adoption and perception of AI in dental education. Additionally, future research should explore the best strategies for implementing generative AI in a way that aligns with the goals and curriculum of dental institutions. It will also be crucial to track the outcomes of this implementation: has the use of generative AI improved student performance and understanding of dental concepts? Which areas of dental education benefit the most from generative AI? These are essential questions that need to be addressed to optimise the use of AI in dental education.
Do you have anything further that you would like to share with our readers regarding the present paper or any related research that you are working on?
Prof. Schwendicke: Yes. We’ve already published some papers that help contextualise this research. For example, we have outlined the essential elements of AI in the dental curriculum in a recent publication,1 contributed to a white paper for FDI World Dental Federation on what dentists should consider when using AI in clinical practice2 and created a readers’ guide for navigating the AI-related dental literature.3 In addition, we are currently editing a book on AI for dentistry, which we believe will help dental educators and practitioners integrate AI into dental education and practice. We are currently researching the integration of AI into dental education and the broader efficacy of AI for dental care. This is a fascinating area of research, and we look forward to continuing to explore how AI can transform the dental profession and improve patient care.
Editorial note:
The study, titled “Artificial intelligence chatbots and large language models in dental education: Worldwide survey of educators”, was published online on 8 April 2024 in European Journal of Dental Education, ahead of inclusion in an issue. A list of references can be found here.
About the interviewees
Dr Sergio E. Uribe is an associate professor in the department of Conservative Dentistry and Oral Health at Rīga Stradiņš University in Latvia and lead researcher at the Baltic Biomaterials Centre of Excellence, RTU, Riga, Latvia. He is additionally a visiting professor in the Department of Conservative Dentistry and Periodontology at LMU Munich in Germany.
Prof. Falk Schwendicke is the director and chair of the Department of Conservative Dentistry and Periodontology at LMU Munich in Germany.
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