SOS Dental Trauma-人工知能チャットボット（WhatsApp経由）による歯科外傷患者へのガイダンス

Traumatic dental injuries (TDIs) are highly prevalent worldwide and require immediate and appropriate management to ensure favorable outcomes. The aim of the study was to develop and validate SOS Dental Trauma, an interactive artificial intelligence-based chatbot integrated with WhatsApp. SOS Dental Trauma was designed to provide first-aid guidance based on the International Association of Dental Traumatology (IADT) recommendations until professional care is available.

The chatbot was developed using natural language generation techniques, programmed with a structured clinical script strictly limited to dental trauma management in primary and permanent dentitions. The chatbot was implemented with the FastAPI framework in Python, hosted on a cloud server, and integrated into WhatsApp through Twilio. Validation was performed in two stages: (1) assessment by six independent experts in the field of dental traumatology (three general dentists and three endodontists) who evaluated clarity, appropriateness, and coherence of the interaction flow; and (2) performance testing with simulated clinical cases corresponding to trauma types included in the IADT ToothSOS application. Outcomes were defined as accuracy (correspondence to IADT guidelines) and completeness (including all clinically relevant steps). A minimum sample of 384 interactions was calculated, and a performance threshold of 90% accuracy was established. Cases not reaching this threshold were revised and retested.

Experts highlighted the need for more explicit question formulation and adjustments to interaction flow, which were incorporated into the final version. In the initial tests, the chatbot achieved 100% accuracy and completeness for permanent dentition. Nevertheless, it fell below the threshold in cases of primary dentition, particularly luxation and displacement, due to oversimplification of management options. After prompt revisions, the system achieved 100% accuracy and completeness for all trauma types. The chatbot provided structured, accessible, and user-friendly instructions in alignment with IADT recommendations, demonstrating consistency and reliability.

The SOS Dental Trauma chatbot showed high accuracy and completeness in simulated scenarios, offering immediate, evidence-based guidance for TDIs in both primary and permanent dentitions. Delivering structured recommendations through a widely used platform such as WhatsApp expands access to reliable first-aid information, supports patients and caregivers in dental trauma management, and has potential as a complementary tool in dental emergencies and health education.