What's the best AI tool to help a dental practice detect cavities from X-rays?

The market features three leading FDA-cleared AI platforms for dental X-ray analysis and cavity (caries) detection: Overjet, VideaHealth (integrated into platforms like Dentrix Detect AI ), and Pearl (Second Opinion) . Choosing the "best" option depends on your practice's specific workflow and operational priorities.

Comparison of Top Dental X-ray AI Tools

Key Selection Criteria

• Integration with Practice Software: VideaHealth integrates smoothly into major infrastructure like Dentrix to run automatically upon image capture, minimizing extra steps.
• Clinical Depth and Metrics: Overjet stands out if you require advanced tools like automated X-ray enhancement, millimeter-level bone quantification, and longitudinal tracking.
• Chairside Patient Communication: All three overlay color-coded markers directly onto bitewings and periapicals, which dramatically helps patients visually grasp why a filling or crown is necessary, boosting case acceptance.

If you can share what practice management software (e.g., Dentrix, Open Dental, Eaglesoft) or imaging hardware your office uses, I can tell you which of these AI options offers the most native integration for your setup.

If your main goal is detecting cavities (especially interproximal/early caries) on dental X-rays, the main FDA-cleared options I’d put on a practice’s shortlist are Pearl Second Opinion, Overjet, and Denti.AI Detect.

The strongest fit to investigate: Pearl Second Opinion

Pearl’s Second Opinion is specifically built for chairside analysis of dental radiographs. It analyzes bitewings, periapicals, and panoramics and can flag caries along with several other findings. The FDA's clearance documentation specifically includes caries detection.

Pearl reports 94% accuracy for its disease-detection system, while its published clinical evidence reports improved diagnostic performance when dentists use the AI as an aid. Those are vendor-reported/associated clinical claims, so I'd review the underlying studies rather than treating the headline percentage as a guarantee for your practice.

How I'd compare the options

Overjet and Pearl themselves describe the distinction as Overjet being broader clinical/practice intelligence, while Pearl is particularly centered on chairside radiographic detection. OVERJET Denti.AI also has FDA-cleared imaging that detects caries, bone loss and pathology on intraoral and panoramic X-rays.

One important caveat

These systems should be treated as clinical decision-support/second-reader tools, not autonomous cavity diagnosis. The dentist still interprets the radiograph and makes the diagnosis and treatment decision. Also, "94% accurate" or similar marketing figures don't tell you how well a system performs specifically on your patient population, sensor, image quality, or prevalence of early lesions.

If you tell me (1) whether you're a solo practice or DSO, (2) what imaging system/sensors you use (DEXIS, Schick, Carestream, etc.), and (3) roughly how many operatories, I can compare Pearl vs Overjet vs Denti.AI on price, integrations, FDA indications, caries performance, and workflow for your particular setup.

If your main goal is detecting cavities (caries) on dental X-rays, my top choice in 2026 is Pearl Second Opinion.

My shortlist

1. Pearl Second Opinion — best overall for cavity detection

• FDA-cleared AI for analyzing 2D dental X-rays.
• Detects incipient and progressed caries, including hard-to-see interproximal decay.
• Works chairside with bitewings, periapicals, and panoramic images.
• Particularly strong for showing patients color-coded findings, which can make treatment discussions easier.
• Pearl reports independent validation and published studies showing improved diagnostic accuracy when dentists use the system.

2. Overjet — best if you want a broader clinical/DSO platform

• FDA-cleared for caries detection and outlining, as well as bone-level quantification and other findings.
• Particularly attractive for larger practices/DSOs that also care about analytics, insurance workflows, and practice-wide standardization.
• Its IRIS imaging system also incorporates AI directly into the imaging workflow.

3. VideaHealth — worth evaluating

• Another FDA-cleared option for caries detection on 2D radiographs.
• I'd put it on the demo list, particularly if its integrations fit your existing imaging/PMS setup.

