SCIENCE
Will robots replace humans in oral pathology? Artificial Intelligence is improving at an exponential rate. Technology has started to replace many previously human-based activities and continues to threaten the positions of humans due to their objectivity, accuracy and low maintenance demands. Will this proceed into the realms of dentistry? Will robots really end up replacing humans?
Tanaka Kadiyo, United Kingdom
W
orld-renowned physicist Stephen Hawking offered stark, timeless words of warning (BBC, 2014) amid the rapid development of artificial intelligence that even facilitated his ability to communicate, having to depend on advanced technology following the progression of his amyotrophic lateral sclerosis (ALS). Are humans, as Professor Hawking proposed, bound to be ‘superseded’ by machines of their own concoction? And, how can we expect such matters to unfold as it relates to pathology in Dentistry? How will the continuous and rapid development of artificial intelligence shape the dynamics of Dentistry; the way people are diagnosed, treated and managed? Should we, as dental professionals, academics, or even patients, be worried or excited? Will it be for the better, or for worse?
A pathologist?
Before answering any questions, the most important component that underpins this discussion is defining pathology itself. Originating from the words ‘pathos’ meaning disease, and ‘logos’ per-
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taining to ‘study of ’, oral pathologists are typically dentally qualified professionals that study the causes and effects of diseases (RCPath, 2020). The weight of the work is highly localised in the analysis of laboratory samples of oral tissue for diagnostic purposes. Specialist pathologists play an integral role in healthcare through referrals and the treatment pathway for an incredible volume of patients. Pathology is central to the work of general dentists too, and indeed it is difficult to diagnose and organise the management of any condition without a grasp of the underlying disease process and a basic understanding of pathology. The author of New York Times Bestseller ‘The High Mountains of Portugal’ poetically describes the life of a pathologist by expressing that: “Under the pathologist’s microscope, life and death fight in an illuminated circle in a sort of cellular bullfight. The pathologist’s job is to find the bull among the matador cells” (Martel, 2016). Oral and Maxillofacial Pathology is one of the thirteen recognised dental specialties. With less than thirty specialists in the
United Kingdom, very few dentists will ever consider this specialty and very few will have had the opportunity to work alongside one (BSOMP, 2020). The oral pathologist practises an assortment of laboratory techniques to scrutinise human tissue samples of the oral cavity, jaws and salivary glands. These techniques can be labelled as macroscopic, microscopic and molecular. Macroscopic investigation symbolises gross sections of tissue, such as the appearance of white confluent patches found in Oral Hairy Leukoplakia (OHL) (Cho et al., 2010 ). Microscopy includes the subspecialties of histopathology, cytology and immunohistochemistry. The histopathologist can see cellular features such as hyperkeratosis, acanthosis and “balloon cells” (Greenspan et al., 2016) - Pathology is full of strange descriptions, from ‘orange peel’ and ‘soap bubble’ to ‘snowstorm’.
The case for robots
Manual interpretation of medical images is very time-consuming, requires considerable specialist expertise, and is prone to inaccu-
