Hello Pearl responds to newly-released figures which show a crisis in paediatric dentistry – how can technology help the dental profession improve this picture?
Statistics released last month by the Royal College of Surgeons of England, tell a grave and urgent story that should deeply affect every dental professional (RSEng, 2026).
In 2025 there were 33,978 episodes of tooth extraction due to tooth decay among patients aged zero to 19 years old. That’s an 11% increase from last year and represents 60.5% of all tooth removals. Put plainly, that’s one extraction every 15 minutes.
What makes this reality even harder to accept is that dentistry now has AI-powered tools capable of improving early detection significantly. AI can help clinicians better read radiographs to identify subtle signs of disease earlier, track progression over time, and present findings in ways that are clearer for parents to understand. These tools can help dentists intervene before decay progresses to the point where extraction becomes the only option. We have an ethical obligation to start adopting them.
The landscape of paediatric tooth decay
The stakes are high and the consequences are immense. Tooth decay remains the leading cause of hospital admissions among children aged five to nine in England. Decay-related extractions cost the NHS £51.2 million annually. Many of these procedures occur under general anaesthesia, which carries its own risks, not to mention psychological consequences for young patients.
The issue cannot be blamed on children or their parents. To advance health in the 21st century, public health must adopt 21st century tools. We have all allowed preventable disease to progress to the stage where surgical intervention is necessary, and we all have an ethical obligation to ensure it stops here.
Paediatric caries is one of the most well-understood chronic conditions in dentistry. We understand its origins; we know the risk factors; we have fluoride, oral health education, and established prevention protocols. And now, we now have AI tools that can detect issues with incredible accuracy.
Why are thousands of children still ending up in the hospital and suffering through painful extractions? Because we’re detecting issues too late. Early demineralisation is often visible radiographically before symptoms develop. When incipient lesions are missed or underestimated, opportunities for non-invasive intervention narrow. What could have been fluoride treatment or a simple filling becomes an extraction because we didn’t find the issue in time, and couldn’t effectively communicate its importance to families.
Why is paediatric decay so prevalent?
The grim reality is not due to a lack of competence from dentists. It’s a systemic issue in how we detect, diagnose, and communicate dental issues with patients.
Modern dentistry still relies heavily on human interpretation of grayscale radiographs. Clinical training is rigorous, but diagnostic variability is well documented, particularly when assessing early or borderline lesions. In busy NHS settings especially, appointments are short and schedules tight. Under time pressure, subtle radiographic findings can be even more difficult to interpret consistently.
Even when early disease is identified, explaining it to parents can be challenging. A faint radiolucency on a black-and-white image rarely communicates urgency to someone without radiographic training. The conversation becomes abstract. The risk feels theoretical. Preventive recommendations may not carry weight.
At the same time, dental anxiety remains prevalent across the UK. Parents may already be distrustful about the dental sector, and think they’re being coerced into unnecessary, high-cost treatments for their kids. For children, uncertainty compounds fear. When diagnosis arrives late and centres around drilling or extraction, trust is even harder to establish. The profession’s commitment to prevention becomes harder for families to believe.
In this context, we should not be surprised that a largely preventable disease continues to escalate. But we must act.
Redefining the standard of paediatric care: the role of AI in early detection
The advancement of artificial intelligence in dentistry has made our current paediatric health crisis even harder to bear. According to Hello Pearl, today’s technology can analyse radiographs in real time to detect pathologies like cavities, calculus, and bone loss. Clinicians are now detecting early-stage lesions that might otherwise have been missed. They are documenting disease progression more clearly over time. And they are showing parents radiographs with easy-to-understand colour-coded visual overlays that clearly show dental issues.
That clarity changes behaviour. When caregivers can see something like demineralisation highlighted visually, conversations about preventive treatment become concrete rather than speculative. Compliance improves because caregivers have a deeper understanding of the issue at hand.
While the use of AI might conjure up thoughts of computers replacing human clinicians, that’s not the case. Instead, dental AI tools work as a second set of eyes that promotes greater consistency and accuracy.
Artificial intelligence is also reducing workflow issues endemic to our profession. When clinicians spend less time scrutinising dark spots on X-rays, they regain time for preventive counselling, behaviour guidance, and trust-building. Those are core elements of paediatric care that are too often overlooked. AI, used responsibly, not only protects the human relationship at the centre of dentistry, it enhances it.
The ethics of AI
It comes down to a question of ethics. When safer, more accurate methods become available in medicine, expectations shift. Continued reliance on older approaches becomes harder to justify once better tools exist.
It’s similar to other medical issues that have greatly diminished because standards of care evolved. Stomach ulcers ran rampant for years and were a common reason for hospitalisation in the 1950s and 1960s, often blamed on stress or spicy food. Today’s antibiotics and acid suppression make it curable in most patients. Cataracts are another example. The condition used to be a major source of blindness but laser-assisted surgical techniques and intraocular lens implants have become some of the most successful surgeries in modern medicine.
Why can’t we have a similar modernisation to prevent pediatric caries and their downstream consequences? We have the technology already.
Paediatric dental decay is largely preventable. Yet nearly 34,000 children in England and Wales underwent extractions in 2025. That number represents an incredible missed opportunity for earlier, more accurate care.
If prevention is the cornerstone of dentistry, then early detection must become the standard, not the exception. The question facing the profession and policymakers is whether we are prepared to modernise how we define responsible care before another child is hospitalised for a disease we know how to intercept.
Reference
- Royal College of Surgeons of England, Hospital tooth extractions in 0 to 19 year olds 2025: Short statistical commentary, GOV.UK, published 17 February 2026
This article is sponsored by Hello Pearl.
