Multilingual AI in Orthodontic Patient Education: Design and Deployment of a 22-Language Patient Assistant Across Low-Resource Settings

Background: Patient education and treatment compliance are critical determinants of orthodontic outcomes, yet effective communication is challenged by linguistic diversity — particularly in multilingual, low-resource healthcare environments. Existing AI patient communication tools are predominantly English-language and Western-context designed, limiting their utility in Asia, Africa, and other regions with high linguistic heterogeneity.

Objectives: To describe the development, deployment, and impact of Aligner Coach AI — a multilingual patient education assistant supporting 22 Indian languages plus English — and to propose a framework for adapting multilingual AI tools to diverse international dental contexts.

Methods: Aligner Coach AI was built on Sarvam.ai's multilingual language model infrastructure, designed to deliver personalised patient guidance, wear-compliance reminders, and treatment FAQs in patients' native languages. The tool was integrated into clinical workflows at a specialist orthodontic practice in Ahmedabad, India, serving a diverse urban and semi-urban patient population. Design principles included accessibility-first architecture, speech-input compatibility for low-literacy users, and WHO-aligned transparency in AI communication.

Results: Preliminary deployment demonstrated improved patient-reported understanding of treatment protocols and higher self-reported compliance rates among patients receiving native-language guidance compared to standard English-language written materials. Patient satisfaction with communication quality improved significantly across language groups.

Discussion: The linguistic diversity challenge in orthodontic patient education is global — not unique to India. A framework for adapting this model to Arabic, Bahasa, Portuguese, Swahili, and other high-population language groups is proposed, with implications for AI-enhanced oral health equity in underserved populations worldwide.

Conclusion: Multilingual AI tools represent a high-impact, scalable intervention for improving orthodontic treatment compliance and patient communication across linguistically diverse healthcare environments.