Artificial intelligence (AI) has the power to increase equity of access to oral care; however, it could also reinforce inequalities and discrimination, according to researchers who reviewed the relationship between AI and oral health. (Image: Prostock-studio/Shutterstock)
LYON, France: Given that dentistry is already struggling to increase equity of care and reduce its adverse impact on the environment, the ethical duality of artificial intelligence (AI) regarding sustainability poses pertinent questions for the industry. A 2022 review of the relationship between AI and oral health generated interest when it called on the oral health community to actively employ the technology to foster more equitable and sustainable oral care. Dental Tribune International (DTI) spoke with one of the study authors, Dr Maxime Ducret, about putting the findings into practice.
AI holds promise for advancing oral health services, yet its alignment with United Nations (UN) and World Health Organization (WHO) sustainability standards is not clearly established. The review emphasised that oral healthcare is embedded in the UN 2030 Sustainable Development Goals (SDGs)—specifically, in SDG 3, which emphasises the promotion and support of well-being at all ages—and that WHO advocates for eco-friendly, minimally invasive dental care, highlighting the role of oral health in planetary health. While not legally binding, the SDGs and the WHO’s strategy for oral health aim to foster collaborative and measurable action among all stakeholders.
The researchers found that AI supported certain efforts aimed at achieving SDGs in oral health, for example, by reducing transportation, optimising the delivery of oral care and increasing equity of access to dental services. However, they noted that AI could also be detrimental to achieving some of the SDGs, as its deployment, implementation and maintenance requires resources that may aggravate inequalities. “Also, AI may be biased, reinforcing inequalities and discrimination and may violate principles of security, privacy and confidentiality of personal information,” the authors wrote.
They concluded that it was necessary for the oral health community to systematically apply evidence-based assessments to the positive and adverse effects of AI tools on sustainable oral health, and to actively use AI to foster greater equity and sustainability in the delivery of oral healthcare.
A call to action for sustainability in AI models for oral health
Dr Ducret, who teaches at Claude Bernard Lyon 1 University, told DTI that it was crucial to avoid the risk of selection bias when gathering data for training AI models. “A random sampling technique and adjustment of the data set to reflect evolving societal dynamics should be considered in the future,” Dr Ducret said, adding that transparency in data collection processes for the training of AI-powered medical devices was of great importance, as it permits external scrutiny.
Researcher Dr Maxime Ducret. (Image: Maxime Ducret)
Avoiding selection bias requires an expansion of data collection in developing countries; however, Dr Ducret said that it was difficult to identify one or two priority measures in this area. He commented: “The aspect that seems most important to us is creating a framework of trust and sustainability around the sharing of data in all countries and to securely keep this data as a valuable resource and recognise a debt towards those who shared it.”
The review was a call to action, and Dr Ducret said that the oral health research community is currently highly active concerning AI-related topics. He explained that several of the study authors are members of an international WHO research group that is set to play a major role in the development of sustainable AI tools for dental care. He explained that this work was ongoing and that some of its focal points included collaborative databases, innovative tools, comparative studies, improvement of the student curriculum and practitioner training.
The review noted that it remains unclear whether AI can truly advance the 2030 SDGs in the field of oral health, and Dr Ducret said that it was important to create awareness regarding these uncertainties. “Our review helped illustrate the true duality that AI represents for our society. Currently, many of us have the feeling that we are in a strategic period from a technological point of view, but few are informed about and aware of the paradoxes and issues that are associated with this. Even though our article raised all these uncertainties, we remain deeply excited for the coming years,” Dr Ducret said.
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