In 2023, there are still no robots in dental offices. Why?

5 September 2023
From the patient's point of view, the symbol of dentistry development is the dental unit – composed of a dental chair and tools like an ultrasonic scaler, dental handpieces, a control panel for the chair, and a suction machine, etc. There is also a screen on which the patient can view X-rays or the result of a dental implant procedure. Oral technologies entered homes: Smart toothbrushes monitor users' habits and teeth-brushing precision. Data is sent to a mobile app, where the user can check, for example, which areas of the mouth need more attention. High-resolution digital X-ray technology with decreased exposure to radiation and cone beam tomography, allowing for a three-dimensional image of the entire jaw, is also rapidly developing. The intraoral scanner displaces the unpleasant dental experience during orthodontic and prosthetic treatment, creating a precise digital image. Lasers are used to treat gum diseases and teeth whitening. CAD/CAM designing technologies facilitate the manufacturing perfectly fitted dental fillings such as crowns and bridges. Remote dentistry, 3D printing, AI, and VR Although it would be hard to perform dental treatment remotely, teledentistry can be applied to assess teeth condition, diagnose teeth and gum diseases early, and monitor the treatment process. Almost everybody already has a device required for teledentistry – a smartphone with a camera. Dental laboratories use 3D printers to manufacture prosthetics, orthodontic models, and implants. AI systems compute the odds of success for complex procedures, such as apicectomy, and design personalized treatment plans. Virtual and augmented reality helps educate patients and simulate procedure results in cosmetic dentistry. It can also be used to divert the patient's attention during procedures, especially if the patient has dentophobia, which is a fear of dental treatments.

The future: regrowing teeth and microrobots

Dentistry strives to leave burs and painful procedures behind. Scientists are working on, among others, biotechnologies protecting against decay and implantable teeth germs that would develop in the place of cavities. There are also the first achievements in robotic dentistry, especially in implantology, which requires high precision. The first fully autonomous robotic implant insertion procedure was performed in 2017 in a clinic in Xi'an, China. The implants were made with a 3D printer, and the embedment error was only 0.3 mm. It is estimated that in China, 400 million people need implants, but there are not enough qualified experts. In 2017, the US FDA approved the use of the robotic system Yomi to facilitate dentists in implant insertion procedures. Its benefits include smooth reaction to patient's movements and imaging in time to make the procedure less invasive. However, while robots can operate on patients under anesthesia, it's hard to imagine that anybody would allow a robot to insert a mechanical arm with a drill into the mouth. This immediately instills fear – after all, the robot does not feel the patient's pain and has no empathy. A barrier to using robotics to treat decay is the need to react to the patient's movements. The bur in a classical arm cannot be used simply due to regard for the patient's safety. But there is a solution for that: Mini robots placed in the mouth directly on the tooth and controlled by the dentist, much like the da Vinci surgical system. It would provide high stability and minimize the patients' fear. Additionally, it could be more comfortable for the patient as they would not have to keep their mouth open wide all the time. Most dental robotics innovation is taking place in China, where there is a vast shortage of dentists, also due to the fact that dentists are not as respected as other medical specialties.