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Where AI ends and the dentist’s wisdom begins
Dr Puneet Batra explains how oral health can reveal clues about wider health, and how AI can strengthen diagnosis.
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For most people, a visit to the dentist begins when something hurts. A tooth aches, the gums bleed, or a problem becomes hard to ignore. Dr Puneet Batra, an orthodontist, academician, and specialist in craniofacial care and digital dentistry, believes the mouth can show signs of a problem before a patient feels anything wrong.
"The first whisper that there is something wrong in our health comes from the oral cavity," Dr Batra said in a recent episode of Voices for Clarity, hosted by paediatric dentist Dr Gauri Kalra. He pointed to bleeding gums, unhealed ulcers, and mobile teeth as warning signs and said the mouth can offer clues about wider health. The World Health Organisation estimates oral diseases affect nearly 3.7 billion people worldwide. In India, lip and oral cavity cancers accounted for 143,759 new cases in 2022, according to the International Agency for Research on Cancer. Among Indian men, 107,812 new cases were recorded, making it the leading cancer site in the 2022 estimates.
When A Child's Treatment Begins with a Conversation
When a child is born with a cleft lip or palate, the first conversation with the family can be as important as the treatment plan. Parents may ask, "What went wrong? Why was it us? Why was it our child? Did we do something wrong?" Dr Batra says the first responsibility of the cleft-care team is to build trust and help the family understand that treatment is possible.
Dr Batra has spent 25 years in cleft care and says he has treated "many thousands" of patients, though he does not keep an exact count. "Surgery is just the first chapter of this journey," he said. Comprehensive care involves orthodontics, dental and oral healthcare, ENT intervention, speech therapy, and psychological support. The aim is to help the child live in society with confidence and dignity.
Smile Train India estimates that more than 35,000 babies are born with clefts in India every year and says its network has supported over 800,000 cleft surgeries since 2000. But for Dr Batra, the most memorable measure of treatment is not a number. One former patient later called him and said, "Uncle, I cleared it," before starting a support group for others with clefts.
For many families, finding treatment is only the beginning. Dr Batra says specialist care is unevenly distributed, and awareness remains a problem, especially in rural areas. Parents may know treatment exists but not where to find the right specialists, when each stage should happen, or what the journey will cost. He points to Smile Train and the government's Rashtriya Bal Swasthya Karyakram as efforts to identify children and connect families with comprehensive care.
The Mouth, The Mind And Prevention
The same emphasis on early attention runs through Dr Batra's approach to routine dental care. Many people wait until pain appears before seeking help. India's national health programme includes population-based oral-cancer screening for people aged 30 and above.
Dr Batra also discusses how stress can show up in the mouth, including sensitive teeth, fractured cusps, and temporomandibular joint pain. His broader point is to pay attention to physical changes instead of waiting for them to worsen. In the rapid-fire part of the conversation, he calls regular dental check-ups an underrated habit. He says brushing is about technique and plaque removal, not brushing harder or longer. He recommends brushing for two to three minutes and says flossing remains important.
When Social Media Starts Designing The Smile
Dentistry is also responding to the demand for a perfect smile. Social media, including AI-generated images, has changed expectations around cosmetic dentistry. Dr Batra warns such images can create expectations that cannot be transferred from one face to another because each patient has distinct facial characteristics and functional needs.
"Everybody's smile is their signature," he said. "It can't be the same. It cannot be imitated. It cannot be copied" The same thinking shapes his view of cosmetic dentistry and ethics. He says he would rather see a dentist refuse an inappropriate procedure than perform one simply because a patient wants it, particularly where healthy tooth structure could be compromised for cosmetic purposes.
What AI Can Change
The changes are not limited to cosmetic dentistry. Digital tools are altering the clinical workflow. Intraoral scanners, CAD/CAM systems, 3D printing, advanced imaging and AI are changing how information is captured, treatment is planned, and care is delivered. Dr Batra sees AI as particularly useful when clinicians need to collate and assess large amounts of information for diagnosis, prognosis and treatment planning.
But he draws a clear line between assistance and responsibility. "Digital technology and AI are going to change how dentistry will be delivered, but the outcomes will still be in the hands of the dentists," he said. A system may help analyse an image or organise information, but a dentist must weigh the patient's medical history, circumstances and ethical consequences. For Dr Batra, AI can add value to diagnosis and treatment planning, while the final ethical decision remains with the dentist.
What Should Never Become Digital
Asked to imagine a dental clinic in 2036, Dr Batra described dentists with scanners, printers and a much larger digital toolkit. He does not expect the patient's experience to become less human. He believes compassion and skill will continue to define care.
Asked what should never become digital, he answered directly: "Human relationships cannot become digital." Trust, faith and compassion, he said, remain at the heart of the doctor-patient relationship.
AI can improve diagnosis and planning, and digital tools can make treatment faster and more precise. But the patient still has to trust the person making the final decision.
When asked what dentistry should be remembered for, Dr Batra looked beyond better teeth to earlier diagnosis, better health, stronger smiles and greater confidence. His final definition was: "The healthiest smile is not perfect. It is teeth in harmony and the patient in full confidence."
