Aged care and artificial intelligence

Abstract

Two recent items have caught my attention in recent months. The first is the role of oral health care for the aged and the second is artificial intelligence (AI). There was a general feeling of ‘reward for hard work’ by the dental profession following a number of submissions from interested oral health stakeholders that resulted in inclusion of oral health in the recommendations of the Royal Commission into Aged Care Quality and Safety. It was particularly pleasing to see the recommendation that at least one oral health practitioner be assigned to every aged care provider in Australia. An endorsement for a Seniors Dental Benefits Scheme to commence in 2023 was also encouraging news. However, the excitement was short-lived when the Federal Budget was delivered with no provision in it for oral health care for aged. Seems like one step forward and three steps backwards. Still, we should not give up and the call for greater funding and support for aged oral care. For any of us who have had the experience of having family members in aged care, the astounding lack of well-managed oral care at this very critical stage of life is all but a reality and a problem that seems to be poorly addressed in the overall medical management of people in aged care facilities. Perhaps this is exacerbated by an ongoing lack of understanding by the medical and aged care sectors that the mouth is connected to the rest of the body. I have often thought how could this issue be better embraced? We have some excellent examples where some inroads have been made for the provision of oral health care in the aged care sector but in general the problem of poor delivery and service persists. If the problem relates to lack of understanding of what goes on in an aged person’s mouth by the frontline aged care workers, then why not try to simplify it for them? Is one solution artificial intelligence? There is no doubt that AI has the potential to make oral health care accessible and effective but there is also the potential for errors to arise if the algorithms developed are not carefully designed and implemented. AI in dentistry is in its infancy but the potential for rapid development is high.1 It has been said that health care can be made more equitable by tailoring algorithms to specific patient populations (i.e. the aged). For example, knowing that delivery of oral health care for the aged has been underperforming for decades, and is a looming community disaster in the waiting, could we develop algorithms specifically targeted towards predicting the manifestations of age on oral diseases? As we move into the exciting age of personalized/precision medicine and dentistry where we will move from the ‘one size fits all’ paradigm to an individual focussed approach to oral health care, the potential for inclusion of AI in this processed should not be discounted. In the future, it should be possible to create algorithms that specifically target the aged and this could be the beginning of progression to an inclusive oral health care programmes for the aged and allow those not familiar with oral health care to participate in the triage and eventual implementation of treatment services as needed by this ever-increasing sector in our community. If the Royal Commission sees a need for inclusion of oral health care in the aged care sector, then we must look to innovative ways to implement this. AI may be one such way that could be harnessed to make aged oral health care more accessible, affordable and effective.

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