Ethical insights into AI-driven caries detection: a scoping review

Background: Artificial Intelligence (AI) has become increasingly integrated into dental diagnostics, particularly for detecting carious lesions. While AI offers benefits such as improved accuracy and efficiency, its use raises important ethical concerns, including transparency, patient privacy, autonomy, diversity and accountability. This scoping review aims to identify these ethical concerns using a structured ethical framework. Methodology: Three databases were searched for papers regarding caries detection using AI. An established ethical framework was used to screen each paper for potential areas of concern. Results: A total of 351 abstracts were screened, of which 7 articles were included in this review. Each article was screened for established ethical principles including transparency, diversity, wellness, autonomy, privacy, accountability, equity, prudence, sustainable development, solidarity and governance. Diversity was the main ethical concern. Concerns related to accountability, equity and transparency were identified in 2 of the articles whereas ethical issue of privacy was identified in 4 of the articles. Only one study mentioned that no ethical approval was taken prior to commencement of study. Conclusion: AI in caries detection faces ethical issues like data bias, privacy risks, and equity concerns, potentially leading to flawed AI models. These issues can be addressed by creating a more specialized ethical framework that is specific to AI in dentistry. Clinical relevance: Understanding ethical challenges in AI-driven caries detection is critical to ensure accurate diagnostics, maintain patient trust, protect privacy, and support informed decision-making. Clinicians must be equipped to navigate these challenges as AI tools become more prevalent in dental practice.