Digitalization in dentistry: ethical challenges and implications

Objective: Scientific papers and books on digital dentistry are in vogue. In most cases, these publications focus clearly on the - undoubted - potentials and possibilities offered by digitalization. The fact that digital dentistry necessarily entails risks and ethical challenges, by contrast, is rarely discussed. This paper aims to complement the discourse on digitalization in dentistry by analyzing precisely these challenges. Method and materials: The study is based on an analysis of international publications and specialist writings on digitalization and its applications in the fields of dentistry and medicine, as well as on the analysis of specific contributions from the disciplines of medical ethics and medical law, and from the public media. Results: The paper identifies and discusses eight core challenges: (1) big data ("digital double" and falsification in dentistry), (2) the dental practitioner-patient relationship, (3) digital literacy, (4) the assumption of responsibility in complex systems, (5) accompanying changes in the dental professions, (6) cost trap and risks of overtreatment in dentistry, (7) consumption spiral and ecologic footprint, and (8) clinical evidence in dental treatments. In addition, a catalog of criteria for assessing the effects of digitalization in dentistry is developed. Conclusion: It is crucial to closely monitor both the potentials and the challenges posed by digitalization in dentistry. Ultimately, it is only those problems that are identified as such that can be resolved and only those technologies that are accepted by dentists, patients, and society that will prevail in the long term. Palabras clave: big data, clinical evidence, diffusion of responsibility, digital literacy, overtreatment