Perspectives of Saudi Dental Student on the Impact of Artificial Intelligence in Dentistry: A Cross-Sectional Study

Fatemah AlAhmari^*

^*Correspondence: Fatemah AlAhmari, Department of Periodontics and Community Dentistry, College of Dentistry, King saud university, Saudi Arabia, Email:

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Introduction

The application of artificial intelligence (AI) has been exponentially increasing in various fields. AI is defined as “a field of science and engineering concerned with the computational understanding of what is commonly called intelligent behavior, and with the creation of artifacts that exhibit such behaviour” [1].

Over the past few years, the emerging domains of AI, such as deep learning systems, have enabled the use of AI technology in health information systems [2,3]. Deep learning systems include training an artificial neural network with many layers (deep neural network) on massive datasets [3]. Deep learning has been effectively used in image classification for various clinical tasks. Currently, the most successful domain of AI applications in medicine is automated medical-imaging diagnosis [4].

AI has several uses in the medical field and can be effectively used for diagnoses, treatment plans, and prognoses of several diseases [5]. In dentistry, AI has been used effectively used in dental caries detection, computer color matching system, design of dental prostheses, temporomandibular joints disorders, orthognathic treatment, root canal morphology, periodontal diseases, diagnosis of cystic lesions, and Cephalometric analysis [6– 15].

As the field of healthcare-related AI expands, this process will certainly make an impact on young dentists in addition to those who are currently studying dentistry. It is becoming evident that there is a need for teaching AI technology to dental students. Therefore, it would be necessary to execute a survey among undergraduate students in dentistry with a view to evaluate their ideas and perceptions regarding the way in which the field of dentistry might be impacted by AI. The aim of this study was to assess perspectives of dental students within Saudi Arabia on the impact of AI in dentistry.

Materials and Methods

This cross-sectional study was performed among dental students to explore perspectives of Saudi Arabian dental students on the impact of AI in dentistry. The research project was approved by Institutional Review Board for Health Sciences Colleges Research on Human Subjects, King Saud University (KSU-IRB 017E).

The survey consisted of 18 questions addressing the perspectives of Saudi Arabian dental students on the impact of AI in dentistry. Research questions were developed by Emir Yü�� zbaşıoğ�� lü et al.[16]. The first section of the questionnaire gathered data concerning social and demographic characteristics. This section included genders and grade levels of dental students (two questions). In the next section, the questions concerned several areas: (1) Sources of information of contemporary AI technologies used in everyday life, (2) Basic knowledge about the working principle of AI, and (3) Use of AI in dentistry. In the last section, 15 statements were presented to the participants who were asked about their level of agreement (disagree, strongly disagree, neutral, agree, or strongly agree).

The participants included undergraduate dental students from the dental college of King Saud University, Riyadh, Saudi Arabia. An electronic survey was distributed anonymously through email between February 1, 2021 and April 1, 2021 using a Google forms (Google LLC).

Data were analyzed using SPSS 26.0 version statistical software (IBM Inc., Chicago, USA). Descriptive statistics (frequencies and percentages) were used to describe the categorical variables. Pearson’s chi-square test was used to compare the distribution of the ordinal scale responses of attitude statements towards AI and also to compare the responses of attitude statements towards AI across the categorical study variables. A p-value of ≤ 0.05 was used to indicate the statistical siğnificance of the results.

Results

Out of 218 study subjects, 53.2% were male, the five grades of subjects were evenly distributed, and a higher proportion (60.6%) of subjects obtained information about AI from social media. Most of them (77.1%) were not aware of the basic knowledge about the working principles of AI, and 63.3% of them were not aware of the application of AI in dentistry (Table 1).

Table 1: Distribution of the gender, grade, source of information and knowledge about AI of students participated in the study (n=218).

The distribution of the 5-point scale responses of attitude statements toward AI in dentistry indicates highly statistically siğnificant differences for the 13 statements. A higher proportion of subjects (52.8% and 21.1%) responded with agree and strongly agree for the statement “I think artificial intelligence will lead to major advances in dentistry and medicine”, a result that is highly statistically siğnificant (p<0.001). Also, for the statement “I find the use of artificial intelligence in dentistry and medicine exciting”, about 64% of them responded with agree and strongly agree, results that are siğnificantly higher than other responses (p<0.001). More than 50% of the study subjects responded with agree and strongly agree for the four attitude statements, which are related to radiographic diagnoses of tooth caries, periodontal diseases, and pathologies in the jaws, three-dimensional (3D) implant positioning and planning, and two attitude statements, which are related to undergraduate and postgraduate dental training programs. The proportion of responses (agree and strongly agree) to these six statements were siğnificantly higher than the other responses (strongly disagree, disagree, and neutral; p<0.001). However, more than 60% responded as strongly disagree and disagree for the statement “Artificial intelligence can replace dentists/ physicians in the future”, which shows highly statistically siğnificant differences in the responses (p<0.001). Also, more than 50% of the subjects responded with strongly disagree and disagree for the three statements “Artificial intelligence can be used as a ‘definitive diagnostic tool’ in the diagnosis of disease”, “Artificial intelligence can be used as a ‘prognostic tool’ to predict the course of a disease and determine whether there is a chance of recovery”, and “Artificial intelligence can be used in forensic dentistry”, which is statistically siğnificantly higher than other responses (neutral, agree, and strongly agree; p<0.001). Distribution and comparison of attitude statements responses toward AI in dentistry are shown in Table 2.

Table 2: Distribution and comparison of responses to questions about students’ perspective toward AI.

