OR WAIT null SECS
Robert Elsenpeter is a freelance writer and frequent contributor to Dental Products Report and Dental Lab Products. He is also the author of 18 technology books, including the award-winning Green IT: Reduce Your Information System's Environmental Impact While Adding to the Bottom Line. As such, he’s particularly interested in the technological side of dentistry.
From advances in materials to new technology, 2018 looks to be a promising year for the dental industry.
The dental field has always been in a state of evolution and growth, and 2018 looks to be a continuation of that tradition. We talked to leaders in the dental world to find out what they expected to be new and exciting in the coming year. Their responses ran the gamut from technology to materials to industry changes.
3D printing has been capable, but not necessarily practical, for many dental applications in the past: cost per print, lack of materials and advances in milling were reasons to avoid taking the plunge into additive manufacturing. While advanced milling is still commonplace for same-day crowns and custom implant abutments, 3D printing has taken the lead in automating several otherwise manual dental lab processes, such as surgical guides, night-guards and stone models. Much like any other technology, industrial 3D printers are becoming smaller, and 3D printing manufacturers have since been targeting the dentist-consumer in an attempt to keep more of their lab costs in-house.
“With the continued momentum of 3D printing, we are getting closer and closer to seeing complete and partial dentures and more detailed restorations being created in-office,” says Lou Shuman, DMD, founder and CEO of Cellerant Consulting Group. “With the improved hardware and ever-expanding palette of 3DP materials, the technology is there and soon will be provided to us by the manufacturing community.”
Automated software using machine learning
In 2018, dentists can look forward to automated software taking over the time-consuming and imperfect science of keeping schedules filled with the right kinds of patients. Launching in 2018, MMG Fusion’s ChairFill will help achieve practice production goals by monitoring available chair time and scheduling pre-selected subsets of patients and procedures. Integrated patient communications and online scheduling allow ChairFill to operate completely independently of staff. The software is capable of monitoring and filling the schedule weeks in advance or detecting and filling last-minute cancellations.
“ChairFill can automatically go in to your patient records, pick out the most profitable dentistry that is available, communicate directly with the patient and schedule the patient, all by itself,” Dr. Shuman explains. “The practice decides how they want to communicate with the patient, by text, by email, or by video, and then they just press a button. By integrating ChairFill into their practice management software, the dentist can see which appointments the software has scheduled as well as how much revenue those appointments generated.”
With the expiration of some patents owned by Align, the increase in clear aligner companies is expected to balloon.
“The aligner market is huge,” Dr. Shuman says. “Obviously, Align has dominated that at about $1 billion in revenue per year, but the market is much bigger than that. With the patents starting to expire in 2018, you can expect the introduction of much more competition in the aligner market. Case in point, the acquisition of ClearCorrect by Straumann.”
Up next: The digital workflow...
“You can expect, in 2018, to see many more advances and products aimed at creating a digital workflow,” Dr. Shuman says. “For the digital-age dentist, it means enhanced speed, integration and accuracy.”
He anticipates improvements benefiting the entire workflow.
“Digital workflow has been one of the most important initiatives from the manufacturing community,” Dr. Shuman observes. “As you would expect, we want things better, faster and more accurate, and that’s exactly where the manufacturers are heading when it comes to digital workflow.”
The sleep space
Dr. Shuman says that the dental sleep space is “coming of age” in 2018. Boosted by the recent ADA policy that calls for every dentist to screen patients for sleep breathing disorders and to treat where appropriate with oral appliances, sleep is the next big thing in dentistry.
“The fact is, we, as dentists, have a huge opportunity to save lives by screening for sleep apnea and treating needy patients with appliance therapy,” Dr. Shuman says. “Sleep integration is not simple, however. Historically, you have had separate companies that provide education, medical billing, home sleep testing and sleep appliances, but these individual services didn’t necessarily work well together. Dentists have had trouble managing all these different providers.”