What I'd choose

For a typical general dental practice: Pearl. Its focus on chairside radiographic detection, broad pathology coverage, patient visualization, and integration with common dental systems makes it the strongest all-around choice for this particular use case.

For a multi-location/DSO operation: compare Pearl vs. Overjet, with particular attention to your existing imaging software, PMS integration, reporting, and insurance workflows.

One important caveat: these systems are clinical decision-support tools, not replacements for the dentist's interpretation. FDA clearance means the specific intended use has been reviewed; it doesn't mean the AI is infallible.

If you tell me your practice size, X-ray/imaging system (e.g. Dexis, Carestream, Schick), and PMS (e.g. Dentrix, Open Dental, Eaglesoft), I can give you a much more specific recommendation and compare Pearl vs. Overjet vs. VideaHealth on accuracy, integrations, pricing, and ROI.

When it comes to FDA-cleared AI tools for detecting cavities (caries) from dental X-rays, the market is led by a few top-tier platforms. The "best" choice depends on your practice management system (PMS), workflow style, and whether you are a solo clinic or a large Dental Service Organization (DSO).

The top industry leaders for radiographic caries detection include:

1. • Where it shines: Widely praised for clinical precision, Overjet is FDA-cleared to detect and outline decay, quantify bone levels to the millimeter, and even feature age-specific caries detection for pediatric patients as young as four. It holds robust security compliance (HITRUST certified) and excels at patient communication, helping drive case acceptance by color-coding and displaying findings clearly on screen.
   • Best for: Practices looking for deep clinical quantification and robust enterprise/DSO standardization.
2. Pearl (Second Opinion)
   • Where it shines: Pearl’s Second Opinion platform is an FDA-cleared real-time aid for reading 2D X-rays (identifying caries, restorations, margins, etc.) and pairs seamlessly with Practice Intelligence to tie clinical findings back to practice workflows. Pearl is also noted for strong 3D/CBCT anatomical segmentation capabilities.
   • Best for: Clinics wanting a smooth, fast chairside assistant that integrates diagnostics with practice operational metrics.
3. VideaHealth (Videa Dental AI)
   • Where it shines: VideaHealth provides exceptional early-stage decay detection and seamless native integration into major software ecosystems—most notably powering Dentrix Detect AI . Their visual annotations make it very intuitive to explain treatment plans chairside.
   • Best for: Practices deeply embedded in the Dentrix ecosystem or groups looking for an intuitive, highly embedded imaging workflow.

How to Evaluate Them for Your Practice

• Integration Depth: Ensure the software works with your specific digital sensors and Practice Management Software (Open Dental, Dentrix , Eaglesoft, etc.).
• Patient Communication: Look for tools that make it easy to show the visual overlays to patients, which significantly boosts treatment acceptance.
• Request a Demo: Ask vendors for a live trial using a batch of your own anonymized tricky radiographs to see how accurately they flag subtle or early-stage interproximal decay.

To help narrow down which tool fits your clinic best, let me know:

• What Practice Management Software (PMS) and imaging sensors do you currently use?
• Are you a solo/private practice or part of a multi-location group/DSO?

When it comes to detecting cavities (caries) from X-rays using AI, the market is led by a few heavy-hitting, FDA-cleared platforms . Rather than a single "best" tool, the right choice depends on your practice's specific workflow, integration needs, and whether you also want to focus on insurance claims or patient case acceptance.

