Abstract
Introduction Reversal of enamel-only proximal caries by non-invasive treatments is important in preventive dentistry. However, detecting such caries using bitewing radiography is difficult and the subtle patterns are often missed by dental practitioners.Aims To investigate whether the ability of dentists to detect enamel-only proximal caries is enhanced by the use of AssistDent artificial intelligence (AI) software.Materials and methods In the ADEPT (AssistDent Enamel-only Proximal caries assessmenT) study, 23 dentists were randomly divided into a control arm, without AI assistance, and an experimental arm, in which AI assistance provided on-screen prompts indicating potential enamel-only proximal caries. All participants analysed a set of 24 bitewings in which an expert panel had previously identified 65 enamel-only carious lesions and 241 healthy proximal surfaces.Results The control group found 44.3% of the caries, whereas the experimental group found 75.8%. The experimental group incorrectly identified caries in 14.6% of the healthy surfaces compared to 3.7% in the control group. The increase in sensitivity of 71% and decrease in specificity of 11% are statistically significant (p <0.01).Conclusions AssistDent AI software significantly improves dentists' ability to detect enamel-only proximal caries and could be considered as a tool to support preventive dentistry in general practice.
Highlights
Reversal of enamel-only proximal caries by non-invasive treatments is important in preventive dentistry
Patients differ widely on their willingness to pay for preventive therapies,[1] but most parents value a healthy dentition for their children and are willing to invest resources to maintain this.[2]
It is well documented that preventive care in children and adults in the UK is offered less frequently than it should be and if prevention is to be adopted more widely in adults, caries detection must be time-efficient and accurate
Summary
Reversal of enamel-only proximal caries by non-invasive treatments is important in preventive dentistry. Detecting such caries using bitewing radiography is difficult and the subtle patterns are often missed by dental practitioners. The early detection and treatment of enamelonly proximal caries can preserve tooth structure and prevent the subsequent cycle of treatment and re-treatment that is involved with. Recent guidelines from the NHS encourage preventive care in dental practices, especially for young children. Can the ideal, personalised caries assessment of adult patients and their preventive care be developed
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