I've spoken with thousands of dentists and have found that delivering clinical outcomes that make patients healthy and happy is their primary motivator. Part of being able to get patients healthy is enabling them to move forward with needed care. Cost continues to be a leading barrier to dentistry. To better understand the impact of the out-of-pocket cost of dental care and how it affects patients’ care decisions, Synchrony completed the

The study provides insights to help the dental community, including CareCredit, help patients be prepared for the cost of care. Brian Harris, dentist, speaker, coach, and the CEO and founder of the Smile Virtual software platform, joins me to discuss the findings.

According to the study, the out-of-pocket cost of dental care for an average adult aged 20 to 79 years ranges from $51,000 to more than $95,000 over a lifetime, not including implants, orthodontics, or more complex dental needs, which could add thousands of dollars to the total. This range includes single coverage, couple coverage, and family coverage. Does this amount surprise you?

Not really. But I’m glad that Synchrony has quantified the lifetime cost of dentistry so that people are more informed and can be, hopefully, more prepared. I agree that dentistry can be expensive. Cost has always been something that captures people by surprise. That’s nothing new. And people are feeling a financial pinch now more than ever.

It also probably doesn’t surprise you that the findings indicate that 58% of respondents believe dental care is not affordable, which may be the reason why the majority of respondents (54%) said they did not go to the dentist this past year because of cost, and why 59% would ignore, wait, or choose a less costly dental procedure.

 No, that doesn’t surprise me either. I think it’s a bigger conversation than the cost and the relevance of financing to help enable care. It’s more about the conversation of how we as a dental community can make it easier for people to get the dental work they want to have done. How do we break down those barriers to case acceptance? We need to stop making things difficult and confusing for patients. I always say a confused patient will make the choice to do nothing.

 One of the things that the research took a look at was patients’ understanding of dental benefits and costs. Three key findings stood out: Only 30% of respondents found understanding dental costs easy, half of insured respondents did not know their annual maximum, and just a quarter knew their annual premium. As you said, we need to make it easier and break down barriers. I believe there is a big opportunity for the dental community to educate patients…so they are informed and can choose what is best for their oral health.

 It is a big opportunity and, I believe specifically for dentists and teams, a responsibility. I think if we look at it more from the lens of the consumer and what does the patient really want? They want to be able to eat without discomfort. They want to have a confident smile. They want to keep their teeth for life. And they want us to make that easy for them. If you give people too many options it can be overwhelming and confusing.

First we have to educate patients about dental benefits so they have an understanding of how they work and what they contribute to the cost of dentistry. Then we need to be up front and transparent with our payment options. We have found that if we stick to 1 main financing company and have financing as part of the treatment plan discussions, it makes it simpler for patients. We always present an estimated monthly payment with financing along with the total cost of care so that patients know their options up front and can choose what works best for them so they can get care.

I agree. We all have a role to play in patient education. CareCredit goes beyond offering financing options to providing in-depth information on procedures, costs, and ways to plan and pay for care. In fact, CareCredit created Well U—a robust collection of articles and videos (carecredit.com/WellU) specifically for this purpose. That’s why 1 stat from the study concerns me, which is that 92% of respondents said they would consider holding off on general dental care because of cost and 83% would consider holding off emergency dental care. We all know that so many dental conditions left untreated result in additional problems and expense. We’ve got to put patients in control of their oral health.

 Exactly. You know, none of us can control interest rates or the economy. But we can control and take responsibility for the way we educate patients and how we present the cost of dentistry, explain their benefits, and provide them a path to get healthy. So they can control and better understand and manage their benefits and out-of-pocket costs, and ultimately get a healthy and beautiful smile they’ll enjoy for life.

This content is subject to change without notice and offered for informational use only. You are urged to consult with your individual advisers [and/or medical providers] with respect to any information presented. Synchrony and any of its affiliates, including CareCredit, (collectively, “Synchrony”) make no representations or warranties regarding this content and accept no liability for any loss or harm arising from the use of the information provided. Your receipt of this material constitutes your acceptance of these terms and conditions.

Articles

Synchrony conducts study to learn how out-of-pocket costs affect decisions about treatments.

Report Provides Insights to Help Give Patients Clarity on the Cost of Dental Care 

Everyone wants a beautiful smile. But not everyone can afford one and not every clinician can deliver one confidently.

That is why United Kingdom dentists Olumide Ojo, BDS, MFDS RCS, and Thomas Sealey, BChD, MMedEd, MSc Endo, worked together to develop SmileFast, a groundbreaking development in the delivery of customized and beautiful smile makeovers using either composite resin or dental ceramics (porcelain veneers).

