Open wide: AI is coming to a dentist's chair near you

AI-guided dentistry could help prevent costly procedures — or increase patients' bills without a clear clinical benefit.

September 20, 2023 Check out STAT+

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By Elizabeth Cooney Reporter, Morning Rounds Writer

Good morning. Today we're looking at the chances of long Covid from reinfection and at some bumps in the road for the first Covid vaccination campaign to get underway after the public health emergency's end. Also, AI in dentistry is promising earlier detection for decay and bone loss. As Casey Ross writes, open wide.

pandemic, part 1 Another long Covid question: Is risk cumulative?  As we head into another season of living with Covid, many of us are rolling up our sleeves for another shot (about a quarter of us, if you ask Pfizer) and resigning ourselves to the continuing risk of infection. What's less clear is our risk of coming down with long Covid. I asked clinical epidemiologist Ziyad Al-Aly if we know whether reinfection increases our chances of developing the condition.  What does your research tell us? It's very clear in our data that reinfection contributes additional risk of long Covid. People need to understand that you can get long Covid the second time, even if you dodged the bullet the first time. You can get long Covid the third time.  So each time you are rolling the dice on long Covid? That is correct. Does that risk add up?  This is really hard to answer. Read the full interview. pandemic, part 2 The fall Covid shot campaign is up and running, with a few bumps The first Covid vaccination campaign of the post-public health emergency era is underway, with pharmacies and doctors' offices booking appointments for and administering the updated shots made by Pfizer and Moderna, STAT's Helen Branswell notes. (Novavax's updated vaccine hasn't yet made it through FDA authorization, but it will follow.) This is the first time the U.S. government isn't the purchaser of the vaccines, so STAT is watching to see how seamlessly — or not — this fall's campaign runs. (Having problems? Let us know.) We've heard of a few glitches, with the occasional pharmacy canceling appointments because they have no doses in stock. Matt Blanchette, senior manager for retail communications for CVS, says that while the majority of the chain's pharmacies have vaccine "we have seen delivery delays to some stores." The message was similar from a Walgreens representative: "We are aware of isolated incidences at a small number of locations where appointments had to be rescheduled due to delays in supply." Shots should still be free to the vaccinee, covered either by insurance, the Vaccines for Children program, or the CDC's Bridge program for un- and underinsured adults. health 'Consistent fear': Pediatric endocrinologists under pressure for providing gender-affirming care  Many pediatric endocrinologists who provide gender-affirming care are concerned about how legislation banning that care is affecting their work and personal well-being, according to a survey published yesterday in the Journal of the Endocrine Society, STAT's Theresa Gaffney reports. Researchers surveyed 223 pediatric endocrinologists, who focus on disorders related to the body's hormones, about their experiences between January 2021 and June 2022. Of those who provide gender-affirming care, over half were concerned about the risk of legal action being taken against them. Almost 17% (21 people) said they were either currently or previously concerned about their personal safety at work or at home, as related to providing gender-affirming care. And 12% (15 people) said they experienced pressure from their institutions that might affect their ability to provide that care. "We and our patients are living in consistent fear," one respondent wrote.

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Closer Look AI is coming to dentistry. Is that a good thing? Mike Reddy for STAT Are you ready for AI at the dentist? A new wave of software is promising to supercharge dentists' ability to spot decay and bone loss that could lead to gum disease — and propose treatments earlier. Eight AI products have won FDA approval and more will follow. That sounds good if it means preventing costly root canals and implants, but whether AI-guided dentistry is actually better remains an open question, STAT's Casey Ross reports.  AI can lead to aggressive treatments that increase patients' bills without a clear clinical benefit, experts told Casey. As is often the case with new technology, standards for using these products on patients lag behind efforts to sell them. Accuracy is hard to measure because of the inherent subjectivity involved in analyzing medical images. "What we need is an internationally acknowledged and standardized benchmarking dataset, which we don't have at the moment," said Falk Schwendicke of Charité University in Berlin. Read more. reproductive health Screening for hypertension in pregnancy expands, with more focus on those at highest risk The USPSTF issued guidelines in 2017 that dictated screening for high blood pressure throughout pregnancy with a goal of identifying who might develop preeclampsia, a condition that endanger the life of mother and child late in pregnancy. That recommendation hasn't changed this year, but the need to reach all patients, especially those at highest risk, has gained a new urgency from the advisory group. That means heightened attention to Black, Native American, and Alaska Native patients, who are much more likely to both develop and die from a hypertensive disorder of pregnancy. The guidance also expanded to include all hypertensive disorders of pregnancy. "Given the U.S.'s abysmal track record in addressing maternal mortality, a new sense of 'hypertensive urgency' is required: screening for and addressing [hypertensive disorders of pregnancy] must be prioritized and addressed with a renewed focus by clinicians, policymakers, and the research community," Srilakshmi Mitta, Cary Gross, and Melissa Simon wrote yesterday in a JAMA Internal Medicine editorial. chart of the day

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What we're reading Google DeepMind's AI model scours our genes to guess who might get sick, Wall Street Journal At Japan's dementia cafes, forgotten orders are all part of the service, Washington Post Biotech lab-space demand falls sharply as industry's 'sugar high' turns into a 'reset', STAT A vanishing nomadic clan, with a songlike language all their own, New York Times Opinion: Value-based payments are making it harder to see your primary care doctor on short notice, STAT

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Thanks for reading! More tomorrow,

elizabeth.cooney@statnews.com

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