A Brief but Important Post

 

For those of us who are using mobile devices (and really... who isn't?) today's post should be read by everyone.  We live in a time where our lives are so much easier and so much more efficient due to the rise of digital data and the devices that bring that data to us.

I saw a stat a while back from a Google study that found the average smartphone user has their device within 1 meter of themselves over 97% of the time.  Of course when you think how many of us charge our device on a bedside table and use it as an alarm clock, it makes sense that, even while we're asleep, those devices are always near us.  

The Yin and Yang of the world means that the many positives our devices bring us, also bring along some unwanted negatives.  Most likely the biggest negative of our digital lives is the security of our data and our communications.  As I said in my May Technology Evangelist column in Dental Products Report, the criminal element has been with us ever since Adam & Eve were kicked out of the Garden of Eden.  

No mater your political leanings or beliefs, those of us in the US benefit greatly from a national security apparatus that works night & day to help protect us from nefarious parties who would love to disrupt our lives and/or get access to our personal and financial data.  One of those US government institutions is the NSA (National Security Agency).  According to Wikipedia, the NSA is responsible for global monitoring, collection, and processing of information and data for foreign intelligence and counterintelligence purposes, specializing in a discipline known as signals intelligence (SIGINT).

One of the NSA's area of expertise is in electronic and digital security.  Because of that, they have accumulated a great deal of information on how to help keep devices secure from unknown and outside sources.  When the NSA speaks, I perk my ears up and listen.  I don't listen blindly (and neither should you), but I pay attention where they make an announcement and try to then perform my due diligence.

Recently the NSA released a document detailing quite a few of  recommended "best practices" for mobile devices.  Many of them are common sense, but all of them are things I feel everyone should consider and be aware of.  In the last few years, there have been several stories in the news detailing organizations, both legitimate and nefarious, that have made it their business to create stealthy programs that can attack unknowing subjects and provide complete hidden access to all of the data and controls of mobile devices. 

While there is no way to be 100% sure your device has not been hacked, especially when the attackers are well funded and selling their services to governments, it still is important to do all you can to protect yourself.  Locks, as my grandfather used to say, are to keep honest people honest.

So take a look at the NSA document and implement its recommendations into your electronic security routine.

If you're like me and really get into this stuff, a great source to get information (and provide financial support if you are so inclined) is the Electronic Frontier Foundation.  

From their website:  

The Electronic Frontier Foundation is the leading nonprofit organization defending civil liberties in the digital world. Founded in 1990, EFF champions user privacy, free expression, and innovation through impact litigation, policy analysis, grassroots activism, and technology development. EFF's mission is to ensure that technology supports freedom, justice, and innovation for all people of the world.

EFF is a donor-funded U.S. 501(c)(3) nonprofit organization that depends on your support to continue fighting for users.

I hope many of you find this information useful.

DentalMonitoring Receives De Novo Approval by FDA for Orthodontic Remote Monitoring

 

AI continues to make incredible progress in the profession of dentistry.  We have seen AI systems that help with radiographic interpretation, scheduling, and even in the speciality area of orthodontic treatment.  I consider myself lucky to have been involved with AI in the profession since its infancy.  I've been able to work with several AI companies over the years and I am continually amazed at the progress this tech has seen in the dental market.

Now we are witnessing even more amazing developments in AI, with DentalMonitoring announcing a new De Novo approval from the FDA.

On May 20th, 2024, DentalMonitoring made waves in the dental industry by receiving De Novo approval from the U.S. Food and Drug Administration (FDA) for an innovative solution. This marks a significant milestone for both DentalMonitoring and the future of orthodontics, paving the way for a more tech-driven and accessible approach to dental care.

What is DentalMonitoring?

DentalMonitoring is a software-as-a-medical-device (SaMD) that utilizes artificial intelligence (AI) and machine learning to remotely monitor orthodontic treatment progress. Here's how it works:

• Patients take regular scans of their teeth using high-resolution images.  This is accomplished through an app installed on their mobile phone and a special device that attaches to the phone.  The device helps hold the patient's lips retracted while allowing the phone's camera to capture images of the teeth.

• The scans are uploaded securely to the DentalMonitoring platform.

• DentalMonitoring's AI technology then analyzes the scans, generating reports and visualizations that track tooth movement and treatment progress.

• Doctors can then remotely monitor their patients' progress, identify potential issues early on, and adjust treatment plans as needed.

Benefits of DentalMonitoring's De Novo Approval

This FDA approval signifies the validity and safety of DentalMonitoring's technology. Here are some of the potential benefits for both patients and doctors:

• Improved Patient Experience: Patients can benefit from fewer in-office visits, potentially leading to more convenient and flexible treatment schedules.

• Enhanced Treatment Monitoring: AI-powered analysis can offer doctors a more comprehensive view of treatment progress, allowing for earlier intervention if necessary.

• Increased Patient Engagement: Regular monitoring reports and visualizations can empower patients to feel more involved in their orthodontic journey.

• Potential Decrease in Problems: Doctors can be made aware of discrepancies in expected treatment as well as other issues such as gingival inflammation and/or decalcification of enamel during treatment.  

A New Era for Orthodontic Treatment

DentalMonitoring's De Novo approval marks a significant step towards a more tech-centric future of orthodontics. While traditional in-office consultations remain crucial, AI-powered remote monitoring tools offer valuable potential for enhancing patient care, treatment efficiency, and overall patient experience.

It's important to note: DentalMonitoring is a tool that complements, not replaces, the expertise of a qualified orthodontic provider.

Looking Ahead

The future of orthodontics is likely to see further integration of AI and remote monitoring technologies. DentalMonitoring's FDA approval is a strong indicator of this shift, and it will be interesting to see how this innovation shapes the way orthodontic care is delivered in the years to come.  Expect this area of AI in dentistry to continue to advance rapidly.

Artificial Intelligence Webinar Questions & Answers

 

On Monday May 20th, I was honored to present a webinar on the Viva Learning platform.  (Disclosure: The event was underwritten by Philips Sonicare.). The Viva Learning platform allowed for one hour of content and unfortunately I didn't have any time left to do a Q&A with the attendees.

