Precision dentistry—what it is, where it fails (yet), and how to get there

OBJECTIVES: Dentistry is stuck between the one-size-fits-all approach towards diagnostics and therapy employed for a century and the era of stratified medicine. The present review presents the concept of precision dentistry, i.e., the next step beyond stratification into risk groups, and lays out where we stand, but also what challenges we have ahead for precision dentistry to come true. MATERIAL AND METHODS: Narrative literature review. RESULTS: Current approaches for enabling more precise diagnostics and therapies focus on stratification of individuals using clinical or social risk factors or indicators. Most research in dentistry does not focus on predictions — the key for precision dentistry — but on associations. We critically discuss why both approaches (focus on a limited number of risk factors or indicators and on associations) are insufficient and elaborate on what we think may allow to overcome the status quo. CONCLUSIONS: Leveraging more diverse and broad data stemming from routine or unusual sources via advanced data analytics and testing the resulting prediction models rigorously may allow further steps towards more precise oral and dental care. CLINICAL SIGNIFICANCE: Precision dentistry refers to tailoring diagnostics and therapy to an individual; it builds on modelling, prediction making and rigorous testing. Most studies in the dental domain focus on showing associations, and do not attempt to make any predictions. Moreover, the datasets used are narrow and usually collected purposively following a clinical reasoning. Opening routine data silos and involving uncommon data sources to harvest broad data and leverage them using advanced analytics could facilitate precision dentistry.