Welcome to the Machine

Paul Feuerstein, DMD


…several dental units…are physically guided by systems similar to a GPS. Many of these are used in teaching institutions but…could evolve into smaller chairside units.

In Stanley Kubrick’s film 2001: A Space Odyssey, the HAL 9000 said, “Let me put it this way, Mr. Amor. The 9000 series is the most reliable computer ever made. No 9000 computer has ever made a mistake or distorted information. We are all, by any practical definition of the words, foolproof and incapable of error.” This quote still stands as a mantra for every dental office that has ever experienced a computer malfunction. We have come to depend on these piles of wires to run our everyday practices. We are also now inundated with Alexa, Google Home, Siri, Bixby, and more, and using artificial intelligence (AI) makes us a bit lazier (“What is an encyclopedia?”) and dependent. Now, not only can we get random information, but these algorithms also seem to track and learn about us.

I must digress here for just a second and dispel a common myth about HAL. According to a few Internet sources, Kubrick’s 2001: A Space Odyssey was developed concurrently with the novel of the same name by Kubrick’s co-screenwriter, author Arthur C. Clarke, who states: “As is clearly stated in the novel (Chapter 16), HAL stands for Heuristically programmed ALgorithmic computer. However, about once a week some character spots the fact that HAL is one letter ahead of IBM, and promptly assumes that Stanley and I were taking a crack at the estimable institution….As it happened, IBM had given us a good deal of help, so we were quite embarrassed by this, and would have changed the name had we spotted the coincidence.”

So how does this relate to our practices? There are a few enterprising companies that are taking a hard look at how we practice dentistry. The first simple example comes from my friends at Simplifeye: Ryan Hungate DDS, MS, and his brother Zach. This is a company I have reviewed here before in regard to its clever integration of the Apple Watch with the Dentrix scheduler. They are working on a number of new ideas, one of which uses Amazon Echo’s Alexa. Their new product, DEXvoice, allows the practitioner to ask Alexa to bring up the last set of bite-wings; issue commands, such as “Let me see all of the images related to tooth No. 14;” and more. Find more information on DEXvoice at amazon.com and other products at simplifeye.co (not “.com”).

Speaking of radiographs, AI is making waves in our interpretation of the images. For years, Carestream Dental has had a product called Logicon Caries Detector Software. Using an algorithm that was actually developed for a project at NASA, the software actually “reads” bite-wings and predicts interproximal decay. The company claims that it shows 20% more areas of concern than seen by the naked eye. As we know, interpretation is sometimes a decision based on the doctor’s experience and also on the patient’s history. Still, it is like getting a second opinion. Logicon is only available with Carestream/RVG sensors.

Right now, Angam Parashar and Ankit Singh, co-founders of Dentistry.AI, a sophisticated artificial intelligence start-up company, are trying to take this to a higher level. They are working with a number of practitioners and clinical radiographs and studying the process of evaluation radiographs. Above and beyond looking for interproximal caries, this software is looking at recurrent caries under restorations, root caries, and more, giving the doctor areas of suspicion that might have been overlooked. It is still in its early testing, but you can get a glimpse of this project at dentistry.ai.

One company that’s using AI to identify trends and increase revenue is Patient Prism. Amol Nirgudkar and his team patented a program that analyzes your phone conversations with new patients and reports the services the caller wanted, his or her insurance information, and whether the call ended in a booked appointment. Within an hour of every new patient call that doesn’t convert, Patient Prism provides coaching tips so that your team can call the potential patient back, address his or her concerns, and win him or her back. Wow. You can get more information at patientprism.com.

Of course, we are all aware of robotic surgery, most of which is guided by a human, but now some decisions are being made by the software. There are several dental units that are physically guided by systems similar to a GPS. Many of these are used in teaching institutions but, other than the current size and cost, could evolve into smaller chairside units. For an interesting look at this technology, check out the DentSim System at dentsimlab.com. Not only does this system guide the students’ preparations, it critiques them.

There is another new robotic system out called YOMI, which was just brought to my attention by Dr. Ed Zuckerberg (who is a wealth of information). Although not exactly AI, its use of haptic robotic technology and multisensory feedback helps to achieve the right location, angulation and depth to place an implant exactly according to plan. Details are available at neocis.com.

There are other programs and devices in the marketplace, but don’t worry yet about losing your job to Wall-E.

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