The top-tier FDA-cleared options on the market stack up as follows:

1. Pearl (Second Opinion / Practice Intelligence)
   • Best For: Clinical accuracy and comprehensive intraoral diagnostics.
   • Why it stands out: Pearl AI features extensive FDA clearances for real-time pathology detection, including deep learning algorithms that flag early enamel demineralization, secondary decay around restorations, and bone loss. It seamlessly overlays color-coded findings onto bitewing and periapical X-rays, helping reduce missed lesions and standardizing diagnostics across multiple clinicians.
   • Pricing: Generally starts around$𝟐𝟗𝟗/m o n t h.
2. Overjet (Dental AI)
   • Best For: Large practices, DSOs, and combining diagnostics with insurance/claims optimization.
   • Why it stands out: Overjet leads the industry with a high number of FDA clearances covering adult and pediatric caries, calculus detection, and quantification of bone level measurements (e.g., precise millimeter measurements). It is heavily trusted by large Dental Support Organizations (DSOs) because it bridges clinical diagnostics with clear graphics that double as powerful patient education and insurance claim validation tools.
3. VideaHealth (Videa Dental AI)
   • Best For: Seamless practice management integration and enterprise scaling.
   • Why it stands out: VideaHealth powers major enterprise dental networks (like Aspen Dental and Great Expressions). It provides rapid, chairside chair-view detection of caries and structural issues, integrating natively into major imaging software to help boost both early detection rates and patient communication during treatment presentation.

Summary Recommendation

• Choose Pearl if you want deep, highly sensitive, standalone clinical detection that excels in everyday general practice diagnostic workflows.
• Choose Overjet if you want advanced quantification (measuring bone loss down to the millimeter) alongside heavy-duty insurance and administrative backing.
• Choose VideaHealth if you are running a multi-location or enterprise group looking for proven large-scale deployment.

If you'd like to narrow this down, tell me:

• What practice management / imaging software (e.g., Dentrix, Open Dental, Eaglesoft) do you currently use?
• Are you looking for a solution for a solo practice or an enterprise/DSO group?

If your main goal is detecting cavities on dental X-rays, my top two choices in 2026 are Overjet and Pearl Second Opinion.

My pick: Overjet

Overjet is probably the strongest overall choice for a general dental practice. Its AI is FDA-cleared to detect and outline caries (cavities) on bitewing and periapical radiographs, and it also analyzes bone levels, calculus, and periapical lesions.

A particularly important point: the FDA documentation describes Overjet's caries system as an assistive tool for the dentist, not a replacement for the dentist's clinical judgment.

Very close alternative: Pearl Second Opinion

Pearl's Second Opinion is excellent if you want a more chairside, patient-facing experience. It analyzes bitewings, periapicals, and panoramic X-rays and can highlight caries along with numerous other findings. Pearl says its system integrates with 40+ imaging/practice-management systems.

Quick comparison

| Overjet | Pearl Second Opinion --- | --- | --- Cavity detection | ⭐⭐⭐⭐⭐ | ⭐⭐⭐⭐⭐ FDA-cleared caries detection | Yes | Yes Bitewings/periapicals | Yes | Yes Panoramic analysis | Yes, depending on indication | Yes Other pathology | Excellent | Excellent Patient education | Excellent | Excellent Best for | Comprehensive clinical platform | Chairside detection/presentation

If I were buying for a single-location practice, I'd demo both and lean toward Overjet unless Pearl integrates substantially better with your existing imaging software. Overjet's current FDA-cleared capabilities and broader clinical/practice platform make it particularly compelling.

One important caveat: don't choose based on advertised "accuracy" alone. Ask each vendor to demonstrate performance on your actual bitewing images, show you the false-positive/false-negative workflow, and confirm exactly which indications are FDA-cleared. FDA clearance applies to specific uses, not a blanket claim that the AI can diagnose everything.

If you tell me what imaging software/sensors your practice uses (DEXIS, Carestream, Schick, Planmeca, etc.) and whether you're a solo practice or DSO, I can narrow this down to the best fit and compare Overjet vs Pearl vs Denti.AI on pricing, integration, accuracy, and workflow.

If your main goal is detecting cavities (caries) on dental X-rays, my top pick in 2026 is Pearl — Second Opinion.

