CoTreat AI Blog

4 Dental AI Quandaries to Discuss

We’ve been developing CoTreat AI for the past four years, and throughout this journey, we’ve consistently engaged in discussions about the opportunities and risks ahead. These often heated discussions have significantly shaped our product's direction. Whether we've made the right choices will become clear over time. While we are already very confident in the value CoTreat AI adds to dentists and dental practices, both in terms of increasing clinical accuracy and reducing workload, the ethical quandaries and the ethical implications of AI are evolving.

Peaches and Lemons - Information Asymmetry in Dentistry

George Akerlof's 1970 paper on 'The Market for Lemons' underscored the concept of information asymmetry, a significant contribution that led to his Nobel Prize win in 2001. The blog discusses how this principle applies to dentistry, emphasising the role of professional ethics and emerging technology in mitigating information disparities.

The book that changed my career

During a routine dental cleaning, a conversation was sparked about a book that my patient was reading. It was Daniel Kahneman's "Thinking, Fast and Slow," a book condensing over 50 years of behavioural psychology into an accessible format.

Plurality and Contrarian Opinions in Healthcare

Handing over decision making power to one person is a bad idea. Surely we know this now as a species. The limitations of individual judgment, the misalignment of incentives (principal-agent problems) and asymmetry in information/power are all major problems with one person wielding absolute power over others.

Wild vs Mild Randomness

There's an interesting dichotomy we can use for assessing suitability for data analysis. Scalable fields (Financial markets, epidemics, terrorist attacks) which Benoit Mandelbrot dubs "wild randomness" and non-scalable fields (Human height, length of a tooth and how fast humans can run) which Mandelbrot dubs "mild randomness".

Missing the Outside view. Where is risk modelling in Dentistry?

My wife and I are presently in the market to buy a house. A recent visit to an open home prompted the discussion on how to fairly price a given property. There is a subjective element of course, but pricing based on location, number of beds, baths and car spaces seem to be the logical and intuitive first step for calculating price. What does the median 4 bed, 2 bath, 2 car house sell for in the same post code? This is an ‘outside view’ way to calculate an uncertain figure. Law of large numbers means a data driven approach gives you the best odds of being in the ballpark.

Medicine & Dentistry

Friendly banter aside, let's discuss structures and cultures within each profession. It's hard for me to admit this outright, but medicine appears to have far superior systems in place to offer patients a better, more evidence based service. This is something that may have arisen from necessity. After all, a bad day in the office for a dentist is the loss of a tooth.

The hidden power of incentives in Healthcare.

Charlie Munger once famously said the under recognition of the power of incentives is one of the main sources of psychological misjudgment. He also went on to say (perhaps facetiously) that he sometimes crosses off preventative investigations ordered by his doctor to ‘not allow him a chance to make a mistake’. What he meant was if a pathology is discovered, then the doctor has an overwhelming incentive to treat that pathology. Charlie clearly prefers sitting on his arse and doing nothing unless there’s an obvious problem he needs a solution for.

Groupthink

If the term sounds Orwellian, it's because it is. Fortune magazine then popularized it in the early 50s, and Irving Janice pioneered the formal psychological research on Groupthink Theory soon after. The central tenant is conformity and convergence on a certain idea when a group starts "deliberating". This phenomenon is more pervasive than we realize because not many of us are aware of Groupthink and even if you do become aware of it, it's more or less impossible to shut off without strict systems in place. Scary stuff.

Clinical vs Statistical Prediction in Dentistry

Adhering to strict, rule based protocols, assuming sufficient data exists to develop these protocols in the first place, is markedly superior to reliance on intuitive "human" judgements for decision making. In a comprehensive literature review spanning half a century across medicine and psychology, conducted by psychologist William Grove in the year 2000, it was found that rule-based protocols outperformed human intuitive judgement.

The Ring of Gyges

It may not seem so, but invisibility is the reality of many situations. If I consult with a cardiologist, i do have to defer to their judgement because i cannot "see" the true validity of the judgement. A large informational asymmetry exists and barring googling or a second opinion I have few other choices. The cardiologist here is invisible to me. Only another cardiologist can "see" whether the judgement is prudent and moral.

Shadow of the Future

Robert Axelrod's concept of the "shadow of the future" in game theory highlights the impact of repeated interactions on our behavior. Unlike one-off encounters, the expectation of meeting someone again influences us to act more cooperatively and considerately, as future consequences come into play. This theory suggests that the potential for ongoing interaction changes the dynamics of decision-making and can foster more collaborative relationships.

Trust in trust

Trust can be hacked. Robert Cialdini (author of Influence and Pre-suasion) and Daniel Kahnemann (author of Thinking Fast and Slow) have demonstrated dozens of ways to hack trust. An aura of authority, the use modern equipment, a good reputation, a good dress sense and a friendly smile are among some of the various halo effects that can create trust without merit. This can sometimes lead to severe lapses in judgment by the patient.

Good questions to ask your dentist before you commit to treatment.