However, before signing off of the event, I copied all of the questions submitted via the Zoom chat feature and saved them.  I told the attendees that I would answer the questions on the blog, so here they are.  If you didn't happen to submit a question, feel free to submit them below in the "Comments" section and I'll do my best to answer them at a future date.

• Question:  Can "AI data" be used in court?  Is the law keeping up with technology and are insurance companies using AI to adjudicate claims?
• Answer:  I do some expert witness work in the dental malpractice field.  I haven't come across AI being used in a court of law yet, but I certainly think it will be.   One of the reasons I feel I haven't seen it yet is because, in my experience, it seems to take a really long time to get a case to court.  Cases can take years before an actual trial occurs.  Since AI has really only gone 'mainstream' since 2022-2023, nothing I've worked on has included AI.  That being said, I certainly think in the future AI *will* be seen in court cases.
• Answer:  Yes, third party payers are beginning to use AI to adjudicate claims.  It doesn't appear to be widespread, but it is already happening.  My concern in this area is currently focused on who is creating the AI network and providing the data.  If a third party payer is using *the same data* that doctors are using, I don't currently see a problem with that.  However, I CAN envision a database being created and used that is trained to deny.  That would be a worst case scenario.  My feelings currently are that third party payers need to justify their systems through an unbiased third party audit.  I'm not aware of that happening yet.

• Question:  What about DEXIS for CBCT?  I think it is called "DTX"
• Answer: Yes, DEXIS has a nice product.  It is called "DTX Studio" and it has some really great features.  I have 'tinkered' with DTX Studio as an evaluation and I thought it was a good product.  If you are looking for an AI solution for your practice, I think it should be on your list to take a look at.

• Question:  Out of curiosity, is DiagnoCAT applying for FDA "clearance" or "approval"?
• Answer:  I don't have a lot of information on that one.  I have looked at the product and worked with some of their test cases.  They allowed me to have access to a limited number of cases so that I could see what they provide and how to use the product.  It's important for me to state here what I am about to say is SPECULATION.  I *think* they are working on FDA 510(K) Clearance, but I cannot state that as fact.  Probably the best thing to do is to reach out to the company directly, if you are interested is where they are in the process.

• Question:  Does Pearl distinguish between caries and cervical burnout?
• Answer:  All the systems being used for radiographic interpretation are looking at the images for 'loss of density' but they are also smart and know *where* to look.  The systems *can* make mistakes in areas such as cervical burnout, which is why I always like to emphasize that these systems DO NOT diagnose.  When performing a clinical exam visually, doctors can evaluate a situation using their own diagnostic data that they gain through the exam process.  We use Pearl in our office and I feel it does a really good job of NOT indicating cervical burnout as caries, but the doctor has the final determination of that fact.

• Question:  Because systems can detect existing RCT, implants, crowns, etc. Can they connect to the office system (i.e. Dentrix, Open Dental, etc.) to chart what is existing for a patient?
• Answer:  I don't know of a system that can do that currently, but I know companies are working on that.  The biggest road block right now, is the fact that having this feature will require PMS (Practice Management Software) companies to give the AI companies access to their systems.  Most PMS companies are very protective of their systems for a number or reason, chief among them is security.  I see this as a tremendous benefit, but the legal aspects of allowing this access will probably keep this as a 'want' for a lot offices for at least the near future.

• Question:  How do you implement Pearl or Overjet into the practice?
• Answer:  Implementation is pretty simple.  We happen to use Eaglesoft and are still on a Client/Sever setup.  When we started, we allowed Pearl remote access to our server which allowed them to install a piece of software on the server.  Once that was done, Pearl uploaded our images into their system.  Now all we need to do is to start Chrome on the workstations and open a tab to log into Pearl.  The radiographs are quickly uploaded (pretty much as they are taken).  When they are uploaded, the patient is then 'clicked on' via the Chrome tab and the images pop up on the screen.  You can then select or deselect the things you would like to see or hide (caries, calculus, periapical radiolucencies, etc.)  We have a tab open to Pearl on every clinical workstation and doctor workstation every day.  I should also add that all of the data is transferred in a HIPAA compliant way.

• Question:  Does Pearl do any detection in pediatrics?  And other than Pearl and OverJet, are there other AI diagnostics you use or have heard of?
• Answer:  The first thing I'd like to state here is that FDA Clearances happen frequently in the AI space so it's probably best to check with the company or check the FDA website with specific questions.  My *current understanding* is that Pearl can be used on ages 12 and above while OverJet can be used in ages 4 and above.   I want to emphasize that I am providing this answer based on my current knowledge.  This info may change as I am typing this!  
• As far as the companies currently providing AI radiographic analysis I'm aware of the following companies: Peal, OverJet, Denti.ai, DentaXr.ai, VideaHealth, DTX Studio, Apteryx XV Web (which uses Pearl), adravision, DentrixDetect, and DiagnoCAT.  This list is probably not inclusive as these are the ones that I thought of as I typed this.  The area of dental AI for radiographic interpreation is a constantly growing and changing industry.

• Question:  Can you talk about cost?
• Answer:  While I don't normally like discussing financials, I can give an overview here.  Just so everyone understands, my personal feeling is that if you treat people to the best of your ability and use the best tools you can, a doctor will make a comfortable income.  However, I realize that doctors constantly 'walk the tightrope' between expenses and production.  I often say that you can be the best doctor on the planet, but if you can't stay in business, your skills won't help many people.  So with that in mind, currently the costs associated with AI seem to be under $500  per month the last time I checked.  If you factor in that a 2-surface posterior composite restoration averages around $250, the math is pretty clear that it doesn't take long before the office can see ROI on the investment.

• Question:  How often is the AI software updated?
• Answer:  In the 'big picture' every time a user makes a correction to the info they are provided the system learns from that.  So, at least in theory, the systems are being updated constantly.  For major changes, in my experience those are pushed out fairly regularly, maybe once a quarter or so.  The nice thing about these systems being Cloud Based is that when updates happen, the user doesn't have to do or install anything.  If an update has happened over night, the next time you open the tab in your browser, those changes are there for you.

• Question:  Any HIPAA concerns with uploading patient radiographs to AI?
• Answer:  I feel that the concerns with the connections between an office and the AI company are no greater than for any other data an office is using when it comes to The Cloud... that includes credit card processing and electronic claims processing, just to name a couple more.  Now don't get me wrong... security should *ALWAYS* be a concern when dealing with patient data and I'm glad you asked that question, because it shows you are concerned about that aspect of things.  There are a lot of people in this industry that have made it their life's work to keep data secure and I trust them to do so.