The company cofounders came up with the idea for SmileFast after years of practicing dentistry and dealing with obstacles such as inconsistencies with predictable results and high costs that prevented many patients from getting the smiles they desired.

“We met on a dental skiing course and had talked,” says Dr Ojo, who practices out of central London. “We had pretty much the same problem but different approaches, or different concepts to it, and we had to find a solution. That’s really how SmileFast came about.”

Dr Sealey said the 2 clinicians started to swap stories about smile makeovers and issues that often prevented either successful results or patient acceptance for the treatments.

“We started, you know, confessing our sins to each other,” explains Dr Sealey, who had been performing several stent-based composite makeovers using traditional wax-ups and the every-other-tooth technique. “I must have done 5 or 6 cases like this and I found it incredibly difficult, and I also didn’t find it very predictable. The reality of it was it was so technique sensitive that the end results were not as accurate as I was hoping for.”

Dr Sealey had shared some of his smile makeover cases online and Dr Ojo started to think it might not be a bad idea if they worked together to develop a procedure that could package the stents and composites together to come away with improved outcomes in less time. The men departed the ski conference in France and headed back to England determined to master the process, which has now taken off in England and is starting to make inroads into the United States.

“I thought, wouldn’t it be amazing if we could package this all together?” Dr Ojo says. “So it would be like a smile in a box very similar to how someone would go to a dentist for an Invisalign smile. They follow the entire pathway and they leave with the perfect smile. But imagine if we could do this with composite and have it not be too technique sensitive or too time-consuming.”

The pair returned to the UK and started researching digital techniques, model making, and how this might all come together to deliver an affordable, predictable smile makeover that could produce long-lasting results.

What came about was a process to create an accurate stent with separators, allowing clinicians to do up to 10 teeth all at the same time with 1 stent. This is possible because all the compartments are preseparated.

“You load the whole thing with composite, place it onto the teeth, cure it, take it off, and it’s done,” Dr Ojo explains. “That was the revolutionary step and that’s what we developed SmileFast on once we realized how good it was.”

SmileFast is now fully patent protected. This stent-delivered composite technique has gone to the next level and is now very accurate, very time efficient, and therefore very accessible to every dentist and to every patient who previously might not have been able to afford alternative treatments like ceramic veneers, the 2 clinicians say.

“That’s where SmileFast becomes so successful because it’s not just helping the dentist, but it’s also delivering a solution to patients and there is such a need for this solution out there,” Dr Sealey says. “That’s why the business has grown so fast in the last few years.”

SmileFast is designed for patients as well as dentists and takes advantage of digital dentistry, something both clinicians have long advocated for.

“The big cornerstone of SmileFast is that everything that we plan is digitized, designed on the patient’s face then transferred into the patient’s mouth in the form of a trial smile, so that it’s perfected in the mouth. It takes away the element of guesswork,” Dr Ojo says.

Using digital wax-ups for digital design to the perfect parameters, then transferring and perfecting that smile means the dentist can deliver the final composite restorations and not just guess the thicknesses of the teeth or the axial inclinations.

“All of this is designed digitally perfect and corrected and then placed into the mouth,” Dr Ojo says. “So what we’re really able to deliver, as Tom says, is not just a solution, but a workflow. And the workflow takes the patient along with us. The patient knows what they’re getting. They know what they’re buying.”

If a SmileFast patient doesn’t like the look of something, if they want something longer or shorter, or they want a different shape of teeth, they have that choice. The cofounders add that while most dentists are brilliant technicians, they don’t often explain the procedure well enough for the patients to know exactly what to expect. With SmileFast’s workflow, this is not an issue.

“Once we deliver this trial smile into a patient’s mouth, the next thing the patient says is, ‘How soon can I book in?’ They’ve got the solution that they’re looking for and that for us has been one of the biggest things that patients are now coming in practices asking for SmileFast because it’s a process rather than just a solution,” Dr Ojo says.

Drs Ojo and Sealey came up with the SmileFast idea around late 2017, spent 6 months developing it, and worked to refine it so it would become a time-efficient process for dentists. They trialed the educational course—which includes a hands-on component teaching the SmileFast technique—on more than 15 dentists and close friends.

“It was incredible. The feedback was amazing,” says Dr Sealey, who has a private cosmetic practice out of Essex and who is an accredited member of The British Academy of Cosmetic Dentistry. “So we knew we had a good product.”

From there the developers tweaked the course, made a few refinements, and went fully live with SmileFast in late 2018. The company held 25 consecutive course days in 2020 to meet demand from clinicians looking to get started. Some days they had 2 courses on the same day, one in London and one in Manchester.

