Dentists Are Using AI to Scare Patients Into Unnecessary Dental Work
In the age of artificial intelligence, a new controversy is emerging in dental clinics across the country. Advanced AI tools designed to analyze dental X-rays are being accused of flagging minor issues as serious problems, potentially pushing patients toward expensive and sometimes unnecessary treatments.
Journalist Joanna Stern, a former Wall Street Journal columnist and author of the book I Am Not a Robot: My Year Using AI to Do (Almost) Everything, recently shared her alarming personal experience. During a routine dental visit, her dentist used an AI system called Pearl AI, which claims to detect 37% more disease and result in 24% more treatment plans compared to traditional methods. The AI flagged significant plaque buildup and recommended extensive periodontal treatment that would cost thousands of dollars, with uncertain insurance coverage.
Stern was surprised by the diagnosis because her teeth felt perfectly fine. Seeking peace of mind, she consulted other dentists for second opinions. These professionals told her the issues were not severe and could likely be managed with improved home care routines. She opted to skip the recommended treatment and, months later, reported no problems with her dental health.
Further investigation by Stern revealed deeper concerns within dental practices. Conversations with dental office staff highlighted internal pressure from management to follow AI recommendations aggressively. Dentists reportedly faced questions like “Why didn’t you drill it?” or “Why didn’t you sell the periodontal treatment?” — framing AI outputs as opportunities to increase revenue rather than purely medical necessities.
Similar AI tools, such as Overjet, are also gaining widespread adoption in dental offices. These systems use machine learning to scan radiographs for cavities, bone loss, gum disease, and other conditions, often claiming higher accuracy than human eyes alone.
The Promise and Peril of AI in Dentistry
Proponents of dental AI argue that these tools represent a major advancement in patient care. By detecting problems earlier, they can prevent more invasive procedures down the line, such as root canals or tooth extractions. Early intervention, supporters say, leads to better long-term oral health outcomes.
However, critics point to significant risks of overdiagnosis and overtreatment. AI algorithms are often tuned for high sensitivity, meaning they may flag minor or even insignificant findings that a careful human examination might overlook or deem non-urgent. In a fee-for-service dental industry — particularly in corporate chains — there is a built-in financial incentive to act on every AI alert.
Dentists remain ultimately responsible for clinical decisions. Professional guidelines stress that AI should serve as an assistive tool, not a replacement for human judgment that considers a patient’s full history, symptoms, and overall health. Yet the combination of sophisticated technology and profit motives can create pressure that sometimes overrides conservative, evidence-based approaches.
This issue is not unique to dentistry. Similar debates exist in radiology and other medical fields where AI boosts detection rates but can also drive unnecessary tests and procedures. Many patients already report feeling pressured into treatments and increasingly seek second opinions as a safeguard.
What Patients Should Do
While not every dental practice misuses AI, the pattern described in Stern’s reporting serves as an important warning. Patients should approach AI-generated diagnoses with healthy skepticism, especially when the recommended work is extensive, costly, or unrelated to noticeable symptoms.
Key advice includes:
- Always ask for a clear explanation of findings, distinguishing between imaging results and actual clinical need.
- Request conservative options first, such as improved hygiene, monitoring, or non-invasive treatments.
- Seek second (or even third) opinions from independent dentists unaffiliated with the original practice.
- Inquire whether the office uses AI tools and how those recommendations are weighed against traditional examination methods.
AI holds genuine potential to improve dental diagnostics when used responsibly. However, as with many technological innovations in healthcare, it must be balanced against human oversight and ethical practice. Until clearer regulations and industry standards emerge, patients would do well to remember that the best dental advice often starts with common sense — and a willingness to ask questions.
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