ADA Puts Out Statement Warning the Public about 'Veneer Techs'

 

Recently there have been several news stories about unlicensed dentists opening offices and actually treating the public.  That includes a woman who was recently arrested in Cook County Illinois who had been arrested for the same unlicensed dentistry scam in Las Vegas shortly before making bail and heading to the Chicago area.

Many of these "Veneer Techs" market themselves on social media (the accused mentioned earlier had a big presence on TikTok) showing photos of supposed 'happy patients' and showing off treatment they reportedly did.  Of course they offer they can do the same for others... and at much lower price than they could get elsewhere.

This is one of the problems with social media.  If you read it or see it, for some reason, it seems 'more true' than if you simply heard about it.  I am no different.  If I read something that looks professional, I have tendency to think "it has to be true".  Fortunately for me, that feeling lasts a second or tow and then my natural skepticism kicks in and I do some research.  Unfortunately, often good people believe these things to be true and unfortunately act on what they've read or viewed. 

While you dentists reading this know what I'm about to say is true, I'm saying the following to those readers who may not have a great deal of dental knowledge and understanding.  I want to state for the record... Dentistry is not nearly as easy to deliver as we make it appear.  The trained and licensed dentist has under gone years of extensive and expensive training.  Many younger dentists are graduating with hundreds of thousands of dollars in debt due to student loans.  Yet they go into the profession and work hard because they are called to help their fellow human beings.  

It's not about the income it's about the higher calling.

So I'm proud of the ADA for taking a stand and bringing this to the attention of the public.  The ADA addressed this recently in the ADA News, but they also have created a page to inform the public about this scary issue.

Here is the ADA Statement which appears on the ADA website:

Statement on Recent Reports of "Veneer Technicians"

CHICAGO, May 14, 2024 – The American Dental Association (ADA) is aware of recent reports of “veneer technicians” offering services to the public. The ADA urges the public to be cautious of these services that eliminate the role of the dentist in diagnosing the patient’s oral health needs, developing a treatment plan to best meet those needs, and safely managing treatment throughout the course of care.

Unsupervised dental treatment from unlicensed individuals has the potential to cause damaging complications for patients, and any dental procedure that may alter the physical structure of an individual’s teeth, gums or jaws, without the supervision of a dentist, has the potential to cause irreversible harm.

Risks that may be associated with services from unlicensed individuals include potential infection from adhesives and curing devices that are not properly sterilized or from placing veneers over unhealthy teeth or untreated cavities; nerve damage from improperly trimming or filing the teeth; and potential choking hazard during placement.

Dentistry is a regulated healthcare profession that requires formal education and licensure. Every state has regulations that require dentists and hygienists to be licensed in order to provide patient care. The level of oversight for dental assistants varies by state and, while dental assistants may or may not be licensed or registered by the state, they are required to perform their duties under the supervision of a licensed dentist. State dental practice acts define the scope of practice for dentists, hygienists, and licensed or registered dental assistants. However, dental laboratory technicians and businesses are generally not licensed.

The ADA is committed to quality care and encourages the public to seek care from licensed dentists to ensure proper diagnosis, treatment, and patient safety for all of their oral health care needs.

For more information about oral health, visit MouthHealthy.org, the ADA’s public education website.

About the American Dental Association
The not-for-profit ADA is the nation's largest dental association, representing 159,000 dentist members. The premier source of oral health information, the ADA has advocated for the public's health and promoted the art and science of dentistry since 1859. The ADA's state-of-the-art research facilities develop and test dental products and materials that have advanced the practice of dentistry and made the patient experience more positive. The ADA Seal of Acceptance long has been a valuable and respected guide to consumer dental care products. The Journal of the American Dental Association (JADA), published monthly, is the ADA's flagship publication and the best-read scientific journal in dentistry. For more information about the ADA, visit ADA.org. For more information on oral health, including prevention, care and treatment of dental disease, visit the ADA's consumer website MouthHealthy.org.

Change Healthcare Announces that Recent Hack Compromised Patient Data

 

As almost everyone is now aware of Change Healthcare, which is owned by United Healthcare, suffered a massive data breach in February of 2024.  The breach was so severe that it ended up forcing Change Healthcare to take all of their systems offline, although it may have been a Ransomware attack that encrypted data making it inaccessible.  Encryption was the likely culprit because Change Healthcare ended up quickly paying a ransom of $22 million to the perpetrators in order to get things back to even a semblance of working order.

This breach affected a "significant portion of the US population" while also having a major impact on the entire US healthcare system.  When Change Healthcare went down it brought their payment services to a screeching halt meaning hospitals, doctors, and pharmacies couldn't file claims or be payed for claims they had already filed.  I've spoken to several doctors that have stated that even now, over three months since the February 21, 2024 breach, they are still awaiting payment on multiple claims.

Now comes word that in addition to the payment problems, patient data was also compromised.  It seems that the hackers posted 22 screenshots on public facing websites that revealed PHI (Personal Health Information) as well as personally identifiable information.

If you have been affected by this hack, you can visit a page with more information that was created by UnitedHealth Group.  

The federal government has also gotten involved in this situation and has created a webpage that provides more information for anyone affected.  

At some point (if it hasn't happened already) some unfortunate patient is going to die due to something akin to this.  This breach caused hospitals to cancel some surgeries, patient records were inaccessible, and some patients could not get needed prescriptions.

Healthcare companies are being increasingly targeted by these Ransomware groups and while I don't personally have the answer, experts need to figure out a way to stop these.  Patient lives are at stake.

Looking to Improve Your Composite Outcomes? Take a Good Look at PinkWave™

 

I've spent many years in dentistry.  The thing I like the most about that, is that it gives me a really unique perspective on where we are because I know firsthand where we've come from and how far we've progressed.

When I was being trained, adhesive dentistry was in its infancy.  True story: when I was in school we had to get every step inspected and checked off.  We had to have someone check our etching for bonded composites, and if there was ONE speck of the etchant on dentin, you were in big trouble.  Prevailing theories at the time said that etching dentin would kill the pulp.  Of course, then along came my friend Dr. John Kanca and the world changed.  Suddenly total etch and wet bonding exploded across the profession.  Dr. Kanca took a lot of flack for his initial position on the subject, but he's a really smart guy and he was proven to be correct in a relatively short time.