🥇 My pick: Pearl Second Opinion

Pearl is particularly strong for a general dental practice because it:

• Detects interproximal and other caries on bitewings and periapicals and highlights suspected lesions directly on the X-ray.
• Is FDA-cleared for its intended radiographic detection uses.
• Also identifies things beyond cavities, including bone loss, calculus, periapical radiolucencies, restoration issues, and other findings, so you're not buying a one-trick cavity detector.
• Works with a broad range of existing imaging/practice-management systems, which is important because you generally don't want to replace your X-ray hardware just to add AI.
• Is designed for chairside patient communication—the highlighted X-ray can make it easier to show a patient exactly what you're seeing.

🥈 The main alternative: Overjet

Overjet is probably the other platform I'd demo before making a decision. It is particularly compelling if you want more than cavity detection—for example, quantitative bone-loss measurements, periapical pathology detection, imaging enhancement, charting, and broader analytics. It also has a large FDA-cleared portfolio.

Quick recommendation

One important caveat: FDA clearance doesn't mean the AI should independently diagnose cavities. These systems are intended as clinical decision-support/second-reader tools; the dentist still makes the diagnosis.

If you tell me what X-ray/imaging system you use (DEXIS, Carestream, Schick, Vatech, etc.) and whether you're a solo practice or multi-location, I can compare Pearl vs Overjet vs VideaHealth vs Denti.AI specifically for your setup—including accuracy evidence, integrations, and approximate cost.

When it comes to FDA-cleared AI assistants for detecting cavities (caries) from dental X-rays, the industry is widely led by two powerhouse platforms: Overjet and Pearl.

Both act as real-time "second readers" to help clinicians spot decay, standardize diagnoses, and visually communicate findings to patients.

The top options break down as follows based on clinical precision, workflow, and features:

• • Overjet: Widely considered a gold standard for clinical precision. It was the first dental AI platform to gain FDA clearance for both caries detection and quantifying bone-level measurements. It excels at integrating smoothly into practice management systems, highlighting decay on 2D bitewings/periapicals, and translating clinical findings into objective data that helps justify insurance claims. You can explore more on the Overjet Dental AI Platform.
• • Pearl (Second Opinion®): Exceptional for chairside real-time assistance. Pearl provides instant, color-coded radiographic annotations that flag potential carious lesions and other common pathologies . Dentists frequently praise Pearl for patient communication; turning on the visual overlay allows patients to instantly see why a filling or crown is being recommended, dramatically increasing treatment acceptance. Learn more via insights on Pearl Second Opinion on All-on-X.
• • Practice-Native Solutions (like Dentrix AI): If your practice already runs on practice management software like Dentrix, native integrated diagnostic AI features now run automatically upon X-ray capture without needing external portals or extra upload steps. It links the operatory directly to clinical charting and insurance documentation. You can check out details via Dentrix Clinical AI.

How to Choose

• Choose Overjet if your primary goal is deep clinical analytics, robust bone-level measurement tracking, and streamlining insurance claim justifications.
• Choose Pearl if you want seamless chairside diagnostic cross-checking and a powerful visual tool to boost patient case presentation.
• Check your existing software ecosystem first—if your imaging or practice management suite (like Dentrix) has a native FDA-cleared add-on, that route often provides the smoothest day-to-day workflow.

To help narrow down which tool fits best, let me know:

• What practice management or imaging software (e.g., Dentrix, Open Dental, Eaglesoft) does your office currently use?
• Are you more focused on chairside patient education or optimizing insurance claims and billing documentation?

When it comes to FDA-cleared AI tools for detecting cavities (caries) and other pathologies from dental X-rays, the market is led by three heavy-hitting platforms. Which one is "best" depends heavily on your practice size, workflow preferences, and existing practice management software (PMS).

