Human-AI collaboration improves adults’ oral biomechanical functions: A multi-centre, self-controlled clinical trial

Abstract

ObjectivesMaintenance of oral muscle functions is important for survival and communication. Utilizing Artificial Intelligence (AI) as a self-health-management material has shown promise. Here we developed a functional and AI-enabled smartphone e-Oral APP that provided real-time feedback features to let humans collaborate with AI, targeting to improve oral biomechanical and speech functions of adults. MethodsA total of 113 neurologically healthy Hong Kong citizens over 50 years old were recruited in this study from June to October 2022. A set of 12 exercises of the tongue, lips, and jaw were conducted with guidance provided in the self-developed e-Oral APP, in which visual-audio demonstrations and immediate feedback on facial movements by an open-source AI-pretrained 68-point Ensemble of Regression Tree (ERT) face landmark detector was given to the users. After 8-week exercises, assessments after 1-week and 4-week post-training were conducted. Primary outcomes were measured on oral functions, including occlusal force, masticatory efficiency, tongue strength, along with dry mouth condition, and oral health-related quality of life (OHQoL), while secondary outcomes were comprised of oral diadochokinesis (DDK) and swallowing ability. The usability of the APP was evaluated by a self-written questionnaire. ResultsAfter exercising a set of 12 exercises on the tongue, lips, and jaw for 8 weeks, 70 out of 113 participants (average age of 67.70±4.93 y.o., 52 female and 18 male) had a significant improvement in the occlusal force (p < 0.001), while masticatory efficiency (p = 0.002), tongue pressure (p < 0.001) and endurance (p = 0.004) were also improved. 80.3 % of respondents rated the APP with an overall rating of 3 out of 5 points, and 68.6 % would recommend the APP to others. ConclusionsAI-based APP can be an effective approach to help healthy adults improve their occlusal force, masticatory efficiency, tongue functions, and oral diadochokinesis after 8-week home oral exercises. Furthermore, these improvements can be sustained for at least four weeks. Clinical significanceThis is the first AI-assisted APP developed for oral muscle training. Our findings demonstrated that a self-administrated human-AI collaboration APP can improve clinically oral muscle biomechanics and functions for healthy adults. AI technology in smartphone gadgets provides a cost-effective, convenient, and reliable means for oral muscles training for adults.