When I started in the profession, composites were rare things.  I placed predominantly amalgam restorations for the first part of my career.

Jumping forward to today, things have changed radically from the old days.  At this point in my career, it's been about 2 decades since I placed an amalgam.  And over the years of progress, I've spent a lot of time studying and learning about adhesive dentistry.

The one thing I like to say is that curing is the 'step child' of adhesive dentistry.  By that I mean, that everyone knows about it, but it doesn't get the attention attention it deserves.  Most of us tend to think that we put the light on the material, wait a few seconds, and then go on to the next step.

However, I can tell you absolutely, that curing is one of the most important aspects of bonding.  If your light isn't strong enough or if you fail to cure for the proper time, all kinds of problems can result.  So, we need to pay attention to curing and better understand the physics and chemistry involved in it.

Today's post is about the PinkWave™ curing light from Vista-Apex and I'm going to spend the rest of the post explaining why I love the science behind it.

In the simplest terms, the light needs to reach every aspect of the material to achieve proper photo-polymerization.  That's one of the reasons (but not the only one) why for many materials, we place them in 2-3mm increments.  At that size, the increment is small enough for the light to penetrate all the way through it.  Some materials today are bulk cure or "large increment cure" with manufacturers creating composites that are a bit more translucent to help the photons reach deep into the restoration.  The deeper the light penetrates, the better the cure.

PinkWave™ handles this depth of cure situation with a unique solution.  The light uses FOUR different LED wavelengths (QuadWave™) to provide increased polymerization and the resultant depth of cure those wavelengths provide.

For the science minded readers, like me, those 4 LEDs provide standard blue, red, NIR (near infrared), and UV to penetrate the beam deep into the restoration.  This combination of light gives PinkWave™ a stated depth of cure up to 8.5mm... which is incredible.

The extra wavelengths have the physics necessary to enhance the cure and the resulting depth of cure, which is SO important for restoration longevity.  And that goes for even the incredibly high mw/cm2 output.  Light intensity doesn't always translate to depth of penetration. which is something that isn't always well understood.  That, in my opinion, is the genius behind PinkWave™.  

The blue LEDs are what activate the photo-initiator (CPQ) which is what most composites use.  However, *some* composites use a different photo-initiator that doesn't use blue to cure.  For those composites, that's where the UV LEDs come into play.  That makes PinkWave™ a truly "broadband" light that will effectively cure any restorative material.

The purpose of the red and NIR (near infrared) LEDs is to gently warm the material.  The wavelength of these LEDs allows them to  penetrate deeply into the material and warm it.  This increases the amount of polymerization that occurs.  Of course heating the material probably triggers concerns in your mind.  Some of you are probably thinking, "what does that do to the pulp?"  Let me put those fears to rest.  The team at Vista-Apex did *extensive* testing in that area and I can tell you with certainty that while it warms the material, it has no effect on the pulp or the tooth.

I always place warm composite.  I have for years.  Multiple studies have shown that warm composite cures more completely.  Warming the material 'energizes' the composite monomers so that the material cures much more completely.

Another great feature of PinkWave™ is in the optics.  Most curing lights work best right at the tip as the photons exit the device.  However, Vista-Apex uses a lens to focus the energy, not at the tip, but at a point 5mm away from the lens.  That puts the energy into the composite where it belongs.

Basically, the device warms the composite AND puts the beam right where it needs to be which results in a deeper, more complete, and better cure. 

If you've been looking for a way to get better clinical outcomes, follow this link and checkout PinkWave™.  I think you'll be impressed.  Curing lights are not all created equal and I feel PinkWave™ is created to perform better.

 

Walmart Announces Closure of Health Centers & No More Dental Care in Stores

 

On April 30th, 2024, Walmart made the announcement that it is closing its health centers and virtual care service stating they were having difficulties finding success with the offerings.  The initiative was launched in 2019, but since the company has had a tough time in the market of health.

This translates to also closing any dental services the company was offering.

The company had opened 51 health centers in five states and had worked on expanding its telehealth program, but stated "there is not a sustainable business model for us to continue".

Walmart stated that "the challenging reimbursement environment and escalating operating costs create a lack of profitability that make the care business unsustainable for us at this time."

They had previously announced plans in March 2023 to open 28 health centers in 2024.  These would have been focused in Dallas and Houston.  The company had also planned to open centers in Phoenix and Kansas City.

As practicing dentists know, the business side of things has been more difficult since the pandemic and it seems that even major retailers entering the market have experience similar issues.

The Associated Press has a more detailed story, which can be found by following this link.  

Formlabs Dental Announces FDA Clearance for 2 New 3D Printed Mouthguard Resins

As we all know, he world of dentistry is constantly evolving, and 3D printing is rapidly changing how dental professionals operate. Now, comes the introduction of two new FDA-cleared resins from Formlabs, which allows for creating comfortable and effective mouthguards directly in-house.  

This blog post dives into the news of Dental LT Comfort Resin and Dental LT Clear Resin V2, providing a clear (pun intended) picture of the benefits they offer to both dental professionals and patients.

Innovation Meets Convenience: FDA-Cleared 3D Printing

For years, 3D printing has held immense promise for the dentistry. Now, with the FDA clearance of Dental LT Comfort Resin and Dental LT Clear Resin V2 by Formlabs, this potential is being realized to a greater degree. These resins allow dental practices create custom-made mouthguards directly on-site, eliminating the need for traditional impression methods, stone models, and external labs.

Dental LT Comfort Resin: Enhanced Comfort 

Dental LT Comfort Resin prioritizes patient comfort with its flexibility. This resin is ideal for patients who clench or grind their teeth, as the flexibility helps to absorb impact and reduce pressure on the jaw. Additionally, the material is easily polished to a smooth finish, maximizing comfort during wear.

Dental LT Clear Resin V2: Superior Optics and Durability

Dental LT Clear Resin V2 (the second generation of this resin) offers impressive aesthetics with its high optical transparency. This makes it a good choice for patients who desire a more discreet mouthguard. This resin also boasts long-term durability, ensuring the mouthguard can withstand regular use.  We've all see patients literally 'chew through' an appliance and this should help in that regard.

