Artificial intelligence in dentistry: chances and challenges
The term “artificial intelligence” (AI) was coined in the 1950s and refers to the idea of building machines that are capable of performing tasks that are normally performed by humans. Machine learning (ML) is a subfield of AI, in which algorithms are applied to learn the intrinsic statistical patterns and structures in data, which allows for predictions of unseen data (Fig 1). A popular type of ML model are neural networks (NNs), which outperform more classical ML algorithms in particular on complex data structures such as imagery or language.
Fissure seal or fluoride varnish? A randomized trial of relative effectiveness
Children vary in their susceptibility to dental caries, with disease prevalence being closely linked to social and economic disadvantage (Locker 2000; Watt et al. 2016). Furthermore, teeth differ in their susceptibility to dental caries. The occlusal surface of first permanent molars (FPMs) is particularly prone to dental caries, often within a short period after eruption into the mouth. Decay on this surface accounts for the majority of affected tooth surfaces in adolescents and adults (Chestnutt et al. 1996; Carvalho et al. 2001; Marthaler 2004; Hopcraft and Morgan 2006). Management of occlusal caries has proven to be a great challenge to the dental profession (Carvalho 2014), and preventing dental caries on the occlusal surfaces of FPMs in high-risk children is a key objective in preventive dental care.
The global need for easy and valid assessment tools for orofacial pain
Urgent need for global oral health improvement
In May 2021, the 74th World Health Assembly of the World Health Organization (WHO; 2021) adopted a historic resolution, WHA74.5, on the urgent need for global improvement of oral health. This resolution reinforces the recognition by the WHO (2022a) that “oral health is a key indicator of overall health, well-being and quality of life.” The seriousness of the new resolution resides in the high prevalence of untreated oral conditions, most notably dental caries (tooth decay), severe periodontal (gum) disease, and extensive tooth loss, affecting around 3.5 billion individuals worldwide (Peres et al. 2019). Poor oral health is not only associated with reduced quality of life, disruption to family life, lost school days, and decreased work productivity (Peres et al. 2019) but has also been suggested to be associated with general health conditions such as cardiovascular disease, diabetes, cancer, pneumonia, premature birth, obesity, obstructive sleep apnea, and dementia (Suzuki et al. 2016; Seitz et al. 2019; Nadim et al. 2020). The ensuing economic burden for our society is enormous: the direct and indirect costs associated with oral health problems have been estimated at US $545 billion per annum worldwide, which is comparable to the economic burden of the two most expensive illnesses: cardiovascular diseases and diabetes (Righolt et al. 2018)
Frequent and persistent salivary gland ectasia and oral disease after covid-19
Viral diseases often affect the oral cavity. For example, human immunodeficiency virus (HIV) infection may initially present with oral lesions, human papillomavirus (HPV) infection may increase the risk of developing oral squamous cell carcinoma, and oral involvement in hepatitis B virus (HBV) and hepatitis C virus (HCV) infections has been documented (Jiang and Dong 2017; Parisi et al. 2017; Ottria et al. 2018; Nayyar et al. 2020). Less characterized is the impact of acute, rather than chronic, viral infections on the oral cavity. We have scarce evidence of oral manifestations associated with severe acute respiratory syndrome (SARS) or Middle East respiratory syndrome (MERS) (De Wit et al. 2016; Otter et al. 2016). Knowledge on oral involvement in coronavirus disease 2019 (COVID-19) is also limited. This is surprising since salivary glands and epithelial cells of the oral mucosa are known to express angiotensin converting enzyme 2 (ACE2), the best characterized entry receptor for SARS-CoV-2 into cells (Pascolo et al. 2020). Moreover, the virus itself has been detected in the saliva of most COVID-19 patients (Xu et al. 2020).
Micro-abrasion and in-office bleaching in the management of a patient with mild fluorosis
Excessive fluoride intake is capable of producing substantial enamel defects identified as dental fluorosis. The affected enamel appears as white, chalky areas. Most of the problems associated with dental fluorosis are aesthetic, particularly when the anterior teeth are affected. Fluorosis is a dental condition that affects between 2.1 and 74.7 percent of the population. Researchers were able to demonstrate a substantial relationship between fluoride concentration in drinking water and the occurrence and severity of fluorosis as early as the 1940s. The amount of hypomineralization and the affected clinical appearance can range from mild to severe. This range is reliant on the quantity of fluoride that was present in the individual's serum during the amelogenesis process. High concentrations of fluoride have been highlighted as the contributing factor in the death of ameloblast, resulting in defective enamel structure. The resultant atrophic odontoblast and a brown discoloured dentinal appearance ensues.
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