The role of AI in enhancing periodontal disease classification and diagnosis

Artificial intelligence (AI) is transforming health care, with applications spanning from early disease detection to personalized treatment plans. One area where AI is making significant strides is in the classification and diagnosis of periodontal disease. Since early and accurate diagnosis is crucial for effective management and prevention of complications, AI has the potential to vastly improve this field, ultimately enhancing patient care.

The importance of accurate diagnosis

Successful treatment largely depends on the accurate classification and diagnosis of periodontal disease. Traditional methods involve clinical examinations, X-rays, probing pocket depths, clinical attachment levels, and bleeding. While effective, these techniques can sometimes be subjective and prone to human error-or even worse-are not done at all.¹ Additionally, they can be time-consuming and require significant expertise to interpret results accurately, especially when dealing with complex or early-stage disease.

By incorporating AI, dental providers can streamline the diagnostic process, ensuring more accurate, consistent, and timely identification of periodontal disease. AI systems, trained on vast amounts of data, can recognize patterns that may not be immediately obvious to the human eye, improving diagnostic outcomes.

AI techniques in periodontal disease diagnosis

1. Image recognition and analysis: One of the most significant ways AI is improving periodontal disease diagnosis is through advanced image recognition. Using machine learning algorithms, AI can analyze radiographs and intraoral photos to detect signs of periodontal disease, such as bone loss, recession, and plaque/biofilm buildup.² AI-powered tools can assess these images much faster and more accurately than traditional manual methods, allowing clinicians to spot early signs of disease that might otherwise go unnoticed.

2. Predictive modeling: AI can also be used to predict the progression of periodontal disease by analyzing a patient's historical data, including risk factors like age, smoking habits, and oral hygiene. Predictive models can help identify patients at high risk of developing severe periodontal disease and allow for more proactive, personalized treatment plans.³ These models can also assist in monitoring disease progression over time, giving dental professionals a clearer picture of how the condition is evolving and whether treatment adjustments are necessary.

3. Natural language processing (NLP): AI-powered NLP tools can process large amounts of unstructured clinical data from patient records, dental notes, and research articles. These tools can extract key insights and patterns to enhance the understanding of periodontal disease, leading to more accurate diagnoses and better-informed clinical decisions.

4. Decision support systems: AI-based decision support systems can assist dental professionals in making more informed decisions about patient care. By integrating patient data with clinical guidelines, AI can recommend treatment options, prioritize interventions, and even suggest follow-up timelines.⁴ This ensures that every patient receives the most appropriate and effective care based on their individual needs.

Benefits of AI in periodontal disease diagnosis

1. Enhanced accuracy: AI systems can process and analyze data with a high degree of precision.

2. Efficiency and timesaving: AI tools can significantly speed up the diagnostic process, by handling repetitive tasks, thus freeing up dental professionals to focus on direct patient care.

3. Consistency across practices: AI can bring a higher degree of consistency or calibration within group practice settings. This reduces the chances of misdiagnosis due to variability in human judgment or skill level. In other words, AI can help standardize the diagnostic process.

4. Personalized care: AI's ability to analyze vast amounts of patient data allows for more personalized treatment recommendations.

Regulations for AI

Several states and cities have begun implementing laws aimed at regulating the use of AI in employment. New York City, Illinois, and California have all passed laws. Other states such as Washington and Massachusetts have introduced bills addressing these concerns-and it is likely other states will follow.

The federal Department of Labor published Artificial Intelligence and Worker Well-Being: Principles and Best Practices for Developers and Employers in October 2024. While not legally binding on employers, this document is intended to be a roadmap for employers "to harness AI technologies for their business while ensuring workers benefit from the new opportunities and are shielded from potential harms."¹

Overcoming challenges and ethical considerations

While the integration of AI into periodontal disease diagnosis holds immense promise, there are also challenges to overcome. The accuracy of AI systems depends heavily on the quality and diversity of the data used to train them.

Ensuring that these datasets are representative of different populations is vital to prevent bias and ensure that AI systems work effectively for all patients.

Another challenge is the need for dental professionals to trust and understand AI-based recommendations. Clinicians must be adequately trained to work with AI tools and be able to interpret their outputs correctly; AI should be viewed as a complementary tool, not a replacement for human expertise.

Ethical considerations also arise when using AI in health-care. Ensuring patient privacy and data security is of utmost importance, as AI systems rely on sensitive health data to make accurate diagnoses and recommendations.

Regulatory and legal aspects

Dental AI systems that require FDA approval are those that are used for diagnosis or treatment plans, and are therefore considered medical devices. These systems undergo rigorous testing and receive appropriate certifications to ensure their safety, efficacy, and reliability. Regulatory bodies and professional organizations should establish guidelines for approving and monitoring AI applications. Certification and accreditation processes will help validate the quality and safety of AI systems, ensuring that they meet established standards and are suitable for use in clinical settings. This is essential to protect patient safety and to give dental practitioners confidence in the technology they employ.³

Conclusion

As technology continues to evolve, AI is poised to play an increasingly critical role in enhancing oral care, providing clinicians with valuable tools to combat periodontal disease and enhance overall patient well-being. By utilizing AI's ability to analyze radiographic and intraoral images, predict disease progression, and support clinical decision-making, dental professionals can improve outcomes and better serve their patients.

References

1. Boartfield R, Twigg A. The benefits, risks, and effective use of AI in dentistry. Dent Econ. January 10, 2025

2. Lee SJ, Chung D, Asano A, Sasaki D, Maeno M, Ishida Y, et al. Diagnosis of tooth prognosis using artificial intelligence. Diagnostics (Basel). 2022 Jun;12(6):1422. doi:10.3390/diagnostics12061422

3. Mahesh Batra A, Reche A. A new era of dental care: harnessing artificial intelligence for better diagnosis and treatment. Cureus. 2023 Nov;15(11):e49319. doi: 10.7759/cureus.49319

4. Patil S, Joda T, Soffe B, Awan KH, Fageeh HN, Tovani-Palone MR, et al. Efficacy of artificial intelligence in the detection of periodontal bone loss and classification of periodontal diseases: A systematic review. J Am Dent Assoc. 2023 Sep;154(9):795-804.e1. doi:10.1016/j.adaj.2023.05.010