For example, a company like SleepArchiTx offers a one-stop solution for dental practices to implement a sleep screening and treatment program.
“Now, instead of working with multiple different companies, a company like SleepArchiTx makes it easier to add sleep to your practice,” Dr. Shuman says. “Screening and treating patients with sleep apnea can bring great benefits to your patient base as well as economic growth for the practice.”
Better restorative materials
Dr. John Flucke, DDS, Technology Editor for Dental Products Report, expects to see greater evolution on the bioactive materials front.
“We’re seeing that across the board withseveral different companies, where people are coming out with these products that will, overtime, convert to hydroxyapatite,” Dr. Flucke says. “I’m very enthused about the ability of different materials to do that. Basically, you put it on the tooth and, long term, part of that chemical will actually become a building block chemical that helps strengthen the tooth.”
The market, he says, looks ready to broaden.
“I think you’re going to see it pick up more in popularity as people see more products that do this kind of thing,” Dr. Flucke says. “When this came out, it was sort of a trade secret with two or three companies. Now you’re seeing more and more companies that have figured out how to create the stuff.”
Digital acquisition devices
“About 10 percent of offices are using some type of digital impressions,” Dr. Flucke says. “That number will continue to rise. We also need to see advancement in scanning for removable prosthetics. The software that does the acquisition will improve as well. I’m also looking for several new devices on the market.”
That growth, he observes, will come from more devices being available.
“We are seeing more and more scanners come on the market,” Dr. Flucke says. “It used to be, if you wanted a scanner a few years ago, we were just looking at E4D and CEREC. And the market has just blown up. Now you’ve got companies like Kodak, and there’s a lot of them coming from Europe and around the world. Last year, in Chicago, was the first time a lot of these European countries made the trek to America. There are a lot of these that are coming along. They probably won’t all stay for the long term because competition tends to shake things out, but the more market you see for these devices, the more doctors may say, ‘There’s something to this.’”
Up next: Improvements to IT security...
The practice’s IT security is an area where Dr. Flucke hopes to see more improvement.
“It reminds me of the performance-enhancing drugs in sports and the Olympics,” Dr. Flucke says. “They come out with these drugs that can’t be detected. So, it’s a constant cat-and-mouse game. And the good guys, whether it’s ransomware or finding the next sports-enhancing drug, they’re always working at a deficit. How do you know to look for something when you don’t know what it is you’re looking for? It’s like that with security. For instance, if somebody asks, ‘Have you ever had a data breach?’ I always say, ‘Not that I’m aware of’ because the best data breaches you never know about.”
The data breach isn’t so much about stealing a patient’s dental history. Instead, the attackers are interested in patients’ health records because it opens the door to identity theft.
“What the hacker cares about is that they have Mrs. Johnson’s first and last name, her date of birth, her Social Security number, her spouse’s name, her address, her cell phone number, her email address,” Dr. Flucke says. “Healthcare records are really coveted.”
While he expects advances in security tools, he hopes 2018 is the year dental professionals will pay more attention to it.
“There are going to be improvements in this from a detection standpoint, but really what I’d like to see is people taking this more seriously,” Dr. Flucke says. “What the bad guys have figured out is that healthcare is really, really open and ripe for picking.”
His concern is especially pointed at those practices with old and outdated systems that haven’t been properly upgraded and improved.
“Spend $500 or $1,000 and have somebody that knows something about IT security come in, look at your office, tweak your routers, and install some type of a hardware firewall or something,” he recommends.
“I feel that the dental economy is starting to rebound,” Dr. Flucke says. “The market for dentistry has been pretty much flat since the recession. It looks like things are starting to improve and I’m hopeful that will continue.”
That trend, he says, goes hand-in-hand with the larger economy.
“I think that people are finally starting to realize that the world is not going to end,” Dr. Flucke says. “That whole mess of 10 years ago with big investment companies going under, I think that really scared people. I think they were scared for quite a while and a lot of people got away from dentistry.”
