Key Takeaways
- Nigeria faces a significant and growing demand for specialist orthodontic care, highlighting a critical gap in access.
- Experts are calling for increased investment in orthodontic training, digital technology, and artificial intelligence to bridge this specialist deficit.
- While AI and digital tools offer immense potential for diagnosis, treatment planning, and remote monitoring, they must complement, not replace, professional human judgment.
- The Nigerian Association of Orthodontists (NAO) is advocating for a '360-degree perspective' in practice, encompassing ethics, technology, and mentorship.
- There is a crucial need for locally generated, ethically governed datasets to ensure AI systems are effective and relevant for Nigerian and African populations.
- Despite challenges like the migration of health professionals, the quality of orthodontic training in Nigeria is recognized as internationally competitive.
Nigeria is grappling with a burgeoning demand for specialist dental care, particularly in orthodontics, as the need for treating dental and craniofacial conditions continues its upward trajectory. This pressing issue has prompted experts to call for urgent action, advocating for greater investment in orthodontic training, the strategic adoption of digital technology, and the ethical integration of artificial intelligence (AI) into practice.
The call resonated strongly during the 20th anniversary conference of the Nigerian Association of Orthodontists (NAO) in Lagos. Specialists at the event underscored how advanced technology could be a powerful tool to extend specialist expertise to underserved communities across the nation. However, a crucial caveat was issued: AI must serve as a complement to, rather than a substitute for, the indispensable professional clinical judgment of orthodontists.
Embracing a 360-Degree Perspective
Professor Idia Izayi-Iyamu, National President of the NAO and Chief Medical Director of the University of Benin Teaching Hospital (UBTH), highlighted the anniversary as a pivotal moment. It offered an opportunity to critically assess the evolution of orthodontics in Nigeria and to strategically prepare practitioners for future challenges and opportunities. She emphasized the association's commitment to moving beyond traditional approaches, advocating for a comprehensive, '360-degree perspective' that integrates ethics, technology, mentorship, and clinical excellence.
“When we started 20 years ago, we were looking at it straight on, which is what we call one dimension. But if you look at life and the world we live in now, it is round. That is a 360-degree perspective with inclusion of Artificial Intelligence,” Professor Izayi-Iyamu stated. She added, “Younger orthodontists need a new version of lecture compared to what we had then because the world is digitally evolved. We said, let’s look at orthodontics holistically in 360 degrees. Let’s look at it from the ethical point of view. What are we doing right? What do we need to do right to get it right?”
AI: A Tool for Enhancement, Not Replacement
Delivering the keynote address, Professor Carlos Flores-Mir of the University of Alberta, Canada, elaborated on AI's transformative potential. He explained that AI could significantly improve access to orthodontic services, particularly by supporting early detection and facilitating timely referrals in regions with limited specialist access. Professor Flores-Mir detailed how emerging technologies, including digital imaging, intraoral scanning, 3D printing, remote monitoring, and data-driven treatment planning, are fundamentally reshaping orthodontic practice.
He noted that AI could assist with complex tasks such as diagnosis, cephalometric analysis, growth assessment, treatment planning, image segmentation, and patient monitoring. However, Professor Flores-Mir issued a strong caution against allowing technology to usurp the role of human clinicians. “AI should not replace the orthodontist. It should reduce the amount of mechanical work that prevents the orthodontist from doing what humans do best,” he asserted, underscoring that orthodontics remains a profession deeply rooted in human judgment and nuanced decision-making.
A critical point raised by Professor Flores-Mir was the imperative for Nigerian orthodontic institutions to develop locally generated and ethically governed datasets. This, he argued, is essential to ensure that AI systems deployed in the country accurately reflect the unique characteristics and needs of Nigerian and African populations. “An AI system is only as good as the data in which it is fed into it. If the data predominantly represents populations from other parts of the world, we should not automatically assume that the resulting algorithms will perform equally well with Nigerian patients,” he warned. He also stressed that the adoption of AI must meticulously address patient privacy, cybersecurity, informed consent, data ownership, and professional accountability.
Pioneering Growth and Enduring Quality
Reflecting on the remarkable development of the profession in Nigeria, Professor Michael Chukwudi Isekwu, widely regarded as a pioneer of orthodontics in Nigeria and sub-Saharan Africa, highlighted the significant progress. He noted the country's evolution from having only a handful of practitioners to boasting over 70 highly skilled specialists. Professor Isekwu, who holds the distinction of being the first professor of orthodontics in Nigeria and sub-Saharan Africa, proudly stated that the quality of orthodontic training in the country is globally competitive. “When you hear somebody is an orthodontist in this country, it equals orthodontists anywhere because I go to examine in England and America and I am a visiting professor,” he affirmed.
Professor Oluwatosin Sanu of the Department of Child Dental Health, College of Medicine, University of Lagos, and Consultant Orthodontist at Lagos University Teaching Hospital (LUTH), also a pioneer in local orthodontic training, recalled being among the first three locally trained orthodontists. She attributed the substantial growth of orthodontics in Nigeria to the visionary mentorship of Professor Isekwu, emphasizing how the expansion of residency programmes has consistently produced successive generations of highly competent specialists.
Addressing Broader Healthcare Challenges
Meanwhile, Professor Wasiu Adeyemo, Chief Medical Director of LUTH, acknowledged Nigeria's strides in healthcare delivery despite persistent challenges, notably the 'japa' syndrome – the migration of health professionals abroad. Professor Adeyemo called for intensified investment in healthcare infrastructure, robust training programmes, and strategic public-private partnerships. He expressed confidence that Nigerian specialists, despite limitations in equipment and infrastructure, possess the capability to deliver world-class services.
Why This Matters
The discussions at the NAO's 20th-anniversary conference underscore a critical juncture for Nigerian healthcare, highlighting how strategic integration of advanced technology and sustained investment in human capital are vital to address specialist shortages and elevate the standard of care. By embracing innovation responsibly and prioritizing local context, Nigeria can significantly enhance access to essential orthodontic services, ultimately improving public health outcomes and solidifying its position in global dental excellence.