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June 9, 2023

Artificial Intelligence (AI) has emerged as a prominent topic in dentistry, with the potential to revolutionize the way oral healthcare is practiced. 

At IDS 2023, we saw so many companies showing off their AI functionality that we started to lose count.

One such company was Pearl AI with their new software, a dental diagnosis and treatment planning tool that uses artificial intelligence to analyze dental images with the purpose to provide accurate diagnoses.

The company aims to help dentists with better patient communication and build patient trust by using AI as a chairside Second Opinion.   

We had the opportunity to interview Kyle Standley, the Chief Clinical Officer at Pearl AI, who shared valuable information about the company.

You can read the blog below or enjoy our interview from IDS 2023.

Could you provide some background information on Pearl and explain how you came up with it?

I created Pearl in collaboration with our CEO, who is also our co-founder. We had a conversation about how we can utilize AI in dentistry. We began exploring this idea in 2015, and in 2019 we spun out the company. Since then, we have been experiencing tremendous growth worldwide.

So AI did exist before 2023 everyone.

That's right. It seems like it's everywhere because of DALL-E and ChatGPT, but we've been working on this since 2015.

What is Pearl AI and how do you use it in your clinic? What does it do for your life?

Pearl is a computer vision company. We read dental imaging, like radiographs. As we take radiographs, we have immediate patients facing pathology detection, so we look at caries, bone loss, calculus, periapical radiolucencies, notable margins, and existing restorations.

We can segment out where the enamel, dentin, pulps, cementum, and bone are. We can index that. That's important because as dentists we are pretty good, but we're not perfect, and the AI is pretty good and it's not perfect but when you bring the two of us together, we get to these superhuman levels of diagnostics. In addition, it helps to build trust with the patient. 

So, unfortunately, we have a trust issue in dentistry. But when you show a patient this third-party AI system with no incentive and find a cavity, and I agree with it, they can have that form of trust. Not only that, but you can make it visual. Rather than referring to a black-and-white image and asking, "Do you see this small gray smudge?" With our technology, you can point to a pink outline and explain, "This pink area is getting closer to the green, which represents the dentin, the sensitive part of your tooth." So you can have these intelligent conversations with your patients, build trust, and allow them to make the right decision for their oral health.

This is thrilling because patient communication can be a challenging aspect of dentistry. Any visual aids, such as smile simulators or ortho simulators, can improve a patient's understanding of the treatment. This can also help alleviate any suspicion some patients may have regarding over-prescription from their dentist. Having a third-party visual aid allows for a clear and objective explanation of the treatment plan.

We call it a second opinion. It's a built-in second opinion. Someone just asked me, why do you call it a second opinion? It's because I'm the first opinion, it's ultimately up to me. But I have this built-in second opinion to where I can even tell the patient, “This is what I think, this is what AI thinks, and together, this is what I think the treatment plan should be.”

So, building trust, allowing something to be, like you said, there's no incentive. Unfortunately, we have financially driven diagnoses and our patients know that the more we diagnose, the more money we make. This isn't great when you're trying to build trust with a patient, so having something that's non-biased, a third-party builds trust, and showing them visually really builds value for the dentist.

I completely agree. It's fascinating, and I can see how many people would benefit from this technology. I've even heard some discussions about the potential use of AI in the future, and how it could become malpractice not to use it to help identify potential issues that a tired human eye might miss. This kind of technology serves as a valuable backup that can help catch every possible indication, ensuring the best possible outcomes for patients.

I think this will be an actual “utility” in dentistry, and I say utility as how we think of water or power. It's just going to be present, it's going to be very normal. Right now it is exciting and it's new. But very soon, I mean, it'll be very normal for the next two or three years. Everybody will have it. Nobody will look at radiographs without the assistance of AI. I mean, there's a lot of technology we think of now that was so amazing when it came out. Now it’s just normal and I think it's going to be a very steep trend with that in just a few years, everybody will have it.

How long does Pearl AI take actually to process a radiograph and provide a second opinion?

About 8 to 30 seconds, depending on the internet. So I always say, if you're taking a series of images by the time you take your second image, the first one will be up.

Can you give us some information about Practice Intelligence and its role in your company?

Practice Intelligence takes what we do with a second opinion, which is indexing all the images and cross-referencing it with what's happening in the practice management system. Practice Intelligence allows dentists to identify areas of opportunity in their practice by analyzing patient data and treatment plans. The software can detect potential cavities and help determine the best treatment plan, such as a filling, inlay, onlay, crown, or extraction. By identifying these areas of opportunity, dentists can improve patient care, increase revenue, reduce liability, and ultimately run a more successful practice.

Do I need to export my data from my current software and then import it into a separate installation for this to work?

Good question. None of that has to happen. We put an agent on your server and every time you take a new image, the software analyzes it and shows it on the front end. So there's nothing like drag or dropping. There's nothing manual that needs to happen once the installation is there. So you take your image, you just pull it up in our software.

Do you support most major imaging software platforms?

We support about 80% of the market's major software. However, for some exotic ones, we may not have support.

Are you considering using AI for 3D imaging, like CBCT and DICOM files?

Yes, we've been training on that for about the last two years and hope to have that out by early next year.

Do you have some beta testers just feeding you data and practicing diagnosis?

Yes, that's right. How AI works is you collect the data first, annotate all the data by hand with humans and feed it into the computer and start to see the output start changing the output, retraining it, making it better over time.

Training AI is like teaching a baby how to walk. At first, they crawl, then they try to stand up and they fall repeatedly until they finally figure it out. This is similar to how AI works, and it's fascinating to watch the process unfold and see it improve over time. It's like watching a baby grow and develop.

Teaching, reteaching, eventually they get it, but you have to give them a lot of input and practice and over time they get better.

So you've got some CBCT experts working through this and analyzing the AI output and then refining it and teaching it to get more accurate?

Yes, that's right. A lot of the experts come in in the training phase and then once they've annotated it, then it's over to our computer vision engineers and their job is to train it and make it do what the human was doing, automatically.

So how much does all this cost?

In Europe, the retail price is 299 euros a month. In US dollars it’s about the same.

What is included in the pricing? Is there a limit to the number of radiographs or is it unlimited? And how does the detection process work?

For 299 in Europe, you're getting Second Opinion. Practice Intelligence, we just are launching in the UK, and Europe. In North America, it's around $500 a month and with that, you're getting Second Opinion and Practice Intelligence, and it's up to 2500 images a month, which usually is around one to two doctors per office. 

And for multiple doctors, in a large practice, how does it work?

We do a more customized, cost-structure.

Has there been any new releases at IDS for the software or just creating more awareness?

The big announcement was bringing Practice Intelligence to the UK and Europe.

Is it going to be available in Australia and New Zealand?

We are currently expanding our operations and have a lot of projects going on in Australia and New Zealand. We are working with some of the major dental service organizations (DSOs) in those countries to get everything up and running. So, we are already established there.

AI and dentistry, it's here. It's now, it's happening, and check out Pearl AI and see if it's right for you and your practice. Thanks for your time.

Thank you.

About the author 

Dr Ahmad Al-Hassiny

Dr Ahmad is a global leader in digital dentistry and intraoral scanners, carrying out lectures as a KOL for many companies and industry. He is one of the few in the world who owns and has tested all mainstream scanners and CAD/CAM systems in his clinic. Dr Ahmad Al-Hassiny is a full-time private dentist in New Zealand and the Director of The Institute of Digital Dentistry (iDD), a world-leading digital dentistry education provider. iDD offers live courses, masterclasses, and an online training platform, with a mission to ensure dentists globally have easy and affordable access to the best digital dentistry training possible.

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