He observes that the number people who dropped from two visits a year down to just one visit a year has skyrocketed. Seventy percent of adults in the United States only see a dentist once a year, he notes.
“In that regard, people are starting to see that you reap what you sow,” Dr. Flucke says. “People that have been putting it off are now starting to come in and say, ‘Oh my gosh, if I would’ve only bucked up and had two cleanings a year, now I wouldn’t have to pay for all this neglect. I think things are starting to rebound now.”
Dr. Flucke hopes physical attendance at educational events will improve.
“I’m hoping educational events will improve in attendance,” Dr. Flucke says. “Major meeting attendance is down as is attendance at CE events in general. Not everything can be learned online. There is no substitute for good, live CE. Unfortunately, the debt that graduates are under does two things. Number one, it limits what they can spend on CE, and number two, it forces many into corporate dentistry, which is more concerned with the bottom line than with doctors learning how to provide the absolute best treatment. This means corporate dentists frequently aren’t allowed to attend CE events the company doesn’t approve.”
Up next: Growth of cloud-based patient software...
Cloud-based patient software
Dr. Jason Watts, DMD, a general dentist in Lithia, Florida, looks to cloud-based patient software as a growing area in 2018.
“It’s cheaper when you start an office, on the IT setup end of it because you don’t need such a large control room,” Dr. Watts explains. “It can also be accessed anywhere on a computer. With all the natural disasters that are occurring from the previous year, I know a lot of dentists who lost multiple backups. At least with a cloud-based software, it’s much more simplistic, where you don’t need such complex technology in your office for your digital software. The only concern is really if the internet goes down, you can’t use it. But, I mean, how long do power failures really last these days? And you can buy a personal hotspot that you can use until your power comes back on.”
Going fully digital
Dr. Watts expects more dentists to embrace the digital workflow, too.
“People are just constantly questioning scanners and electronic health records and digital X-rays and whether it’s worth it or not,” Dr. Watts says. “It’s just time. No longer, ‘Is it worth it or not?’ The technology is there, it’s incredible, it’s cost-efficient. The only people that are resisting the change are the ones who just don’t want to make an investment because they’re just so stuck in their ways. No longer is it a discussion of, ‘Is this scanner good?’ Now it’s, ‘Which scanner is better because there are so many scanners.’ It’s just like going to a smartphone. ‘Is the smartphone better than a flip phone?’ People were so resistant, but now everyone is saying, ‘Which smartphone should I buy?’ There is no longer an excuse to not be digital in your office.”
Utilize a consultant
“If you want to grow, or think you are doing all you can, hire a consultant to come and challenge you further,” Dr. Watts says. “They will find out more you can save or better ways to improve.”
He notes that consultants can help with many different facets of one’s practice.
“If you are a practice owner or a dentist that’s wanting to grow and you feel like you’re stuck or you feel like you’ve already maximized your practice or your practice isn’t growing or you should be making more money, everyone should have a consultant,” Dr. Watts says. “The best dentists in America have consultants because it’s someone else challenging them to do more and someone else offering a different perspective that’s fresh and new to the practice.”
Bulk fill composites
Advancements in materials will make treatment as well as inventory management easier for doctors.
“Cutting costs on composite isn’t necessary anymore,” Dr. Watts says. “We have universal composites that can pretty much do almost anything. Instead of having 100 different inventories of composites in your office, you really only need one or two, and dentists that are just so old school when it comes to layering, it’s just not necessary anymore. The patient, in the end, just wants something that’s functional and they’re more concerned in today’s world about the length of an appointment than what it looks like because no one is going to look in their mouth that closely. Obviously, it’s personal pride to reconstruct artwork that belongs in the museum, but the end story is that patient will have a better experience coming in and out of the office faster than they would sitting there for 20 to 45 minutes to do a basic filling that you could do in 15 to 20 minutes.”
The new year promises exciting things for dental practices. Whether it be advances in materials, technology or the industry itself, 2018 will offer some exciting advances.