Written in collaboration with Fred W. Michmershuizen, Senior Editor, Inside Dental Hygiene and Inside Dentistry as part of their January/February Issue.
Innovative technologies are reshaping how clinicians detect, measure, and prevent disease.
Diagnostic dentistry is undergoing a rapid transformation. Tools that once relied heavily on tactile judgment, two-dimensional imaging, and subjective interpretation are now being supplemented by artificial intelligence, multimodal imaging, salivary and genetic assays, and engineering-based structural measurements. Together, these technologies are expanding what clinicians can detect early, measure objectively, and communicate clearly, and revealing a profession moving toward personalized, preventive, data-driven care.
Microbiology, Genetics, and Noninvasive Biological Diagnostics
Beyond enhanced imaging, several experts highlight the rapid expansion of not only salivary testing but also genetic assays that identify patients’ underlying biological risk factors well before any clinical signs emerge. Dr. Graham is excited about genetic testing. AI Genetics, a company based in Canada, offers a swab that can help predict a patient’s caries and periodontal risk—low, intermediate, or high—years before disease onset. He pairs this with saliva testing to monitor bacteria, matrix metalloproteinases, and other biomarkers, which can track whether a patient is improving or requires more preventative care.
Other technologies Dr. Graham highlights include transillumination and fluorescence. He’s been using DEXIS CariVu since 2014 to see cracks, craze lines, and proximal lesions without x-rays. He notes that the KaVo DIAGNOcam Vision Full HD combines fluorescence, transillumination, and a high-definition camera to enhance early detection. CaviSense, a single-use interproximal device, evaluates demineralization through pH changes, while GC Tri Plaque ID Gel highlights plaque and cariogenic risk in three ways, helping patients visualize their oral hygiene. Even home care has advanced. Dr. Graham praises the Slate power flosser as an effective tool for patients who struggle with traditional flossing.
Dr. Graham’s teaching today reflects a broad perspective. His focus has shifted to national speaking and hands-on education delivered through Catapult Education, the company he co-founded, now featuring more than 30 speakers. Most of the companies and technologies he references in his work partner with Catapult, underscoring the organization’s role in bringing promising innovations to clinicians.
When it comes to periodontal care and oral-systemic connections, new tools are emerging as important pillars of diagnosis. Periodontist Sam Shamardi, DMD, an educator, author, and entrepreneur, recently returned to Southern California after more than 16 years practicing on the East Coast. Alongside his clinical work, he has spent years in academia, serving on the Harvard postgraduate faculty and as an adjunct assistant professor at the University of Pennsylvania. He is also focusing on an often-overlooked issue in dentistry: hearing loss among dental professionals. When it comes to diagnostics as it relates to periodontology, he says, “With perio, we truly have the ability to help the patient, not just with their oral health, but their systemic health.” He points out that periodontics sits at the intersection of dentistry and medicine, but that this connection remains underappreciated both within and outside the profession.
“So much of what we sometimes miss comes as a result of either not having all the tools at our disposal or being rushed in the chair,” Dr. Shamardi says. He highlights three technologies that are transforming periodontal diagnostics: AI, saliva testing, and ultrasound. “AI helps us identify areas of bone loss, periapical lucencies, calculus, and infection that the naked eye might miss,” he says, noting that compared to traditional radiographs, AI software can distinguish vastly more gradations of gray, pinpointing areas that may need closer inspection. “Its job is not to diagnose; its job is to simply point out areas that may need closer inspection,” he says.
Saliva testing, Dr. Shamardi says, reinforces the link between oral and systemic health. “We can now identify five specific bacteria that have a direct impact on periodontal disease and implant complications, but also on systemic conditions like Alzheimer’s, diabetes, cancer, and adverse pregnancy outcomes.” With this knowledge, clinicians can tailor treatment plans and adjust long-term maintenance strategies. He says it’s particularly valuable for implant patients because it can flag those who are at higher risk for developing peri-implantitis.
Ultrasound is another emerging tool, Dr. Shamardi says. “We can measure pockets, identify defects in bone or tissue, and even assess blood flow after procedures like gum grafts to evaluate healing and implant protection,” he says.
Shervin Molayem, DDS, a periodontist and implant surgeon practicing in Los Angeles, emphasizes the critical role of technology in making diagnostic processes in dentistry more consistent and precise. With more than 15 years in clinical practice and a track record of innovation, he has focused on integrating multiple diagnostic tools to create objective, reliable measures for patient care.
Dr. Molayem highlights the subjectivity inherent in traditional dental diagnostics. Techniques such as gum probing and tooth mobility assessments often vary between practitioners and are dependent on tactile judgment, which can significantly impact treatment decisions. “The difference between a plus one and a plus two in mobility can determine whether a patient receives gum surgery or an extraction,” he explains. To address this, he has collaborated with AI-powered systems that bring greater consistency and precision to these measurements. One such tool measures probing depth with consistent pressure and precision using AI-assisted optics, while another quantifies tooth mobility through electromagnetic vibration analysis, providing an exact, reproducible value.
In addition to objective physical assessments, Dr. Molayem integrates salivary diagnostics and radiographic technology. Salivary testing allows identification and quantification of specific oral bacteria, enabling targeted interventions. He cites research showing that specific prebiotic mints can reduce harmful bacteria by 90% over several months, providing preventive measures that complement clinical diagnostics. Radiographic detection, enhanced by AI, can identify up to 37% more disease than the human eye alone, as AI can discern hundreds of shades of gray that are imperceptible visually, he says.
This article was originally published on Inside Dentistry. See the full article here: https://www.insidedentistry.net/2026/02/charting/