METHODS: Frontal view intraoral photographs fulfilling selection criteria were collected. Along the gingival margin, the gingival conditions of individual sites were labelled as healthy, diseased, or questionable. Photographs were randomly assigned as training or validation datasets. Training datasets were input into a novel artificial intelligence system and its accuracy in detection of gingivitis including sensitivity, specificity, and mean intersection-over-union were analysed using validation dataset. The accuracy was reported according to STARD-2015 statement.

RESULTS: A total of 567 intraoral photographs were collected and labelled, of which 80% were used for training and 20% for validation. Regarding training datasets, there were total 113,745,208 pixels with 9,270,413; 5,711,027; and 4,596,612 pixels were labelled as healthy, diseased, and questionable respectively. Regarding validation datasets, there were 28,319,607 pixels with 1,732,031; 1,866,104; and 1,116,493 pixels were labelled as healthy, diseased, and questionable, respectively. AI correctly predicted 1,114,623 healthy and 1,183,718 diseased pixels with sensitivity of 0.92 and specificity of 0.94. The mean intersection-over-union of the system was 0.60 and above the commonly accepted threshold of 0.50.

METHODS: Participants were invited from 3 day-care community centers. Intraoral photographs were captured and assessed by both GumAI (test) and a panel consisting of 2 calibrated periodontists and a dentist (benchmark). Mean sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, and F1 score were calculated to determine GumAI's diagnostic performance in comparison to the benchmark. User acceptance with this tool was assessed using 2 Rasch Theory-based 5-point Likert-type questions.

RESULTS: 44 participants were recruited out of 80 invited older adults. GumAI demonstrated a sensitivity of 0.93 and specificity of 0.50 compared to the panel's assessments, with a PPV of 0.90 and NPV of 0.56. The accuracy and F1 scores were 0.85 and 0.91, respectively. All participants expressed high acceptance of the process.

CONCLUSION: GumAI demonstrates high sensitivity, PPV, accuracy, and F1 score compared to the panel's assessments but falls relatively short in specificity and NPV. Despite this, the tool was highly accepted by older adults, indicating its potential to enhance gingivitis detection and oral hygiene management in community settings. Further refinements are necessary to improve specificity and validate usability measures.