Dentistry is now a field where skill and experience work hand in glove with the latest technology. Like every other aspect of modern life, it is benefiting from cutting-edge advances in the form of digitalisation, 3D printing and artificial intelligence. The impact is already being seen in many dental surgeries, with dentists now able to offer unprecedented accuracy and speed, meaning hours spent in the dentist’s chair and multiple repeat visits are no longer required.
A recent report in the British Dental Journal spoke of dentistry’s “tilt towards technology”, noting that AI in particular is permitting innovative approaches to treatment that could “never have been previously considered”.
Digital dentistry has greatly been on the rise over the last few years and dentists have been investing heavily to ensure a better experience for both themselves and their patients, says Dr Rozelle Owens of D4Dentist, who notes most clinics have “at least” a digital scanner now.
“I love the workflow of digital scanners,” she says. “I really hated analogue, which involved taking a messy impression, sending it to the lab, pouring it into a cast and then using that to create whatever custom piece required; for me there are far too many factors I couldn’t account for, and so many possible error points in the process. Not to mention that having an impression of your mouth is far from pleasant, while an intraoral digital scan is very simple and comfortable.”
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“Dentistry is going digital in a big way,” agrees Dr Ed O’Flaherty of Seapoint Dental. “Our 3D scanners mean people can see their entire mouth instantly and their full smile. Previously it would have been a case of the dentist with the tiny mirror, trying to pull your lips back to show you something wrong, but now we can show you with 100 times magnification.” This allows for joint decision-making between dentist and patient, he adds.
“Now patients can see it themselves and be part of the whole process, which I think is very important.”
“We now scan all of our patients as part of their exam and record taking, as we find that being able to show our patients their teeth is of great benefit, because what was once a bit abstract is now clear and easy to explain,” adds Owens.
New technologies are also enabling the rise of minimally invasive dentistry, adds O’Flaherty. “When it comes to smile makeovers people don’t want to have a big biological cost to looking good, they want their teeth to last forever,” he says. “Now we can 3D print thin layers of enamel so that we can layer them over a tooth, this is so natural looking that it can change the look of the teeth or the colour of the teeth without doing any damage to the tooth underneath.”
Far from being futuristic, AI is already firmly embedded in dental practice
Owens says the speed and capability of digital dentistry is a “game changer”. Her practice has invested in becoming fully digital, using digital scanners, sophisticated milling units and 3D printers. This means same-day ceramic restorations through the use of computer-aided design and computer-aided manufacturing are possible, so patients do not have to return for multiple visits for routine ceramic restorations such as inlays/onlays or crowns. “Ultimately it means we can provide a faster, more efficient service to our patients. Having any appointments that require lab work such as crowns would have taken weeks with a temporary crown for the patient, which was a compromise, but now can be delivered in a few hours.” For example, patients with temporomandibular disorders, a very uncomfortable and painful condition causing jaw pain, can now have a splint (or mouth guard) printed on the same day to relieve these symptoms.
Digital smile design is now the norm, says Dr Ambrish Roshan of Docklands Dental. “This utilises a combination of a dental scan, a 3D face scan, photographs and software which helps us virtually plan a new smile for our patients,” he says. “Once planned, we 3D print the final design model and transfer the prototype into our patient’s mouth to ‘test-drive’ their new smile in the clinic where they are able to see and feel how this new smile fits in their face.” In more complex cases where dental rehabilitations are required, he notes that a fourth dimension – the jaw movement – can be incorporated by digitally recording the movement pathway created by the patient’s jaw joint.
Rohan says they have multiple 3D printers in Docklands Dental, which have quickly become indispensable. “These help in the manufacturing of a vast range of dental appliances, such as retainers, night guards and whitening trays, surgical guides and even temporary teeth. Some new materials have been developed and will be launched this year to even 3D print ceramic restorations.”
Roshan also uses cone beam CT scanning, which allows for safe planning of dental implant procedures to ensure that vital structures are kept within a safe distance from the planned implant. “This can then be used to fabricate surgical guides for our patients,” he notes.
Far from being futuristic, AI is already firmly embedded in dental practice. “Any tooth realignment done with Invisalign is already powered by AI,” notes O’Flaherty. “We also use an AI-powered software called ‘second opinion’, which checks over the X-rays and gives second opinions in terms of decay and root canal need.” This can reinforce what the dentist is saying so that the patient knows the right advice is being given on treatment.
AI in dentistry is rapidly growing with software options targeting different areas, Owens says. “We are signed up to try Kiroku, which has specific software that assists with note-taking, meaning we can record a consultation and it will summarise and format the consultation, which is very handy.” Software options that offer assistance with reading X-rays such as pearlAI are receiving excellent feedback from the dental world, she adds.
“Digital radiographs, or X-rays, in our practice are analysed using an AI software to aid in the disclosing of dental decay, periodontal bone loss [gum disease],” Roshan says. “While all dentists are trained to read, detect and diagnose dental diseases on an X-ray, these softwares provide a second layer of checks to reduce the human error. The software also highlights the areas of disease for our patients to visually see it for themselves.”
O’Flaherty believes AI will become even more embedded in dentistry as time goes on. For example, in the near future AI will be used to design superior crowns. “A technician will ultimately refine it but the bulk of work will be done by AI,” he says.
As the British Dental Journal paper stated: “Technology is there to assist us. It’s a powerful tool but as technology becomes more innovative, we need to become wiser.”
According to Roshan, there is no fear of dentists being replaced by technology. “Each individual piece of technology allows for a collective improvement in standard of care and level of dentistry delivered to patients,” he says. “From the very beginning of examination and diagnosis, to treatment planning and visualisation of simulated outcomes right up to the execution of precision dentistry, these tools provide dentists with the ability to practice to the highest standards.”