The distribution and comparison of the 5-point scale responses of attitude statements toward AI in relation to gender shows no statistically siğnificant difference for the 13 statements as shown in Table 3.

Table 3: Comparison of responses to questions about students’ perspective toward AI between male and female study subjects.

The distribution and comparison of the 5-point scale responses of attitude statements toward AI in relation to the binary response to the question “ Do you know the basic knowledge about the working principle of AI?” are shown in Table 4. Statistically siğnificant differences for nine attitude statements for which higher proportion of subjects who had basic knowledge about working principle of AI had responded positively (as agree and strongly agree) when compared with the subjects who did not had have basic knowledge about working principle of AI (p<0.05). For one statement “Artificial intelligence can replace dentists/physicians in thefuture”, more than 50% of them responded with strongly disagree and disagree even though they had knowledge about working principles of AI, which is statistically siğnificant (p<0.0001). For the other two statements, the responses were not statistically siğnificantly different (p > 0.05).

Table.4: Comparison of responses to questions about students’ perspective toward AI in relation to study subject’s response for basic knowledge about the working principle of AI.

Distribution and comparison of the 5-point scale responses of attitude statements toward AI in relation to the binary response to the question “Do you know the application of AI” are shown in Table 5. Siğnificant differences for 11 attitude statements in which higher proportion of subjects who had basic knowledge about working principle of AI had responded positively (as agree and strongly agree) were found when compared with the subjects who does not know the application ofAI (p<0.01). For one statement, “Artificial intelligence can replace dentists/physicians in the future”, more than 50% of them responded as strongly disagree and disagree even though they know the application of AI which is statistically siğnificant (p=0.023).

Table 5: Comparison of responses to questions about students’ perspective toward AI in relation to study subject’s response for the application of AI.

The distribution and comparison of the 5-point scale responses of attitude statements toward AI in relation to the study subject’s year of study (preclinical and clinical) are shown in Table 6. Statistically siğnificant differences for six attitude statements for which higher proportion of subjects who were in their clinical years of study responded positively (as agree and strongly agree) when compared with the subjects who were in preclinical years of study. (p<0.01). For one statement, “Artificial intelligence can replace dentists/physicians in the future”, about 65% of them who were in their clinical study years responded as strongly disagree and disagree, and 12% of them as agree, results that are statistically siğnificantly higher than the responses of the subjects who were in preclinical years of study (p=0.007). For one statement “Artificial intelligence applications should be part of postgraduate dental training”, more than 80% of the subjects who were in preclinical years of study responded as agree and strongly agree, results that are siğnificantly higher than the responses of the subjects who were in clinical years of study (p=0.042). For four statements addressing attitudes, the responses were not siğnificantly different between the subject of preclinical and clinical years of study.

Table 6: Comparison of responses to questions about students’ perspective toward AI between study subjects and preclinical and clinical years.

Discussion

Over the last several years, AI applications in medicine have expanded exponentially, which will have an impact on the future of the practice in the medical field, and it is increasingly evident that AI education for medical and dental students is necessary. The current study explored the perspectives of dental students within Saudi Arabia on the impact of AI in dentistry.

The present study indicated 77% of dental students are not aware of the working principle of AI, 63% of the participants are not aware of the application of AI in dentistry, and 60% of them used social media as their sources of information. This findinğ is in accordance with a recent study conducted by Wood et al. (2021) with medical students regarding AI in clinical practice in the US [17]. According to their survey, most students (72%) heard about AI from social media. Similar findinğs were also reported in the study concerning attitudes of Turkish dental students with respect to AI by Emir (2020) in which participants noted that their information was provided more by social media sources than academic ones [16].

AI approaches has been effectively used in the diagnosis of various lesion in caries diagnosis, periodontal diseases, and cystic lesions [6,13,14]. In the present study, the participants indicated that they believe that AI technology could be used for radiographic diagnosis of tooth caries, radiographic diagnoses of periodontal diseases and jaw pathologies, and 3D implant positioning and planning. Similar findinğs were obtained from a Turkish study in which the participants agreed that AI applications would benefit the dentist when making diagnoses of tooth caries and periodontal diseases [16].

Considering the potential inflüence of AI technology on the future of the medical field, the need to include these topics in the curriculum exists. It is interesting to note that majority of dental students in clinical and preclinical years in the present study agreed that AI should be part of undergraduate and/or postgraduate dental training. The results demonstrate a need to incorporate AI into dental curricula. Our findinğs support other studies demonstrating that students recognize the importance of AI technologies in their field and their interest to learn new technologies [16–18]

Although dental students believe that AI will revolutionize dentistry in the future, 66% of the participants did not agree that AI will replace human dentists in the future. This findinğ corresponds with those from other studies in which the students indicated that AI would not replace doctors because of its limitations, such as lack of conversations with patients to earn their trust, reassure them, and/or show empathy [16,18–21]. Moreover, in some cases the doctors need to perform examinations or interpret histories and promote further discussion [22].

It should be noted, nevertheless, that this research has certain limitations. This study was carried out among dental students from one institution. Therefore, the results would not be applicable to other dental schools due to different curricula and dental training programs. Furthermore, because we only looked at undergraduate dental students’ attitudes, it is possible that postgraduate or more senior dentist students would express different sentiments.

Conclusion

According to the findinğs of this study, most Saudi dental students at KSU are enthusiastic about AI application in dentistry. They believe that AI can be used effectively for diagnoses of several diseases. A need to incorporate AI technology in dental curricula for the student to learn these emerging technologies exists. Follow-up surveys and multicentre studies need to be carried out to further investigate these issues.

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