Expert systems in dentistry. Past performance--future prospects.

Expert systems are knowledge-based computer programs designed to provide assistance in diagnosis and treatment planning. They assist the practitioner in decision making. A search of the literature on expert system design for medical and dental applications was carried out. It showed an increase in the number of articles on this subject. Between 1984 and 1991, 608 articles have been published in medical journals and two in dental journals. Because it is likely that this development will influence dental practice in the future a critical review of medical literature on the topic has also been carried out. A number of general principles are described to give the dental practitioner some insight into how expert systems work. A set of criteria have been formulated from the medical literature which expert systems should meet. These requirements are also applicable to dentistry and may be used to judge dental expert systems. In the last part of the paper the features of several dental expert systems developed in the past decade are described in the light of these criteria. It is concluded that in the future more attention should be paid to the development and evaluation of expert systems in the clinical setting. Only well-designed and properly evaluated expert systems can be expected to earn a place in everyday practice.