We read with great interest the article by Dave and Patel, which discussed how artificial intelligence (AI) is transforming healthcare and dental education.1 More recently, the British Dental Journal featured ‘AI in dentistry: Innovation meets accountability', which highlighted how AI is reshaping diagnosis, treatment planning, and patient communication.2

We contend that digital dentistry and AI should be appraised not only for accuracy and efficiency, but for their capacity to enable care for patients with special healthcare needs (SHCN). Responsible AI must deliver measurable inclusion, not merely technical progress. Its integration into inclusive, patient-centred care remains limited. Most AI-related research and applications focus on image interpretation or workflow optimisation rather than accessibility for patients with behavioural, cognitive, or physical barriers.

Virtual reality (VR) exemplifies the opportunity. Evidence shows immersive VR can reduce dental anxiety and pain.3 Yet evidence on its use among adults with learning disabilities, autism, or complex medical conditions remains scarce – ironically, the groups most likely to benefit. A similar pattern is seen in other tools. A recent scoping review reported that intraoral scanners, CAD/CAM systems, and 3D imaging can improve diagnostic accuracy and patient comfort in special care dentistry.4 Unfortunately, most research still involves cooperative participants. Adults with disabilities who may struggle with conventional impressions due to restricted mouth opening, strong gag reflexes, or involuntary movements are rarely represented.

Clinical experience suggests that an adapted digital workflow can make treatment more achievable for special care patients. As an example, using gentle stabilisation and short, paused scanning sequences with a papoose board has enabled adults with intellectual disabilities to complete full-arch scans safely and comfortably. These digital models supported prosthodontic planning before general anaesthesia, reducing repeated visits. With thoughtful adaptation and the right tools, technology can make care both efficient and humane.

Although these technologies offer clear benefits, current studies often prioritise technical performance over inclusivity. Just as ramps and communication aids make clinics physically accessible, the same spirit should guide how we design digital spaces in dentistry. AI, VR, and other innovations should not only optimise efficiency but also ensure that individuals with SHCN are not left out. Grounded by ethical safeguards, these innovations can make dentistry not only more advanced but also more equitable.5 True progress should be measured not by how fast technology evolves, but by who it helps most. Innovation means little if it leaves the most vulnerable behind.