Benefits for Dental Professionals

The introduction of these FDA-cleared resins offers advantages for those of us in the profession:

• Faster turnaround times: In-house 3D printing eliminates the need to wait for external labs, allowing for quicker delivery of mouthguards to patients.

• Increased patient satisfaction: Offering comfortable and aesthetically pleasing mouthguards can significantly improve patient satisfaction.

• Streamlined workflow: 3D printing allows for greater control over the entire mouthguard creation process.

A Brighter Smile for Everyone

The availability of FDA-cleared Dental LT Comfort Resin and Dental LT Clear Resin V2 marks a step forward in dental 3D printing. These innovative materials help dental professionals to provide patients with comfortable, effective, and custom mouthguards, ultimately leading to a healthier and happier smile for everyone.  I often tell patients that we can build mouthguards much more easily than we can build back a worn dentition.

Considering 3D Printed Mouthguards?

If you're a dental professional interested in learning more about how these FDA-cleared resins can benefit your practice, head over to the Formlabs Dental website and check out their 3D printing solutions. You can also consult with a dental equipment supplier to discuss these materials and determine if they're a good fit for your needs.

 

Business Experts Predict Amazing Growth in the Field of Orthodontics in the Coming Years

As I've probably mentioned before, this year I was honored to become a Candid Academy Faculty member.  My good friend, Dr. David Little and I both joined in February/March time frame.

I love providing orthodontic treatment and I follow that part of the industry pretty closely.  Because of my fascination with all things ortho, I was excited to see a recent report on PR Newswire that stated experts are expecting the market for orthodontic services to be a record breaking $8.39 billion by 2027.

The prediction is that estimated growth of the market will be at a rate of 17.13%

My personal opinion is that this interesting news, but it doesn't greatly surprise me.  With clear aligner companies (like Candid) orthodontics for the GP is much more simple than it would be if every case needed brackets and wires.  I also feel that many patients who want minor corrections didn't see the big benefit of going through the bracket and wire process.  However, when minor corrections can be performed quickly and easily with clear aligners, that makes the treatment much more palatable for people who otherwise might seek treatment.

There's also the fact that the explosion of technology in healthcare is making orthodontics more available.  New resins have made aligners more responsive and better for patients.  Combining those resins with the continual advances in 3D printing means things fit better than ever before and move the teeth an in incredibly precise manner.

My complaint on the PR Newswire article is that they mention many "problems" that can result from orthodontic treatment.  They failed to state how *rare complications are*.  In all my years of doing dentistry and evaluating patients... most of whom I did NOT treat orthodontically, I've probably seen less than 5-10 cases where there was an uncorrectable problem.

Considering the article mentions well researched numbers on growth, they should have also provided well researched numbers on the complications, which are rare... very rare.

If you'd like to read the full article, follow this link.  

Another Hacking Trick used against Healthcare Offices...

 

As almost everyone now knows, you should *never* click on a file emailed to you without first making sure it is authentic.  Even then there are risks, but by contacting the people or organization that supposedly sent the file, you can eliminate the majority of that risk.

Generally speaking, in the chain of security, the human element is the weakest link.

This is especially true when faced with well thought out social engineering schemes.  The person attempting to start a breach will usually try to put the target into a panic, which helps them because when humans panic, we tend not to think as clearly.  In my office, we once got a call from someone claiming to be from the local power company telling us they were going to shut our power off in one hour unless we paid the bill. They told us that they could take care of it with a credit card, but that we had to give them the number NOW or we were going dark.

 Of course, we panicked.  It was only when someone had the presence of mind to ask if they could give us our account number along with the date and amount of our last payment that we figured out it was a scam.  The person on the other end of the phone call couldn't answer those questions.

Along similar lines, I've learned of another social engineering scam.  The office receives an email that is faked to appear to be from the state medical or dental board.  A complaint is alleged and a file is attached that supposedly contains the complaint.  Of course, in a panic people click on the file and in addition to opening a fake complaint, it also installs a file that allows the criminals access to and control of the network.

This scam has been used with some success against plastic surgery offices.  The worst part of this scam for those offices *and* the patients is that hackers then download all the patient files and use what is in them to extort money from the office.  Some offices that have been hit have had the worst possible scenario evolve out of it.  The hackers are then posting photos of patients that were taken pre and postoperatively.  Being in the practice of cosmetic surgery, many of the photos are of patients disrobed.  Hackers have been posting these images in publicly accessible websites.  You can imagine the humiliation that patients face when they learn that photos are online of them not wearing clothes.  Some of the sites have gone as far as to post the patients' contact info with the images.

The lesson here is to NEVER click on a link or any file from an outside source without verifying its authenticity.  Data security breaches are increasing in the healthcare sector every year and we all need to do everything we can to protect the patients we care for.

Medit Announces Launch of the New i900 Intraoral Scanner

 

The Medit i900

The dental industry is abuzz with the release of the Medit i900, the latest intraoral scanner from the innovative company Medit. Medit has a history of disrupting the market with user-friendly and high-precision scanners at a good price point, and the i900 promises to be another game-changer.

Today's blog post dives into the features of the i900 and explores how it might impact the future of digital dentistry.

Intuitive Design 

The i900 boasts a completely redesigned user interface. Gone are the buttons, replaced by a sleek and intuitive Touch Band and Touch Pad. This allows for comfortable scanning from any angle, regardless of hand size. The scanner itself is incredibly lightweight, weighing in at just 165 grams.

Unparalleled Precision and Speed

Medit boasts that the i900 is their fastest scanner yet. The all-new 3rd-Generation Optical Engine with a 10-bit camera captures incredibly detailed scans with a wider field of view. This translates to sharper images and improved accuracy for capturing even the most challenging oral structures. The improved technology also tackles issues like capturing reflective surfaces like metal restorations or bleeding gums.

Enhanced Workflow

The i900 incorporates real-time haptic feedback, guiding the user's hand for smoother and more efficient scanning. The 360° Touch Band allows for easy navigation, and customizable controls on the Touch Pad and Touch Menu streamline the workflow. All of this combines to create a more positive experience for both the dentist and the patient.

Is the i900 Right for You?

