Comparison of traditional regression modeling vs. AI modeling for the prediction of dental caries: a secondary data analysis

Introduction: There are substantial gaps in our understanding of dental caries in primary and permanent dentition and various predictors using newer modeling methods such as Machine Learning (ML) algorithms and Artificial Intelligence (AI). The objective of this study is to compare the accuracy, precision, and differences between the caries predictive capability of AI vs. traditional multivariable regression techniques.

Methods: The study was conducted using secondary data stored in the Temple University Kornberg School of Dentistry electronic health records system (axiUm) of pediatric patients aged 6–16 years who were patients on record at the Pediatric Dentistry Clinic. The outcome variables considered in the study were the decayed–missing–filled teeth (DMFT) and the decayed–extracted–filled teeth (deft) scores. The predictors included age, sex, insurance, fluoride exposure, having a dental home, consumption of sugary meals, family caries experience, having special needs, visible plaque, medications reducing salivary flow, and overall assessment questions.

Results: The average DMFT score was 0.85 ± 2.15, while the average deft scores were 0.81 ± 2.15. For childhood dental caries, XGBoost was the best performing ML algorithm with accuracy, sensitivity. and Kappa as 81%, 84%, and 61%, respectively, followed by Support Vector Machine and Lasso Regression algorithms, both with 84% specificity. The most important variables for prediction found were age and visible plaque.

Conclusions: The machine learning model outperformed the traditional statistical model in the prediction of childhood dental caries. Data from a more diverse population will help improve the quality of caries prediction for permanent dentition where the traditional statistical method outperformed the machine learning model.