Focus on artificial intelligence ethics in dentistry

Artificial intelligence (AI) is currently used in a growing number of tools and softwares in dentistry such as image or radiographic analysis or to contribute to a more predictive oral healthcare.¹ However, it also raises critical ethical issues and societal challenges. Two recent articles of your journal specifically discussed how they relate to dentistry.^2,3 The authors identified and reported three negatives impacts of AI in clinical dentistry, namely the risks linked to the accuracy and security of data, a possible reduction of communication and humanistic care, and finally the risk of negatively impacting patient's autonomy and medical ethics. Although, we can agree with some of their observations, we think that the fields of AI Ethics and Sustainability have been overlooked. Beyond these three risks, we believe that bringing a technology like AI in dentistry also means that we must also consider the complex challenges that come with it. The governance and moral framing of AI is a critical contemporary challenge. In a recent systematic review, we reported that most of the dental research has not yet integrated AI Ethics considerations, while the situation could reinforce biases and inequalities, weakening the confidence of both patients and practitioners in the future applications of AI.¹

These questions raised by the development of AI explain why more than 80 guidelines were proposed by a wide range of organizations (public, private, civic) in recent years to better frame a responsible use of AI.^1,4 Most of these documents tend to converge around known ethical issues: non-maleficience, beneficence, justice, autonomy, but also one principle quite unique to AI: explainability.⁴ Some of these declarations and statements, like the Montreal Declaration or the European Union Ethics Guidelines for trustworthy AI could be integrated in publications of dentistry that make use of AI systems.

To push the comment further, talking about AI Ethics is increasingly correlated to the pressing topic of Sustainability. The latter has still received little attention in dentistry. Observers now start studying how the development and use of AI systems must ensure a strong environmental sustainability of the planet.¹ Your journal was one of the first to underly this challenging question with a letter to the editor in 2022 suggesting to “ further thinking tools for embedding AI into current dental curriculum for achieving environmental sustainability and good health in 2030”.³ We agree with this statement but would like to point out that a reflection is not sufficient, and we now need more work, tools, and training on the 17 United Nations’ Sustainable Development and its 17 Goals (SDGs). Indeed, we recently analyzed this question, and we realized that AI and SDG are a double-edged relationship, with sometimes challenges and risks that were not where we might expect initially.⁵

This correspondence wants to highlight two pressing needs, 1) to more proactively report potential ethical and societal issues that researchers could identify in our work with AI in dentistry, and 2) to share how to prevent these issues, because they are of major interest to our community.

Declarations of competing interest

The authors have no conflicts of interest relevant to this article.