AI at the Dentist: How Artificial Intelligence Detects Caries and Periodontal Disease
What If Your Dentist Never Missed a Thing?
Imagine sitting in the dental chair. Your X-ray is taken. Your dentist examines it — and at the same time, an AI system analyzes the same images, layer by layer, pixel by pixel. Not as a replacement for the clinician, but as a second pair of eyes that never gets tired.
This may sound futuristic. It isn't. At Pul's Zahnmedizin, AI-powered diagnostics will be an integral part of every examination when we open in 2027.
What this means for you as a patient — that's what this post is about.
The Problem: What the Eye Can Miss
Reading a dental X-ray is demanding. Dentists train for years to identify caries, bone loss, inflammation, and other pathologies on two-dimensional images. Yet studies show that detecting certain findings remains a challenge.
A meta-analysis published in the Journal of Dental Research found that the sensitivity of visual caries detection on radiographs for proximal caries ranges between 40 and 70 percent, depending on clinician experience and the stage of decay (Source: Schwendicke et al., Journal of Dental Research, 2015). This means that even experienced dentists may miss up to 60 percent of early interproximal caries lesions.
This is not a criticism of the profession — it's a reality of human perception. X-rays are two-dimensional projections of three-dimensional structures. Overlapping anatomy, density variations, and image quality make interpretation complex. Add to this the fact that a dentist evaluates dozens of such images per day, often under time pressure.
How AI Diagnostics Work
AI systems for dental diagnostics are built on deep learning, a form of machine learning where neural networks are trained on large datasets. In essence, the AI learns to recognize patterns in radiographic images that correlate with specific pathologies.
The Training Process
A typical AI model for caries detection is trained on hundreds of thousands to millions of dental radiographs annotated by experienced dentists and radiologists. Every cavity, every inflammation, every bone defect is labeled. The network learns the visual signatures of different pathologies from these examples.
After training, the AI can analyze new, previously unseen radiographs and flag findings — in fractions of a second.
What the AI Detects on a Dental X-ray
Modern dental AI systems can identify a wide range of findings:
Caries: From early enamel lesions to deep dentin decay. The AI recognizes demineralization zones that are often difficult to distinguish from normal density variations on conventional radiographs. Studies show that AI systems achieve a sensitivity of 75 to 93 percent for proximal caries detection, significantly exceeding the average of purely visual assessment (Sources: Lee et al., Scientific Reports, 2018; Cantu et al., Journal of Dental Research, 2020).
Periapical Lesions: Inflammations at the root apex that may indicate the need for root canal treatment. AI systems achieve a sensitivity of up to 92 percent on CBCT scans (Source: Setzer et al., Journal of Endodontics, 2020).
Periodontal Bone Loss: The AI quantifies bone loss around each tooth and generates a severity profile, enabling a more objective assessment than visual evaluation alone.
Tooth Fractures and Resorption: Hairline cracks and root resorptions that are barely visible on conventional radiographs.
Anatomical Structures: Nerve pathways, maxillary sinuses, supernumerary teeth, and other anatomical variants are automatically identified.
What This Means for Your Treatment with Us
At Pul's Zahnmedizin, we integrate AI diagnostics directly into our clinical workflow. In practice, it works like this:
Step 1: Imaging
Depending on the clinical question, we take a conventional radiograph (panoramic X-ray) or a three-dimensional scan with our Cone Beam CT (CBCT). CBCT technology produces hundreds of individual cross-sectional images that together form a complete 3D image of your jaw.
Step 2: AI Analysis
While you're still in the treatment chair, the AI analyzes your images. It flags anomalies, quantifies findings, and generates an overview of all detected pathologies — color-coded and prioritized by urgency.
Step 3: Clinical Assessment
Every AI finding is reviewed by your dentist and placed into the overall clinical context. The AI does not deliver diagnoses — it delivers leads. The diagnosis is made by the dentist, who sees the full picture: your symptoms, your medical history, the clinical examination, and the imaging data.
Step 4: Discussion with You
We show you the results on screen, presented in an understandable way. The color-coded markings make it easy to see where a finding is located and how urgent it is. Transparency is one of our core values. You shouldn't have to trust blindly — you should understand what's happening and why.
The AI sees what the eye might miss. The decision always rests with the dentist — together with you.