While the i900 boasts impressive features, it's important to consider your specific needs. If you're a dentist looking for a cutting-edge scanner to enhance your practice, the i900 is definitely worth investigating. However, pricing information hasn't been released yet, so it's wise to compare it to other scanners on the market before making a decision.

Stay tuned for further updates and reviews on the Medit i900 as more information becomes available.

 

For the last several years, when I've needed to protect my eyes from laser wavelengths, I've used Ease-In-Shields.  In fact, I was so impressed with them, that I brought them up during the meeting of the Cellerant Best of Class meeting where we determined the winners for 2017.  If I remember correctly, they were a unanimous winner with myself and the rest of the panel all voting "yes" to give them the award.

They offer incredible protection, but the *best* feature in my opinion is how easy they are to use.  Over 80% of dentists work with some type of magnification.  Doctors become so used to seeing everything magnified that we don't want to work without our surgical telescopes (loupes).  The question is "how do I continue to work with mag AND protect my eyes.  These lenses slide behind your glasses and allow the doctor to continue to work with magnification while also protecting the eyes.  The big plus is that you don't even have to take your mag off to use them.  They gently and easily slide between the scopes and your face which makes putting them on simple.  The operator doesn't even need to remove their mag, the shield slides in easily behind them while the mag stays in place on the doctor's face.

When you're finished they can be wiped down with a disinfectant.  It's a great and super easy thing to use.  I was thrilled to learn that the company has now been acquired by one of my favorite companies, Ultradent.   Here is all the info from the company...

SOUTH JORDAN, Utah May 8, 2024. Ultradent proudly announces the acquisition of Ease-In-ShieldsTM from ViewMax Solutions, LLC. Ease-In-Shields provides unique eye protection for laser and curing light users, with their double patented shape, allowing the shields to fit into most loupe and eyewear shapes for maximum safety.

Of the Ease-in-Shield acquisition, Scot Andersen, Ultradent’s Vice-President of Business Development, said, “After years of working with ViewMax Solutions LLC, we’re pleased to announce the acquisition of their product, Ease-In-ShieldsTM. We’re excited to continue working in conjunction with the founders to promote Ease-In-Shields more broadly in the dental space.” 

Ease-In-Shields’ polycarbonate construction makes them both light and strong, less prone to fogging, and unlike other laser filter inserts in the market, offering total protective coverage as certified by Laservision USA’s Safety Laboratories.

The Ease-In-Shields won the prestigious 2017 Cellerant “Best of Class” Technology award, thanks to the unprecedented protection they offer and their unique benefits, such as quick and hygienic placement and removal from loupes without having to remove eyewear from the face. Ease-In-Shields’ various options afford eye protection for different types of laser wavelengths and accommodate many facial sizes.

FBI Sounds Warning on a Credible Cybersecurity Threat to Offices in the Dental Industry

 

There is a reason I believe in the ADA.  Although I don't agree with everything they do, dentistry needs a united voice to communicate with the public and legislators.  Density also needs a voice that can speak to the profession when something important is happening that the profession needs to be aware.  Today is one of those days.

In case you have not been notified or perhaps missed the email sent yesterday May 7th, today's post is *incredibly* important to dental practices.  I am posting the email I received in its entirety.  Please read it!

The American Dental Association (ADA) urges all dental practices to remain vigilant after it was contacted by the Federal Bureau of Investigation (FBI) with information regarding a credible threat to the practices of oral and maxillofacial surgeons.

Current Threat Information from the FBI

On Tuesday, May 6, 2024, the FBI informed the ADA and the American Association of Oral and Maxillofacial Surgeons (AAOMS) of a credible cybersecurity threat to the practices of oral and maxillofacial surgeons. The FBI said that as of that date there were no known cyberattack victims, but the agency is working proactively to raise awareness to help prevent victimization. The FBI suspects the group behind the cyberattacks may be shifting tactics to oral and maxillofacial surgery practices after targeting plastic surgeons last year.

While this current threat is focused on oral and maxillofacial surgeons, the FBI is concerned that the practices of general dentists and other specialists could also eventually be targeted.

Cybercriminals often use social engineering scams — such as phishing (email), SMSishing (through text or instant messaging apps) and vishing (using phone calls and voicemail) — to gain access to sensitive personal data such as electronic protected health information. Spear phishing refers to a phishing email appearing to be from a trusted contact. For example, a threat actor may use phishing to impersonate a credentialing agency. Through these scams, threat actors try to convince people to reveal sensitive information, or to click on a link, open an attachment or visit a website that causes malware to be deployed. This malware can lead to ransomware, which blocks system and/or file access  until money is paid.

The FBI provided an example in which the threat actor poses as a new patient or says they want to become a patient at the practice to obtain new patient forms online. Once the forms are received, the threat actor will then contact the practice to report they are having trouble submitting them online and ask if they can scan the forms and email them instead. The threat actor then emails the “forms” as an attachment. When the attachment is opened malware is deployed in a phishing scheme.

The FBI requests dental practices that experience any fraudulent or suspicious activities to report them to the FBI Internet Crime Complaint Center at ic3.gov.

Precautions Practices Can Take

The Cybersecurity & Infrastructure Security Agency (CISA) recommends four vital ways to protect your practice from cyberthreats:

• Teach your team to recognize and avoid phishing

• Require strong passwords

• Require multifactor authentication

• Update all business software

The following resources  are also available to support healthcare professionals:

• A CISA.gov toolkit aids healthcare practices in building cybersecurity foundations and implementing more advanced, complex tools to stay secure and ahead of current threats.

• The U.S. Department of Health and Human Services’ Knowledge on Demand resource offers five free cybersecurity trainings that align with the top five threats named in HHS’ Health Industry Cybersecurity Practices. HHS also offers information on how the HIPAA security rule can help defend against cyberattacks.

• The Office of the National Coordinator for Health Information Technology’s Security Risk Assessment Tool, a resource designed to help medium and small providers conduct a security risk assessment as required by the Health Insurance Portability and Accountability Act.

• The U.S. Department of Health and Human Services Office of Information Security and Health Sector Cybersecurity Coordination Center’s “Artificial Intelligence, Cybersecurity and the Health Sector” guide shares how health care entities help protect against AI-enhanced cyberthreats.

