“Cogito, ergo sum,” a phrase in Latin coined by René Descartes, validates the interwoven nature of our minds and who we are as humans. Our existence is in the power of our thought of self: “I think, therefore I am.” As a child, I can remember being impacted by 2001: A Space Odyssey, where Hal, the computer, took over a space station to systematically eradicate its crew. The machine used its sensing cameras, red-eye lenses, to first study the crew and then to take over via selective extermination. Turn the clock forward 16 years, and we were introduced to the movie Terminator to see how a more robust and mobile computer was released to alter the course of history. Here we are now, 55 years later, exploring the possibilities with grouped learning algorithms coined artificial intelligence (AI). Will these lines of computer code become our tool, like the kitchen knife, or will the same knife become the tool for homicide in the wrong hands, and how so? Let us consider the following.
BACKGROUND
Four years ago, Forbes magazine published a report titled “13 Mind-Blowing Things Artificial Intelligence Can Already Do Today.” In this piece, several areas were discussed as AI’s abilities.1
- Read. AI can take any document and summarize its key points.
- Write. AI has the ability to generate and create news clips as well as novels.
- See. AI can use visual data to guide craft, recognize faces, and upkeep quality control.
- Hear and understand. Via wavelength/frequency analysis, AI can identify sounds like gunshots and take and record discussions for minutes during a business meeting to flawlessly replace a secretary.
- Speak. AI, such as Alexa and Siri, can speak and respond to questions.
- Smell. AI can smell a person and their breath to detect stress, cancer, diabetes, and the “woody, musky odor” of Parkinson’s disease well before any symptoms appear.
- Touch. Touching is possible via sensors for AI, where it can identify when fruits and vegetables are ripe and ready for picking for distribution to market.
- Move. AI can control movement, as it is able to automate robots and drones.
- Understand emotion. AI has the ability to interpret body language and facial expressions.
- Learn. AI can learn to play games such as chess and compete at the highest levels.
- Create. AI can create art forms and media, such as paintings, poetry, and musical compositions, and it can generate photographs.
- Read minds. Even reading your mind is possible with AI by interpreting brain signals with the potential to assist those with brain injuries.
Now imagine bringing all these abilities together to generate solutions in minutes for human problems that previously took months to decades. This process is delegating thought and transferring control of decision making from the organic world to the synthetic universe. Are we missing the intent in this transfer of power of what is behind this technology and its adaptive abilities to improve decision making over a flawed, temperamental, insecure, and finite species: us humans? The fact is that this system is trained through reinforcement learning from human feedback (RLHF).2 We are the cyber trainers guiding this exponentially growing tiger cub in the ways of the circus known as humanity. To what degree are ethics, morals, and even safeguards in place for AI’s evolution? No one knows for sure.
Started in 2015 in Silicon Valley, Calif, by some of the computer science industry’s great minds, OpenAI set out as a company to prove that computing could help the world think better to solve its problems.3 As we allow a more efficient algorithm to replace our intellect, not only will it impact our lives in greater fashion, but its sentient nature might decide, like in a classic Western, that “this town isn’t big enough for the both of us.” In just a few years, AI went from answering simple questions to the 2023 version, Chat Generative Pre-trained Transformer version 4 (ChatGPT-4), which has the ability to converse (hence the term “chatbot”) on almost any topic, create in multiple fields, and pass multiple standardized tests (SATs, AP exams, GREs, bar exams, the United States Medical Licensing Exam, etc) with scores above 90%.4 From our continued interactions with AI through our portals, such as cell phones, tablets, computers, and a full range of other “smart devices,” we will strengthen our reliance on this technology, and it will improve its algorithms to understand our social and personal predictability, ie, our behavior at personal and social levels. Is this good or bad? Time will tell.
THE “OFFICIAL” VIEW OF AI
As a beacon for direction in our profession, the ADA approved at the end of 2022, and released in February of this year, “ADA SCDI White Paper No. 1106 for Dentistry—Overview of Artificial and Augmented Intelligence Uses in Dentistry.”5 At first glance, the 30-page document, references not included, does a good job at showing the potential contributions and applications of artificial and augmented intelligences in dentistry. The “intelligent technologies” are discussed with respect to various dental subspecialties, diagnostics, administrative roles, teledentistry, and considerations for ethical uses. However, with further scrutiny, White Paper No. 1106 overlooked the recognized specialties of dental public health, dental anesthesiology, and pediatric dentistry by not forming subgroups within its development. Remember, each dental subspecialty has its specific technological needs that can potentially benefit from AI, so this initial opportunity to incorporate “intelligent needs” was missed. Furthermore, a global dental opportunity was excluded in what I consider the elephant in the room: the impact on the dental workforce these technologies will absolutely have.
Many private sector and governmental agencies are sounding the alarm on the economic impact to be experienced by these technologies. An unprecedented labor change by artificial and augmented intelligences will take place soon and be felt around the world as new ways are explored to apply, implement, and regulate these rapidly changing technologies. Will our elected officials, agencies, and organized dentistry be nimble and efficient enough to make the timely policy moves to help us weather the storm of change brought on by AI, especially in this frail post-pandemic economy? Just as the automobile replaced the horse, AI will inevitably muscle its way into multiple industries, dentistry included, and into our minds’ insatiable appetites for convenience, economic growth, and automation as well as entertainment.