What AI Cannot and Should Not Do
As powerful as the technology is, there are clear boundaries we intentionally maintain:
No standalone diagnoses. The AI flags anomalies. Whether it's a cavity requiring treatment or a harmless enamel irregularity is determined by the dentist.
No treatment decisions. Whether a tooth should be crowned, filled, or simply monitored requires clinical judgment, a conversation with the patient, and consideration of individual factors. An AI cannot provide this.
No substitute for clinical experience. The AI works with image data. It doesn't feel how a tooth responds to probing, whether gums bleed on contact, or whether a patient describes pain. Clinical examination remains indispensable.
No autopilot. AI systems must be properly deployed, calibrated, and interpreted. This requires trained personnel and an understanding of both the capabilities and limitations of the technology.
Data Protection and Security
Your dental X-rays are health data — and therefore subject to the highest protection standards. At Pul's Zahnmedizin, strict rules apply:
AI analysis is performed locally in the practice or on European servers, in compliance with the GDPR and the recommendations of the German National Association of Statutory Health Insurance Physicians for AI use in medical practices (Source: KBV, AI Guidance for Medical Practices, 2025). Your images are not transmitted to third-party providers outside the EU. Processing is purpose-bound: your data is used exclusively for your diagnostic assessment and not for training external AI models.
A Look at the Numbers
The adoption of AI in dentistry is accelerating. The global market for dental AI was valued at approximately $1.97 billion in 2024 and is projected to reach $5.79 billion by 2030, representing annual growth of over 19 percent (Source: Grand View Research, Dental AI Market Analysis, 2024). In Germany, a growing number of dental practices are deploying AI-assisted systems, particularly for radiograph and CBCT interpretation.
The European Federation of Periodontology (EFP) published a 2024 consensus document evaluating the use of AI in periodontology as promising while formulating clear guidelines for responsible integration (Source: EFP, Consensus Report on AI in Periodontology, 2024).
What This Means for Your Dental Health
Integrating AI into dental diagnostics serves a single purpose: ensuring nothing gets overlooked.
For you as a patient, this means:
More thorough examination. The AI scans every image systematically and completely, regardless of time of day, workload, or image complexity.
Early detection. Early-stage caries, beginning bone loss, small inflammatory foci — the earlier a finding is detected, the simpler and gentler the treatment.
Transparent findings. The color-coded markings make your findings visible and comprehensible. You understand what we see and why we recommend a particular treatment.
Consistent quality. The AI works with the same diligence on every image. It doesn't have bad days, time pressure, or blind spots.
Dentistry That Leaves Nothing to Chance
At Pul's Zahnmedizin, we use AI because it makes our diagnostics better — not because it sounds modern. Every technology in our practice must answer one question: Does it improve patient care?
AI-powered diagnostics passes this test. It gives us the confidence that findings are caught before they become problems. And it gives you the confidence that nothing in your examination is left to chance.
Follow our journey. We're building a practice where technology serves your health.
Frequently Asked Questions (FAQ)
Does the AI make my diagnosis?
No. The AI analyzes your X-rays and flags anomalies that may indicate caries, inflammation, or bone loss. The actual diagnosis is always made by the dentist, who evaluates the AI findings together with the clinical examination, your symptoms, and your medical history. The AI is a tool, not a decision-maker.
How accurate is AI at detecting cavities?
Current studies show that AI systems achieve a sensitivity of 75 to 93 percent for proximal caries detection. This significantly exceeds the average of purely visual assessment by dentists, which ranges between 40 and 70 percent depending on the study. AI is particularly strong at detecting early-stage caries that are difficult to see on conventional X-rays.
What happens to my X-ray images?
Your images are processed in compliance with GDPR — either locally in the practice or on European servers. They are used exclusively for your diagnostic assessment and are not transmitted to third-party providers outside the EU. Your data is not used for training external AI models.
Do I need additional X-rays because of the AI?
No. The AI analyzes the same images we create for your examination anyway. No additional X-rays are required. The AI analysis is an added benefit that causes no additional radiation exposure.
Does the AI analysis cost extra?
AI-powered diagnostics at Pul's Zahnmedizin is an integral part of our examination and is not billed separately. It's a built-in component of our digital workflow and our commitment to quality.