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Health inequalities are avoidable and can be reduced by improving access to healthcare. In the hope of making dental care and oral health education accessible to those who need it the most, Dr Kyle Turner created a free artificial intelligence (AI)-based application for dental check-ups. In this interview, he talks about what prompted him to launch Pearlii and shares his experience of growing up in a vast remote area in Australia where access to oral healthcare was, and still is, restricted.
Dr Turner, what is Pearlii, and what inspired you to create the application?
I created Pearlii because, when I was growing up, I didn’t have any access to dental check-ups or oral health education. And now, as an adult, I’m paying thousands in treatment costs. My family was poor, and we lived in the Outback. I remember first learning to brush my teeth twice daily during a sleepover when I was a teenager. While getting ready for bed, I made fun of my friend for brushing his teeth at night. No one had ever told me before that I was supposed to be brushing my teeth twice daily, let alone after every meal.
Inequalities in health are never more pronounced than in a person’s oral health, be it between rural and urban people, indigenous and non-indigenous people, and certainly between rich and poor. Your smile is an immediate indicator of your socio-economic status, your employability and your self-esteem, and a major predictor of your overall health. Thankfully, my dad’s friend was kind enough to give me the 101 on oral hygiene, and I’ve been scrupulous about my oral hygiene ever since. However, many children are not as fortunate and haven’t encountered such an important intervention point. I built Pearlii to improve access to dental care and oral health education for those who have previously lacked this access.
“Inequalities in health are never more pronounced than in a person’s oral health”
How does Pearlii work, and how accurately does it detect oral health problems in patients?
Pearlii users upload five photos of their teeth and gingivae using a smartphone. We’ve developed a technology to control the camera’s lighting and focus. The images must be clear, so we instruct users to ask someone else to take their photos if they’re unable to do so themselves.
We’ve worked the longest on developing our machine learning algorithm to detect potential dental caries. It’s important to highlight that I built Pearlii to give something to people who have limited access to the dentist for reasons such as high treatment cost, limited time or poor access to dental care. It is intended to be a free self-help tool to improve your oral health. One of the key ways that Pearlii makes money is through our users booking dentist appointments. We’ve onboarded more than 3,000 dentists around Australia, and we incentivise our users to see the dentist. We desperately want our users to get the treatment they need earlier than they would normally have done.
Finally, I’m an epidemiologist by trade. I’ve been dying to run larger trials! Sadly, owing to strict COVID-19 restrictions in Melbourne in Australia, we haven’t been able to run formal research studies, but these are in the pipeline at the Royal Dental Hospital of Melbourne. Before then, we’ve been running small internal trials with our partner dentists. We plan to scale up these trials later this year, going through the standard research processes.
AI continues to influence healthcare. What potential does it have to advance dentistry?
Thanks to advancements in computer vision software and camera technology in smartphones, we have reached the point where we can teach a computer to scan photos of teeth in order to check for dental problems such as dental caries and periodontal disease and to provide oral health education tailored to the results in just seconds. It might sound like something from the future, but it is here today.
We’re now entering an era of DIY healthcare, and telehealth, big data analytics and cloud-based care are rapidly on the rise. Patients are increasingly taking matters into their own hands, choosing to jump online, download an application or join a local network to find the health information and support they need. AI is only accelerating this transition towards more personalised, more accessible healthcare.
AI may seem too technical, but it is mostly a combination of computer vision, where we teach a computer to identify imagery; machine learning, where we write an algorithm to enable a computer to find patterns in data; and predictive analytics, where we use statistical modelling to better predict an outcome, such as weather forecasts. As you can imagine, the list of potential applications is almost endless.
In dentistry, computer vision is being used to scan dental radiographs and to identify dozens of pathologies, such as dental caries and bone loss, in just seconds and with remarkable accuracy. Predictive analytics are being used to scan dental patient records to find hidden patterns and instantly chart treatment plans. The dental market is being transformed by AI before our very eyes. We will continue to see improved diagnostics, enhanced communication, reduced healing times, better triage of patients, reduced infection and readmission rates, as well as significant cost-savings for patients and dentists.
“The dental market is being transformed by AI before our very eyes”
Do you think that dental technology that uses AI could one day replace a dentist?
No, I don’t think so. There will always be a need for in-person dental care, especially when it comes to taking radiographs and performing dental surgery, for example.
What is your personal experience of dental care access in Australia, and how can Pearlii help remove some of the barriers to accessing dental services in the country?
I strongly believe that the costs of dental care should be covered by the Australian Government. We’re a wealthy country. Sadly, the average waiting time in Australia for a general dentist appointment in the public system is two years—three years if you live outside of the city. This is appalling. A staggering 90% of dentists in Australia work in private practice, and most are charging through the roof. On average, a dental check-up costs around $231. I’ve heard all types of excuses from dentists for why they charge so much, but it is inexcusable. These people are running a business; they want to maximise their earnings. And what is the result? More than half of Australians, or 65%, have not been to the dentist in the last two years. The industry reeks of privilege, and it is overdue for a shake-up.
What is the next step for Pearlii?
We’re extremely lucky to have some well-known impact investors backing Pearlii. We’ve raised $1.25 million in seed capital to date. We have a great ambition to improve oral health globally. Australia has been an ideal pilot site to develop our technology and brand, but we’ll be ready to expand by the end of 2021.
Editorial note: More information about Pearlii can be found here.