Why AI Needs Governance in Dentistry
Artificial intelligence isn’t science fiction anymore — many dental offices are already using or considering AI‑powered tools for:
· Automated charting and documentation
· Imaging analysis (e.g., radiographs, CBCT interpretation)
· Smarter appointment reminders
· Billing error detection
· Patient communication automation
But without proper governance, AI can introduce bias, privacy risks, workflow disruptions, and legal exposures — especially in highly regulated dental settings.
The AMA STEPS Forward® module on AI governance lays out structured steps for safe and ethical AI adoption. This blog is my response to Governance for Augmented Intelligence from the American Medical Association (AMA). We (me and AI) have tailored its core lessons specifically for dental teams.
New Legal Requirement for Texas Dentists: SB 1188
Effective September 1, 2023, Texas Senate Bill 1188 (SB 1188) requires health care providers, including dentists, to disclose in writing to patients whenever an AI tool is used in diagnosis or treatment recommendations.
If you’re using AI for radiographic interpretation, diagnosis suggestions, or chart automation — you must notify your patients in writing.
This law underscores the importance of having a formal AI governance process that includes compliance with disclosure requirements and documentation practices.
Download: AI Use Disclosure Form
To help your practice stay compliant with Texas SB 1188 and maintain transparency with your patients, we have provided a customizable template.
Download the AI Use Disclosure Form Here
What Is AI Governance?
In health care, AI governance means creating a framework to evaluate, implement, monitor, and scale AI tools in ways that ensure:
· Safety and patient privacy
· Ethical use and fairness
· Compliance with laws and standards
· Staff readiness and training
· Measurable outcomes and continuous improvement
This isn’t about banning AI — it’s about managing AI responsibly so you get value without unintended harm.
Step‑by‑Step Framework for AI Governance in Dental Practices
The AMA toolkit outlines eight key steps. Here’s how to adapt them to dental settings:
Step 1 — Establish Practice Leadership and Accountability
Create a small AI governance team inside your practice — not a bureaucracy, but a clear leadership point. Include:
· Practice owner or manager
· Lead dentist
· IT or tech‑savvy team member
· Compliance or privacy coordinator
Make it clear who is responsible for evaluating AI tools and decisions in your office.
Step 2 — Hold a Working Group to Define Priorities
Your working group should:
· Inventory current and proposed AI tools
· Set priorities (clinical value, admin efficiency, cost saving)
· Identify potential risks (privacy, bias, error propensity)
Tools for this can be simple spreadsheets or checklists — but document everything.
Step 3 — Assess Current State and Prioritize Use Cases
Before adopting anything:
· Catalog what tools you already use (e.g., EHR suggestions, imaging AI)
· Identify where AI could add the most value (e.g., reducing no‑shows, improving chart completeness)
· Weigh benefits vs. risks
This assessment informs what you adopt — not the other way around. (edhub.ama-assn.org)
Step 4 — Develop Written Policies
Every AI tool should be governed by clear policies that describe:
· What the tool is intended to do
· When and how it should be used
· What data it will access or generate
· Who reviews the outputs
· How errors are reported and addressed
SB 1188 Disclosure Requirements: Incorporate written patient notice whenever AI is used in diagnostics or recommendations (required by Texas law).
Written policies/procedures protect you legally and operationally.
Step 5 — Define Intake and Assessment Processes
Before you adopt an AI product, evaluate:
· Vendor credentials and support
· Data security measures
· Impact on workflow
· Compliance with HIPAA/OSHA/other regs
· State-level disclosure laws (e.g., SB 1188 in Texas)
Control adoption through a repeatable process so decisions aren’t made ad hoc.
Step 6 — Update Implementation and Planning
Once approved:
· Plan technical integration (EHR, imaging software, billing systems)
· Set up training for staff
· Make sure you have fallback measures if the AI tool fails
This is not plug‑and‑play — it must be planned and tested.
Step 7 — Monitor and Oversight
Just “turning on” an AI tool isn’t enough. Regularly:
· Monitor performance
· Track error rates
· Watch for bias or unexpected results
· Review user feedback
Assign a responsible team member to report issues monthly or quarterly.
Step 8 — Support Readiness and Continuous Learning
AI evolves fast. Your governance committee should:
· Update policies as new tools and risks emerge
· Offer ongoing staff training
· Benchmark outcomes (time saved, errors avoided)
This turns short‑term use into long‑term transformation.
Why This Matters for Dental Practices
AI can improve care quality, reduce administrative burden, and enhance patient satisfaction — but only if it’s governed well. Poorly governed AI can:
· Miscode claims
· Introduce charting errors
· Violate patient privacy
· Create legal exposure
· Undermine trust in your office
Dental practices can adapt established governance principles from medicine to maintain compliance and quality care.
Practical Scenarios in Dentistry
Here’s how AI governance applies in real dental workflows:
· Automated Charting: Establish rules for reviewing AI‑generated notes before signing them.
· Diagnostic Imaging AI: Require dentist review of all flagged findings — AI assists, not replaces. (And disclose AI use per SB 1188.)
· Billing Alerts: Train staff on what constitutes a recommended vs. definitive suggestion.
· Patient Communication Bots: Limit PHI exposure and track responses for quality control.
· Every tool must have governance — even simple templates or auto‑responders.
Quick Governance Checklist for Dental Offices
Appoint an AI governance lead
1. Create a written AI policy
2. Conduct an AI use inventory
3. Define intake and vetting process
4. Monitor performance regularly
5. Train staff on outputs and limits
6. Review HIPAA standards and Texas SB 1188 with your attorney
7. Use this checklist at least yearly.
The Toothcop’s Take
AI isn’t here to replace your clinical judgment — it’s here to augment it. But without governance, even the smartest tools can create liability, bias, and compliance risks.
Governance isn’t red tape — it’s responsible innovation.
Feel encouraged to try new things. AI is here to stay. Purposefully evaluate this new technology and learn how you can leverage it to augment your dental practice operations. The use of technology will be the differentiator between you and the practice next door. Don’t get left behind.
As I alluded to earlier, I used AI to augment but not write this post. How did we do?
Do Good. Stay informed,
- Tink