“It was insane,” Dr Sealey says. “I believe it’s something like 1 out of every 5 dentists in the UK has been trained on SmileFast. That’s how exciting this process is.”

He adds that many clinicians and patients are quick to share their satisfaction since going with this new smile makeover solution.

“It’s minimally invasive, very predictable, very cost-effective, time-efficient dentistry that completely transforms patients’ lives,” Dr Sealey says. “It’s amazing for us to see how SmileFast has helped these people and helped dentists to develop their careers. I think something like 10,000 smiles have been done over the last 5 years for patients so it’s a pretty incredible thing to be a part of.”

Dr Ojo says the courses and the workflows have evolved to make the SmileFast process even better for patients and clinicians alike. They’ve been able to refine and improve both the teaching and the solution, improving efficiencies along the way.

“A significant number of UK dentists are now trying SmileFast,” Dr Ojo says. “And it has given them the confidence to have a treatment plan. One of the things that is pretty unique with our system is yes, we talked about the solution, but we have a teaching element to our cases.”

For every case that is submitted, the dentist uploads the pictures and the stereolithography file or models to SmileFast, which then get uploaded onto a portal where at least 1 clinical dental mentor assesses the case along with a master technician. The cases are assessed both esthetically and functionally, and Dr Ojo says they actually deem about 10% of cases to be unsuitable for the process, which means they don’t take on cases unlikely to deliver great results.

“What we’re not doing, like some other systems might do, is just saying, ‘Yep, perfect. Bring it,’ ” Dr Ojo says. “We’re not trying to monetize it. What we’re trying to do is give a valued service.”

Initially the 2 founders assessed all the cases and oversaw the workflows. Now there’s a team of about 15 clinical mentors who assess the cases from across the UK and the US and provide treatment plans or a treatment proposal.

“We’ll identify the weaknesses or the things to consider because, again, not every case is a slam-dunk case,” says Dr Ojo. “We do have something called the traffic light system. We call it green for predictable cases, amber for those cases that require some augmentation before proceeding, and then, as I said, 10% of cases are deemed to be red cases, which we believe are outside the scope of traditional composite dentistry.”

With this system, the dentist is fully in control of the end outcome, with the ability to verify and make amendments to the digital setup. When that stage is complete, SmileFast digitally prints the models and sends them to the clinician, who takes the model to the office and transfers it into the patient’s mouth, where the second verification is done. When everyone is happy, it is transferred into the final step.

“That’s kind of how the process has allowed some dentists who weren’t confident but now it gives them a predictable platform beyond which they can say, ‘Let me submit the case. Let me get started.’ It has transformed the lives of a significant number of dentists as a result,” Dr Ojo says.

One thing that makes SmileFast unique is that it starts out with teaching how to assess a smile and how to deliver a classic veneer smile makeover to improve the esthetics. It teaches the process and the courses include hands-on training skills with composite bonding and smile design.

SmileFast has started to conduct courses in the US and clinicians are now using it and lecturing outside the UK. Information on courses can be found online at smilefastusa.com.

“We don’t think of SmileFast as just a solution-based system,” Dr Ojo says. “We’re offering it as an educational platform and an ecosystem where you can dip in and dip out where you need to, and really we’re thinking about just a holistic approach to make that patient journey a complete one. We’re sure that the patient can come in at any point and need a solution and we really believe that SmileFast can help the patient and the dentist on that journey.”

Cofounding dentists have developed a stent-based composite smile solution designed to be quick and affordable.

SmileFast Makeovers Are in Position to  Bring UK Success to America

Over the past 6 years, I have examined all the individual components of the information technology (IT) needs of dental offices. We’ve explored topics such as digital radiography, computers and networks, business analytics software, the Health Insurance Portability and Accountability Act (HIPAA), and a host of other topics. However, of all the topics I’ve written about, in my opinion, none is more critical than cybersecurity.

There is nothing more valuable to a dental practice than their patient information, and every office should make it their highest priority to protect and secure that data.

If you’ve read the recent articles I’ve written, then you know that I feel strongly that ransomware is far and away the biggest threat I’ve seen in my 35-plus years in dentistry, more than HIPAA, more than Occupational Safety and Health Administration issues, more than COVID-19. Even a cursory scan of the daily news would show the hundreds if not thousands of dental practices that have been attacked either by their own lack of adequate security or a lack of best practices from their IT company.

If you are committed to protecting your patient information, there are 3 general approaches that I recommend. You have to do everything in your power to keep the malware from reaching your network, deal with any malware that does get through, and, finally, be prepared to recover from an attack if all else fails.