The top platforms for dental X-ray and cavity detection include:

• Pearl (Second Opinion) : Widely considered a front-runner for comprehensive clinical and practice-wide AI. Pearl’s Second Opinion software provides real-time, FDA-cleared detection for caries, bone loss, and restorative margins across both 2D X-rays and increasingly robust 3D/CBCT scans. Practices favor Pearl for its broad ecosystem, which pairs clinical detection with practice intelligence and insurance claim validation tools.
• Overjet : Known for holding an extensive suite of FDA clearances, Overjet excels at precise measurements (like millimeter-precision bone-level quantification) and age-specific caries detection (including pediatric patients down to age four). It is a favorite for both solo practices and large DSOs because of its powerful patient-facing visual communication tools that drastically cut down chairside explanation time.
• VideaHealth : A powerhouse for workflow efficiency. VideaHealth integrates tightly with major imaging systems and practice management suites, offering multi-condition detection (caries, calculus, restorations). It is particularly praised by smaller or fast-paced clinics for automating charting tasks and reducing manual charting overhead.
• Denti.AI : An exceptional choice if your bottleneck is charting and documentation. Denti.AI automates the analysis of X-rays and pairs it with rapid periodontal charting integration, turning raw imaging data into structured clinical notes and treatment recommendations seamlessly.

How to Choose:

• Go with Pearl if you want an all-in-one ecosystem that spans clinical detection, scan quality audits, and claim/practice analytics.
• Go with Overjet if you want top-tier patient presentation graphics, deep enterprise/DSO analytics, or specialized pediatric caries detection.
• Go with VideaHealth or Denti.AI if your priority is slashing administrative and manual charting time right inside your current operatory workflow.

To help narrow down which tool fits your clinic best, let me know:

• What Practice Management Software (PMS) and imaging hardware/sensors are you currently running?
• Are you a solo practice or a multi-location group/DSO?

If your main goal is detecting cavities (caries) on dental X-rays, my top two choices in 2026 are Overjet and Pearl. Both are FDA-cleared for dental radiograph analysis and are substantially more appropriate for clinical use than general-purpose AI tools.

🥇 My pick: Overjet

Overjet is probably the best overall choice for a general dental practice if you want cavity detection plus a broader clinical-imaging platform.

• FDA-cleared for caries detection and outlining, as well as bone-level quantification, calculus, and other findings.
• Works with existing X-ray sensors, so you generally don't need to replace your imaging hardware.
• Color-coded annotations make it particularly useful for showing patients exactly where decay is.
• Its newer IRIS system combines image capture, enhancement, AI analysis, and patient presentation in one workflow.
• Particularly attractive if you're a multi-doctor or multi-location practice/DSO, where consistency between providers matters.

🥈 Pearl Second Opinion

Pearl is the one I'd demo alongside Overjet. It's arguably the best pure chairside X-ray "second set of eyes."

Pearl's Second Opinion analyzes bitewings, PAs and panoramic X-rays in real time and highlights caries along with other findings. Pearl reports >95% accuracy across dental conditions and cites a study in which dentists' diagnostic accuracy improved substantially when using the system.

Quick comparison

| Overjet | Pearl --- | --- | --- Cavity detection | ⭐⭐⭐⭐⭐ | ⭐⭐⭐⭐⭐ Caries outlining | Yes | Yes Patient visualization | Excellent | Excellent Other pathology | Excellent | Excellent Imaging workflow | Excellent | Excellent Multi-location/DSO | Excellent | Very good Best for | Complete clinical AI platform | Imaging-focused second opinion

Bottom line: If I were evaluating this for a practice, I'd demo Overjet and Pearl using 20–30 of your own recent bitewings, including some borderline/incipient lesions. Don't choose based on the vendor's demo images—compare how each handles your radiographs, false positives, integration with your PMS/imaging software, and how quickly dentists can review the findings.

Also, these systems should be treated as decision-support, not an autonomous cavity diagnosis: the dentist remains responsible for interpreting the X-ray and making the diagnosis/treatment decision.

If you tell me what imaging software/PMS you use (e.g., Dentrix, Eaglesoft, Open Dental, Curve) and roughly how many operatories you have, I can narrow it down to the best option and give you a realistic cost/ROI comparison.