Sir, as a British dentist, maxillofacial radiologist and researcher since 1980 in artificial intelligence (AI) applied to dentistry, I was asked recently if AI-generated dental radiography reports protect general dentists from failure to diagnose litigation. Currently, 89% of general dentists report their own CBCT images.1 Unless they have had special training, they are at risk of failing to diagnose oral and maxillofacial diseases, and vascular disease of the carotid arteries.

AI programmes are being designed to perform tasks normally carried out by human specialists such as medical and dental radiologists. As a peer reviewer for the journal Oral Surgery Oral Medicine Oral Pathology Oral Radiology, I see a lot of manuscripts from researchers who seek to publish their work in the field of AI and oral and maxillofacial radiology. The current state of the art is that some programmes are being used for the automatic generation of reports limited to caries, periodontal bone levels and endodontic treatment/apical radiolucencies from dental panoramic and CBCT images.

For an AI program to be equivalent to a dental radiologist, it must perform to an equal standard of diagnostic accuracy for the full range of expected pathologies, such as caries, the periodontal diseases, impacted teeth with proximity to the mandibular canal/maxillary sinuses, cysts of all types, benign and malignant tumours, infections such as osteomyelitis and sinusitis, bone dysplasias and degenerative diseases of the temporomandibular joints. In addition, vascular calcified atherosclerotic degenerative changes of the external and internal carotid arteries are often seen in panoramic and CBCT images much more frequently than malignant tumours.2

Randomised blinded clinical trials published in peer-reviewed journals are required to prove the accuracy and efficacy for reporting oral and maxillofacial diseases by AI programmes. To my knowledge, there are no AI programmes currently available which can perform these difficult diagnostic challenges equivalent to a dental radiologist. An AI report that says: 'This report was produced by an Artificial Intelligence program and then checked by a person' is not equivalent to a report produced by a GDC-registered dental radiologist.3,4 Any dentist who believes that a current AI dental radiology report will protect them from liability of failure to diagnose, is wrong. The dentist has the responsibility to either interpret the radiographs themselves or request a dental radiologist to provide it for them.