There are literally dozens of ways to deal with ransomware, but as the old saying goes, an ounce of prevention is worth a pound of cure. The first line of defense is making sure you have a good firewall in place. By good, I mean business-class like Sophos or SonicWall, not the consumer-level firewalls like Linksys or D-Link or Netgear. A firewall will scan all incoming and outgoing traffic and will often stop malware before it can get into your network. I also recommend what’s called patch management, which is required by HIPAA. Because all software has security holes in it, you must, by law, keep those software programs up-to-date with the latest security patches. Any good managed service IT provider can assist you with this.

There are many viruses that we call zero-day, meaning they attack vulnerabilities that aren’t even known to exist. In those cases, a firewall and patched software won’t necessarily help. In those cases, you have to have systems in place to deal with the viruses. In the past, a good general-purpose antivirus application was adequate; that’s not really true anymore. However, there’s an even newer and more exciting approach called application whitelisting and ring-fencing, where only those programs that you preapprove are allowed to run and unapproved programs (like viruses) are stopped in their tracks. I’ve been installing application whitelisting for my clients for 2½ years and have not seen a single virus hit any of those systems with that protection in place.

If you have followed the first 2 steps above, the chances of being hit with a virus are very, very low—but low doesn’t mean impossible, so you should be prepared. Having a solid and tested backup and disaster recovery system is critical. However, we’ve seen more and more attacks called double and triple extortion. Double extortion is when they download a copy of your data and threaten to put it online and triple extortion is when they are able to access the patient files and threaten to contact your patients directly.

For these reasons, I highly recommend a minimum of $250,000 of cyberliability/breach insurance. Between legal costs and HIPAA fines and penalties, you’re going to need it if you ever suffer a breach.

In the modern era, there is no longer a single approach to protecting and securing your data. You must have a layered or stacked approach to doing everything you can to make sure the bad actors out there don’t put your entire livelihood at risk.

Providing your dental practice with adequate cybersecurity measures requires blocking malware from systems, addressing any malware that does get through, and preparing to recover from a data breach. 

The 3 Critical Components of Effective Cybersecurity

Access to care has long been a challenge for dentists and patients alike. While preventive care could prevent numerous oral health issues, it’s not accessible for a large percentage of patients—a percentage that has increased year over year.

According to the National Center for Health Statistics, the percentage of adults aged 18 to 64 years who saw a dentist fell from 65.5% to 62.7% between 2019 and 2020.

 Some of the decline may be attributed to the onset of the COVID-19 pandemic, but the numbers are still moving in the wrong direction.

“There are plenty of challenges in treating hard-to-reach patients: Funding, the number of caregivers willing to do the work, proper financial incentive to provide the care, and the amount of equipment required to perform dentistry are the main challenges I see,” says Stuart Kazen, director of domestic sales for Aseptico Inc. “On the positive side, there is more recognition about the lack of access to care and more effort to fund dental care. There is better equipment and technology.”

This technology may be key to bridging the gap. By utilizing technology-supported remote services and mobile technology, dentists can better connect with hard-to-reach patients and add the convenience to treatment that will keep patients coming back.

“Emerging technology holds tremendous promise in overcoming oral health challenges, reducing disparities, and enhancing access to care through various avenues,” says Maria Kunstadter, DDS, CEO of The TeleDentists.

These avenues encompass many areas, including precision dentistry using cutting-edge technologies that enable personalized treatment plans designed to improve outcomes for diverse patient populations; telehealth and remote monitoring that can bridge the gap between underserved communities and dental care providers; digital health records and analytics; mobile applications that encourage self-monitoring; and artificial intelligence (AI), computer vision, and machine learning.

“Technology has brought about transformative changes in how dental health professionals interact with and reach underserved populations, including improved care coordination,” says Tina Saw, DDS, founder and CEO of Oral Genome. “In the past, underserved communities faced challenges due to limited access to dental care and outdated communication methods like paper charts and phone calls. However, with the advancement of technology, dental practices have been able to bridge the gap and better serve these populations through enhanced care coordination.”

Bridging the gap to serve these populations isn’t easy. In 2022, there were 7192 dental care health professional shortage areas (HPSAs) in the United States—meaning the 69 million people living in those areas had limited or no access to dental care. To remove the HPSA designations across the United States, 11,896 practitioners would need to join the workforce.

This shortage of dental professionals and lack of access to care are particularly prevalent in rural communities, where 43% of people don’t have access to care.

