Omar A El Meligy, Ahmed O Elmeligy
Background/Objective: Artificial intelligence (AI) is increasingly transforming healthcare and has emerged as a promising tool in pediatric dentistry. This narrative review examines the methodological foundations, current applications, limitations, and future directions of AI in pediatric dental practice. Methods: A structured literature search was conducted in PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar for relevant English-language publications from database inception through to May 2026, using predefined search terms and eligibility criteria. Following screening and full-text assessment, 72 unique publications were retained for the narrative synthesis. Results: AI applications in pediatric dentistry include early childhood caries detection and risk prediction, dental plaque assessment, identification of mesiodens and supernumerary teeth, dental age estimation, automated tooth detection, fissure-sealant evaluation, and craniofacial growth prediction. Several imaging-based models demonstrated performance comparable to experienced clinicians. However, many studies relied on retrospective, single-center datasets and lacked external or prospective validation. Additional concerns included algorithmic bias, data privacy, limited interpretability, and infrastructure requirements. Conclusions: AI has considerable potential to improve diagnostic efficiency, consistency, and personalized preventive care in pediatric dentistry. However, it should be used as a clinical decision-support tool rather than a replacement for professional judgment. Future research should prioritize prospective multicenter validation, multimodal and explainable systems, standardized reporting, and ethical clinical implementation.