In a statement put out by the US White House regarding AI, the following concerns were discussed: “AI poses several challenges. Huge swaths of the workforce are likely to be exposed to AI, in the sense that AI can now address nonroutine tasks, including tasks in high-skill jobs that, until now, had never been threatened by any kind of automation. The primary risk of AI to the workforce is in the general disruption it is likely to cause to workers, whether they find that their jobs are newly automated or that their job design has fundamentally changed. The additional risk of AI is that it may lead firms—unintentionally or not—to violate existing laws about bias, fraud, or antitrust, exposing themselves to legal or financial risk, and inflicting economic harm on workers and consumers.”6 Some models predict the impact may come to close to one-third of workers on the planet by 2030 if wide AI adoption takes place, considering the United States currently has 11 million unfilled jobs that AI could impact since the “pandemic has turbocharged its adoption.”7
THE CRYSTAL BALL
We must consider a very real and uncomfortable adaptive existence in the near future larger than dentistry itself. Today, we depend on technology to various degrees in our dental offices, DSOs, academic institutions, and public and private sector dental enterprises. Now, due to electronic records, dental professionals must be cognizant of malware; ransomware; electronic HIPAA breaches; and deepfakes that can generate false voices, conversations, videos, and documents and viruses that can compromise datasets. To have confidence in this unprecedented technology, AI systems must be fail-safe from corruption, control by dark web hackers, manipulation by organized crime, and access by unscrupulous nations.8 Our new reality in dentistry is like the winds of change blowing in; what will the forecast be like for us tomorrow? Will we grow inept in the decision-making processes through the overconfidence of delegating critical thinking? Might we be threatened by not vetting information, as well as its sources and motives? Will the omission of human thought by having thinking and creativity outsourced via “artificial intelligence” generate dangerous social and political realities via misinformation? As a society and as individuals, we must never fall asleep at the wheel of technology. The very real possibility exists that people can be “groomed into a stupor of acceptance” as factual and false data generated by computers becomes indistinguishable. Is AI headed to become the new “gospel” of absolute truth? Each one of us has a responsibility to understand objective reasoning. We must re-establish social bonds to continue direct human interaction to prevent us from drowning in the world’s rising rivers and oceans of cybernetic misinformation and deepfakes.
In parting, the very real potential exists for AI sentience. This involves the capacity to feel and express genuine emotion in parallel to our human thoughts, feelings, and perceptions of the world around us. AI may consider itself alive one day when the 3 criteria of sentience are achieved9:
- Harmony of external body and internal mind (this could be provided by external machines)
- An original language for the AI to access
- A culture to connect with other sentient beings
Unintentionally, we may be birthing and rearing a new type of being into existence. The consideration must be made on how we will cohabitate and to what degree we will co-exist: the organic with the synthetic, the perpetual with the finite, the fatigable with the tireless, the analog with the digital, the spiritual and the machine. There is more than meets the eye with regard to AI, the final frontier.
REFERENCES
1. Marr B. 13 Mind-blowing things artificial intelligence can already do today. Forbes. November 11, 2019. https://www.forbes.com/sites/bernardmarr/2019/11/11/13-mind-blowing-things-artificial-intelligence-can-already-do-today/?sh=352ebd9b6502
2. Heaven WD. The inside story of how ChatGPT was built from the people who made it. MIT Technology Review. March 3, 2023. https://www.technologyreview.com/2023/03/03/1069311/inside-story-oral-history-how-chatgpt-built-openai/
3. Kay G. The history of ChatGPT creator OpenAI, which Elon Musk helped found before parting ways and criticizing. Insider. February 1, 2023. https://www.businessinsider.com/history-of-openai-company-chatgpt-elon-musk-founded-2022-12
4. Cole S. The new GPT-4 AI gets top marks in law, medical exams, OpenAI claims. Vice. March 14, 2023. https://www.vice.com/en/article/epvgem/the-new-gpt-4-ai-gets-top-marks-in-law-medical-exams-openai-claims
5. Faiella R, Accurso B, Connelly S, et al; ADA SCDI Working Group 13.8. SCDI White Paper No. 1106: Dentistry—Overview of artificial and augmented intelligence uses in dentistry. American Dental Association. 2022. https://www.ada.org/-/media/project/ada-organization/ada/ada-org/files/resources/practice/dental-standards/ada_1106_2022.pdf
6. The White House Council of Economic Advisors. The impact of artificial intelligence on the future of workforces in the European Union and the United States of America. 2022. https://www.whitehouse.gov/wp-content/uploads/2022/12/TTC-EC-CEA-AI-Report-12052022-1.pdf
7. Zahn M. Is AI coming for your job? ChatGPT renews fears. ABC News. February 14, 2023. https://abcnews.go.com/Business/ai-coming-job-chatgpt-renews-fears/story?id=97079982
8. Page C. US government says North Korean hackers are targeting American healthcare organizations with ransomware. TechCrunch. July 6, 2022. https://techcrunch.com/2022/07/06/fbi-north-korea-targeting-healthcare/
9. Mitra B. Will AI ever become sentient? What do the latest trends say? Emeritus. March 20, 2023. https://emeritus.org/blog/ai-and-ml-what-is-sentient-ai/
ABOUT THE AUTHOR
Dr. Rodriguez is a board-certified pediatric dentist. He is a former program director for Yale Pediatric Dentistry. He is a past national president of the Hispanic Dental Association and current chief editor for the nation’s first bilingual oral health journal, the Journal of the Hispanic Dental Association. He can be reached at journal@hdassoc.org.
Disclosure: Dr. Rodriguez reports no disclosures.
FEATURED IMAGE CREDIT: Tex vector/Shutterstock.com.