• Additional resources can be found at ADA.org/riskmanagement

As the nation’s largest organization of dentists, the ADA is advocating on behalf of all dentists at the federal level to recommend several measures to protect and ensure the resilience of health care infrastructure against cyber threats. The ADA will continue to lead this charge and provide cybersecurity updates as they become available, all in service to you and your patients. Please visit ADA.org to see the many ways the ADA advocates on behalf of dentists nationwide.

Online Dental Care Solution Dentistry.One Named as a 2024 NJBIZ Health Care Hero

 

Over the years, I've become a big fan of MouthWatch and the other companies under their umbrella.  Good products, good prices, and good people make for success.  The folks at MouthWatch have that covered.  That's why I'm happy to provide the following info regarding one more jewel in their crown...

Dentistry.One, a virtual-first dental care solution introduced by MouthWatch, LLC, was recently named a 2024 Health Care Hero by leading New Jersey business publication, NJBIZ.  

The annual award recognizes excellence, promotes innovation, and honors the efforts of the individuals and organizations making a significant impact on the quality of health care in New Jersey. 

Candidates were nominated by NJBIZ reader submissions, with the winners selected by a panel of independent judges. This year’s Health Care Heroes Awards recognized individuals and organizations across 11 categories. Dentistry.One was named a Health Care Hero in the “Innovation Hero” category.

“On behalf of the entire Dentistry.One team, we thank NJBIZ for this prestigious recognition of Dentistry.One and our commitment to developing innovative approaches that create greater access to oral healthcare,” said Brant Herman, Founder & CEO, MouthWatch & Dentistry.One. “New Jersey has long been a pioneer in nurturing healthcare businesses impacting the health and well-being of individuals around the world. We are so proud to be part of this innovative and dynamic community.” 

Dentistry.One virtual-first oral health care offers access to a nationwide network of on-demand dentists, personalized care coordination, oral health coaching, and a digital connection between dental and medical care through proprietary teledentistry software. 

Online dental consultations with Dentistry.One are accessible anytime, from anywhere and include services such as emergency care, pre-op and post-op support, non-narcotic e-prescriptions, second opinions, caries risk assessment, sleep apnea screening, oral hygiene instruction, chronic care coaching, and product recommendations. 

About MouthWatch / Dentistry.One

MouthWatch, LLC, is a leader in developing digital technology solutions that drive success for dental professionals, improve oral health care, and enhance the overall patient experience.

Headquartered in Metuchen, New Jersey, MouthWatch is widely known for its intraoral cameras that help engage patients in treatment planning through high-quality, affordable imaging technology, and its TeleDent software that provides practices and organizations with a teledentistry option to engage patients with providers remotely. 

In January of 2023, MouthWatch launched Dentistry.One, a virtual-first care network that addresses the expectations of today’s modern healthcare consumers, the need for greater efficiency in healthcare, and the proven connection between good oral health and total health. Dentistry.One features on-demand dental consultations, personalized care coordination, and oral health coaching for prioritizing oral health. 

MouthWatch hardware and software are in use at over 42,000 practices, over 30 leading Dental Service Organizations (DSOs), and over 100 dental schools. The company has been recognized three times in the Inc. 5000. For more information, visit mouthwatch.com. or dentistry.one.

Ivoclar and SprintRay Join Forces

 

There's been a lot of news out of the industry as of late dealing with the 3D printing space.  Today I'll delve into a recent announcement that pairs two industry leaders.  Let's take a look at the partnership between Ivoclar and SprintRay.

Ivoclar and SprintRay: A Powerful Partnership Shaping Dental 3D Printing

The dental industry is witnessing a significant transformation driven by digital technologies, and 3D printing stands at the forefront of this evolution. Recently, two industry leaders, Ivoclar and SprintRay, joined forces to further propel the possibilities of 3D printing in dentistry. 

Ivoclar: A Legacy of Dental Innovation

Ivoclar, a familiar name in the dental world, boasts a rich history spanning over a century. They have consistently provided high-quality dental materials and solutions for fixed and removable prosthetics. Their commitment to innovation has positioned them as a leader in the dental industry.  Almost anyone practicing dentistry touches their products.

SprintRay: Pioneering 3D Printing Solutions

SprintRay, a US-based technology company, has carved a niche in developing cutting-edge 3D printing solutions specifically tailored for dental applications. Their comprehensive range of 3D printers and dental resins provides dental professionals with efficient and precise tools.

The Partnership

The collaboration between Ivoclar and SprintRay signifies a strategic move to leverage the strengths of both companies. Here's what this partnership promises:

• Streamlined Workflows: Integrating Ivoclar's high-quality materials with SprintRay's advanced 3D printing technology can streamline workflows in dental practices and laboratories.
• Enhanced Accuracy and Precision: The combined expertise of both companies can lead to the development of even more precise and accurate 3D printing solutions for dental applications.
• Broader Material Options: Ivoclar's extensive material portfolio, coupled with SprintRay's printer compatibility, can offer dental professionals a wider range of options for various dental procedures.
• Innovation at the Forefront: This partnership fosters a collaborative environment that can accelerate the development of innovative 3D printing solutions for the future of dentistry.

A New Era in Dental Care

The Ivoclar-SprintRay partnership holds immense potential to dental 3D printing. By combining their expertise and resources, they can contribute significantly to provide the industry with:

• Improved Patient Care: More efficient and precise 3D-printed restorations can lead to better patient outcomes and satisfaction.
• Increased Accessibility: Wider adoption of 3D printing technologies can potentially make dental care more accessible and affordable.
• Advanced Dental Applications: The collaboration paves the way for exploring further possibilities in areas like bio-printing and permanent fixed prosthetics.

As this partnership unfolds, the dental industry can expect exciting advancements in 3D printing, ultimately transforming the way dental professionals deliver care and patients experience dental treatments.  When it comes to 3D printing in the profession, I feel the future is brigh.

DGSHAPE Americas Announces New 3DX Dental 3D Printer Bundle, Powered by Roland DGA

 

 Roland DGA’s DGSHAPE Americas dental business group has announced the addition of the 3DX Dental 3D Printer Bundle, Powered by Roland DGA to its line of dental products and accessories. This bundle offers a reliable, full-service 3D printing solution at one affordable price, along with Roland DGA’s world-renowned customer service and support. Equipped with the 3DX bundle, dental businesses can produce a wide variety of products in-house quickly, easily, and cost-effectively, including dental models, dentures, provisional crowns and bridges, occlusal guards, surgical guides, custom clear retainers, removable die fits, and more.

