Abstract
Background/Objectives: The digital transformation of dental practice is positioning artificial intelligence (AI) as a key tool for both clinical support and administrative optimization. While clinical uses of AI are well documented, there is limited evidence on managerial perspectives. This study explored how dental clinic managers view digital workflow transformation and AI implementation. Methods: A cross-sectional questionnaire-based study was conducted among 200 managers of dental clinics from urban and rural areas in Bucharest, Romania. The survey evaluated perceived difficulty and availability related to digitalization, current use of digital tools, demographic characteristics (age, professional experience, practice environment), and attitudinal dimensions reflecting digital pragmatism and efficiency versus human impac. Results: Managers demonstrated moderate digital pragmatism (median 2.84, IQR 2.29-3.44), embracing AI mainly when linked to efficiency, operational control, and economic sustainability. Lower perceived difficulty was associated with higher availability, current use of digital tools, younger age, and fewer years of managerial experience. Urban managers were more likely than rural managers to report higher availability and current use of digital tools, although this comparison should be interpreted cautiously given the small rural subgroup. Efficiency considerations outweighed human-impact concerns (median 3.9, IQR 3.46-4.2), yet caution persisted toward solutions requiring major organizational restructuring or potentially affecting clinician-patient interaction. This study is a pilot, exploratory investigation aimed at generating preliminary insights into the phenomenon of interest and refining the methodological approach and hypotheses for subsequent, larger-scale research. Conclusions: Dental clinic managers approach AI adoption through an efficiency-driven and risk-aware framework, favoring incremental digital integration over disruptive transformation. The results underline the need for context-sensitive implementation strategies, managerial training, and targeted support, to ensure that AI-enhanced workflows improve efficiency while preserving organizational stability and patient-centered care.