Despite their potential to enhance evidence-based clinical decision-making, adoption among dental students remains limited because of insufficient trust in AI-assisted diagnosis and inadequate understanding of the economic value of AI-supported dental care. This study investigated the effects of perceived diagnostic usefulness, trust, and digital financial literacy on behavioural intention and AI-CDSS adoption among dental students. A cross-sectional survey was conducted with 350 dental students, and the data were analysed using partial least squares structural equation modelling (PLS-SEM). The results showed that perceived diagnostic usefulness (β = 0.356) and trust (β = 0.321) significantly enhanced behavioural intention, whereas digital financial literacy positively influenced trust (β = 0.287) and indirectly promoted AI-CDSS adoption. Behavioural intention was the strongest predictor of AI-CDSS adoption (β = 0.612) and partially mediated the relationships between the antecedent variables and adoption behaviour. The model explained 64.8% of the variance in behavioural intention and 37.4% of AI-CDSS adoption. These findings highlight the importance of integrating AI-assisted diagnostic training, clinical decision-support competencies, and cost-effectiveness evaluation into dental curricula to prepare future dentists for evidence-based, patient-centred, and technology-enabled oral healthcare.