The 3DX bundle was created exclusively to complement DGSHAPE DWX wet and dry dental milling solutions. Its 3DXPRINT 3D printer incorporates state-of-the-art 4K LCD 3D print technology that provides fast, precise, and uniform production of 3D-printed dental applications, while the small footprint and high-quality output make it the ideal printing solution for dental laboratories and clinical offices of all sizes.

Within its compact housing, the 3DXPRINT features a large 190 x 120 x 180 mm build plate that offers a generous 40-square-inch surface, allowing users to print up to eight full-arches at one time – all with outstanding consistency and precision. Its print speed ranges from 10~50 mm per hour, depending on material layer thickness. In addition, its open-architecture platform is validated for use with resins from over 20 resin manufactures and more than 150 resins.

The 3DXPRINT’s durable, state-of-the-art design was developed through a 5-million-layer test process in real-time dental conditions to ensure the highest level of performance and reliability. Incorporating industrial-grade optical components further ensures an optimal product life cycle. It also features an automated cooling system (ACS) for ideal temperature maintenance.

“We are excited to offer this fast, precise, and affordable 3D printing solution to our customers,” said Roland DGA Dental Marketing Manager Lisa Aguirre. “The 3DX bundle is a complete, advanced, easy-to-use 3D printing solution that perfectly complements our high-performance DWX milling machines. By integrating its capabilities into their workflows, businesses can optimize their production and offer same-day applications with outstanding uniformity and accuracy.”

The 3DX bundle comes complete with the 3DXPRINT 4K LCD 3D printer, 3DXWASH cleaning system, 3DXCURE curing system, and 3DXMODEL resin. In addition, it includes easy-to-use 3DXWORKS CAD design and slicing software, with no maintenance, update, or annual fees. 3DXPRINT is backed by Roland DGA’s unsurpassed one-year trouble-free warranty and support.

To learn more about the new 3DX bundle, visit www.rolanddga.com/3DXPRINT. For more information on the complete line of DGSHAPE dental milling solutions, visit https://www.rolanddga.com/dental.

About Roland DGA Corporation and DGSHAPE Americas

Roland DGA Corporation serves North and South America as the marketing, sales, distribution and service arm for Roland DG Corporation and its subsidiary, DGSHAPE. Founded in 1981 and listed on the Tokyo Stock Exchange, Roland DG of Hamamatsu, Japan is a worldwide leader in wide-format inkjet printers, engravers, photo impact printers and CNC milling machines. DGSHAPE Americas is the Roland DGA dental business group dedicated to the DGSHAPE line of products, most notable as a market leader in dental milling machines. To learn more about Roland DGA Corporation and DGSHAPE Americas, visit https://www.rolanddga.com/dental.

About Roland DG Corporation

With the purpose of “To Empower Creativity and Excitement Worldwide,” Roland DG Corporation strives to bring new opportunities to society through digital solutions that make it easy for anyone to create things. The company’s inkjet printers and printer/cutters are widely used in a variety of visual communication fields, including signage and interior decoration. In the digital fabrication field, our inkjet printers, cutting machines, and 3D digital fabrication tools enable the personalization and customization of items tailored to individual customer needs. By adopting a high-mix, low-volume, on-demand approach, Roland DG aims to create new applications. Recently, Roland DG has further expanded the digital transformation frontier. The company provides a cloud-based service to enhance customers’ printing operations and profitability and a cloud-based production improvement solution offering the expertise of its proprietary production support system for small and medium-sized manufacturers. To learn more about DGSHAPE Corporation, visit https://www.dgshape.com.

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Chlor-XTRA a Great Product for Endodontic Irrigation from Vista Apex

 

As a general dentist I love the fact that everyday I get to do a variety of procedures.  Variety is the spice of life and I think that *really* applies to my professional path.  It's even better when I get to try and test new techniques, products, and equipment along the way.

If I had been given the opportunity to specialize, I would have turned it down.  I just love so many aspects of the profession, that I would not do well mentally if I had to do the procedure every day all day.  However, with that being said, my favorite procedure is endodontic therapy.  I mean, I really love doing root canals.  If you're not in the profession that probably sounds weird, but to me they are like a puzzle that I love figuring out.

The thing I want to focus on today is irrigation.  Using the right chemistry is intrinsic to long term clinical success.  In the last 20 years we have seen incredible advances in the instrumentation side of endodontic therapy, but instruments only do about 1/2 of the work.  You read that right, instruments only do about 1/2 of what needs to be done to ensure success.

I read a study recently from NIH that stated "57.8 - 68.8% of studied canal areas are unprepared by mechanical instrumentation".  Think about that for a moment... if you aren't using the proper chemistry, the instruments only clean a portion of the canal.  Those "unprepared" areas harbor bacteria that can cause continuing or recurring problems.

I will feature other Vista Apex irrigation products in future posts, but today's focus will be on the irrigant I normally reach for first when I'm performing endo... Chlor-XTRA™.    It's a 6% sodium hypochlorite solution.

However, it's not just a standard solution.  It also contains wetting agents and proprietary surface modifiers.  Those special chemicals allow Chlor-XTRA™ to 'flow' down into the canals and get inside all those small little irregular surface areas that haven't been reached by instruments and they harbor bacteria.  Those impossible to reach areas include lateral canals and isthmuses where a file won't reach no matter how hard you try.

Sodium hypochlorite actually *kills* pathogens and it is necessary to get the canal system as clean as possible.  You can also ensure Chlor-EXTRA™ is well dispersed in those difficult to get to areas by using ultrasonic activation of the liquid through use of the cordless EndoUltra® unit.  I'll be making a post about that device in the not too distant future.

There are a lot of companies in the industry that sell sodium hypochlorite products.  However, they are not all interchangeable.  When I sit down to perform endo, this is what I reach for.  In my hands, this product has a proven track record of performing well.

If you are looking to up your game when it comes to endodontics, I truly think you should take a look at the products from Vista-Apex.  Over the years, I've gotten to know many of the folks there pretty well and I can tell from firsthand experience that they are great people with really great products.