As I look at the roadmap for AI in implant dentistry over the next five years, particularly from my perspective working with cutting-edge technologies, I worry that our industry is sleepwalking into a similar trap.
A vast swathe of our industry is currently obsessed with the automatic door version of dentistry: faster scans, instant designs, one-click fabrication. The technocrats promise us a world of frictionless efficiency.
But I am here to offer a contrarian view. If you want to maintain your status as a high-value clinician in 2030, your goal shouldn't be just to maximise efficiency. It should also be to master the art of strategic inefficiency.
The Commoditisation of Perfection
Here is the uncomfortable economic truth about AI: It is a great leveller.
In the past, the difference between a master technician and a novice was vast. In five years, AI algorithms trained on millions of successful cases will enable a mediocre lab to produce a mathematically perfect implant design in seconds.
This brings us to a critical point often overlooked in digital dentistry: the visibility of effort.
If a patient believes that a computer did 99% of the work, their willingness to pay high fees evaporates. If they see a 'click to print' workflow, they expect the economics of the assembly line. If they see craftsmanship, they accept the premium of the bespoke.
If Nexus Dental Lab simply takes your scan, runs it through an AI 'black box,' and prints the result, we are no longer your partner. We are a vending machine.
And you do not pay professional fees to a vending machine.
You pay Nexus to manufacture a world-class medical device. But the premium you pay isn't just for the materials; it is for the safety protocols that ensure it won't fail.
This is why, for example, I still personally finalise our Atlantis designs (over 10,000 now and counting!). To an outsider, that might look like an inefficiency or a bottleneck. But it is our economic moat.
In an age of automated, faceless design centres, we differentiate by process. We accept the software's first proposition as a draft, but we insist that an expert human handles the finalisation. We don't just sell you the design; we sell you the sign-off.
History provides a powerful context here. This lineage stretches back over 20 years, with tens of thousands of abutments informing the decisions we make today. This deep well of data reframes AI from hype into evolution.
It reinforces the fact that what we are witnessing is not a disruption of our standards, but the refinement and acceleration of principles we have been applying from day one.
This leads to my first prediction for the next five years: the lab's value will shift from creation to curation.
As we progress, the heavy lifting of design will inevitably shift from human hands to algorithms. AI will dominate design.
When that shift matures, the role of my senior technicians will evolve. We will move from being authors to being editors; from manufacturers to algorithmic stewards.
Think of it this way: AI is excellent at eliminating manufacturing variance (the crown will always fit). But it is terrible at managing contextual variance (e.g., the patient is a nervous bruxer requiring a protective occlusion, the tissue is fragile, or the aesthetic demands are unique).
Our primary function will be to scrutinise what the AI proposes and, crucially, know when to reject it. We will stand as the human firewall between the statistical probability of the software and the biological reality of your patient.
Escaping the Uncanny Valley
There is a second reason why we must resist the lure of total automation: biology hates mathematical symmetry.
AI models are statistical by design; they gravitate towards the average. They prioritise mathematical symmetry over biological reality.
But nature is rarely symmetrical. When you impose a geometrically flawless row of teeth onto a human face, the result is not beauty; it is dissonance. It looks artificial. It looks like a row of piano keys.
It falls into the 'Uncanny Valley', that strange zone where something looks almost human but just off enough to provoke revulsion.
The Science of the Creep Factor
This isn't just an artistic preference; it is hard-wired evolutionary biology.
The term 'Uncanny Valley' was coined by roboticist Masahiro Mori in 1970, but the instinct is millions of years old. Evolutionary psychologists call it Pathogen Avoidance.
Our brains are designed to be hyper-sensitive to things that look almost human but are slightly wrong. In our ancestral environment, if something looked human but was too pale, too rigid, or lacked the subtle micro-movements of life, it wasn't a robot; it was a corpse or a diseased tribe member.
Our brain's response to near-perfection is not admiration; it is revulsion. It is a safety mechanism screaming, 'Stay away, this is not healthy.'
When an AI designs a smile that is mathematically symmetrical and perfectly opaque, it inadvertently triggers this ancient alarm system. It creates a smile that signals 'artificiality' rather than 'health.' To the subconscious mind, a perfect set of teeth doesn't look like a great dentist did them; it looks like a factory did them.
The strategic answer to the 'Uncanny Valley' lies in a concept from cognitive psychology known as cognitive surplus.
Because the technician no longer has to expend mental energy solving the engineering of the crown, their entire bandwidth is freed up to apply something the computer does not possess: wisdom.
This is where we deploy the years of collective experience that reside within the walls of Nexus. It is the space where we apply the lessons we learned the hard way. It is where we inject the insights from thousands of hours of Continuous Professional Development.
Crucially, it gives us the breathing room to exercise our zest for questioning everything, that distinctively human, slightly obsessive sense of fun that drives us to ask, "Is this actually right? Or is it just what the computer thinks is right?"
We are shifting the technician's focus from functional architecture to optical dynamics and the tertiary anatomy.
This allows us to introduce the philosophy of Wabi-Sabi (the appreciation of the imperfect) at a scale never before possible. We will use the digital workflow to handle precision, so the human can focus entirely on imperfections, surface texture, translucency, and the slight irregularities that signal organic life.
Paradoxically, we will use the most advanced technology on earth to disguise the fact that we used any technology at all.
The Liability of the Algorithm
Finally, we must address the problem of the pilot in the cockpit.
We tolerate autopilots flying our planes 98% of the time. But we pay the pilots their high salaries for the 2% of the time when the computer gets confused. We pay them to override the system.
As a surgeon, your existential risk is not that you are too slow. It is that you become dependent on a system you do not understand.
If an AI creates a surgical guide based on a CBCT scan, and that AI misses a pathology because it was an outlier in the dataset, who is responsible? You cannot sue an algorithm.
This is where the relationship between the surgery and the lab changes. You are not hiring Nexus for our printers. You are hiring us for our Paranoia.
You are hiring us to look at the AI's proposal and say: 'Wait. The algorithm recommends placing a standard implant here because the bone volume is sufficient. But looking at the density mapping, the quality of that bone is suspect, it looks like soft D3. If you drill standard protocol here, you'll lose stability. We should switch to a more aggressive thread profile or angle the implant to engage the cortical plate.'
The Next 5 Years: High Tech, High Touch
So, where are we going?
While our competitors are racing to see who can adopt technology the fastest, we are focused on something far more critical: determining how that technology should be governed.
The elite labs and the elite clinicians will use AI differently. We will use the time saved by automation to double down on the things AI cannot do: reasoning, risk assessment, and aesthetics.
We have always sold you more than just a crown or an abutment; we sell you certainty.
That has always been the Nexus promise.
Our strategic vision for the next five years is to fortify that promise.
We will cultivate a new breed of technician, not just a digital designer, but a clinical auditor. As we integrate these powerful AI tools into our workflows, our pledge to you is that we will never allow the machine's efficiency to override the patient's safety.
The future isn't about robots replacing humans. It is about the human who has the wisdom, the status, and the confidence to argue with the robot.
That is the destination Nexus is steering towards. We are positioning ourselves to be the pilots in the cockpit, ensuring that while the technology does the flying, humanity determines the destination.