 A 2019 study confirmed that people in rural areas were less likely to have seen a dentist in the prior year than patients in urban settings; 57.6% vs 66.7%, respectively.

“One significant hurdle is the lack of access to dental care in these communities, often due to limited facilities and a shortage of skilled dental professionals who are willing to work in such areas,” Dr Saw says. “Geographical barriers further compound the problem, making it difficult for patients in remote or medically underserved regions to access dental services.”

Even within urban populations, many people face challenges in accessing care. Language barriers, limited health literacy, and disabilities create unique obstacles to providing necessary oral healthcare. Disparities are also closely tied to other social determinants of health, which affect several racial groups disproportionately. Between 2019 and 2020, 66.6% of White adults aged 18 to 64 years reported going to the dentist compared with 56.8% of Black adults and 55.3% of Hispanic adults.

Financial differences also play into these disparities. Only 50.4% of adults in urban areas in homes with family income less than 139% of the poverty level received oral health care in the prior 12 months, while 79.3% of adults with income over 400% over the poverty level saw a dentist.

“Financial constraints and inadequate dental insurance coverage prevent many individuals from seeking regular preventive care or timely treatment, leading to the exacerbation of dental issues,” Dr Saw says. “Overcoming these obstacles requires targeted efforts to improve access, increase provider availability, implement outreach programs, and develop culturally sensitive approaches to ensure that all individuals, regardless of their circumstances, have access to quality dental care.”

In addition to income barriers, insurance deficits also negatively impact access to care. One study found that only half the children enrolled in Medicaid saw a dentist in 2019.

Medicaid is not required to provide dental benefits for adults.

“The biggest challenge is our profession,” Dr Kunstadter says. “Who is reaching out to those populations? When you look at the number of medical doctors who accept Medicaid, it’s in the high 80%. Dentists in my state who accept Medicaid is 29%. We need to engage our profession to provide services to those who need our help.”

Traveling to the dentist or even making room in a work schedule to go across town for an appointment can deter people from seeking treatment. To combat this, dentists are finding a way to bring treatment to people, instead of the other way around. Teledentistry is one way this is being accomplished.

“Why take half a day off from work or school to go into an office when the virtual consultation can be the solution?” Dr Kunstadter says. “For offices, why drag people in, use PPE [personal protective equipment], staff time, and chair time when a virtual consultation can solve the problem. It’s a learning curve for all new technology, but when implemented, will add innovation and improve workflow.”

With teledentistry, all it takes is an internet connection to have access to a dental specialist. Dentists can triage a problem, educate patients on home care, prescribe any necessary medications, and make assessments about whether the patient needs to come into the brick-and-mortar facility for hands-on care—all without the patient ever setting foot in the office.

“Virtual care helps patients be connected to that initial component of understanding the need for treatment and really eliminating the frustrations that are going to come up if you’re traveling an hour and a half to go see a doctor,” says Brant Herman, CEO and founder of MouthWatch and Dentistry.One. “If you have inflammation and need an antibiotic before your appointment, let’s get that done virtually. If you need to come in for treatment, let’s get the right stakeholders or family members on the call. If you have a follow-up appointment done virtually instead of in office, you’re more likely to attend it.”

In summary, Herman says, teledentistry gives clinicians the opportunity to educate the patient on why they should come in. They can address issues that might prevent a patient from going through with treatment before the appointment, allowing for a productive office visit when the patient does come in. The practitioner gets the opportunity to educate, reassure, and communicate all the things that might prevent treatment from happening, saving time and money for both the patient and the practice.

“Virtual care is a game changer in providing care to more patients,” Dr Kunstadter says. “All offices should offer teledental services. It not only increases chair time by eliminating unnecessary trips to the dentist but also can reach new patients who want the convenience of teledental visits.”

Platforms such as TeleDent from MouthWatch are designed to improve patient outcomes with remote monitoring while improving chair time efficiency. Clinicians can message patients or have live video chats to discuss issues or treatments. TeleDent allows practitioners to store notes, visual treatment plans, tooth numbers, images, videos, and more in a patient record and share intraoral images with other specialists or providers.

For dentists who are hesitant to add teledentistry to their offerings, there are other solutions. Dentistry.One is a network of providers across the country. Working with an insurance company or rural health authorities, Dentistry.One connects patients with a dentist to do an evaluation, talk to the patient to get an understanding of their needs, and make initial treatment decisions such as calling in a prescription. If necessary, Dentistry.One can coordinate in-office care for the patient.

“Dentistry.One can then find a dentist who accepts their insurance that has an open time slot,” Herman explains. “We send an oral health report based on the virtual consult to the doctor, and they, without doing anything, have a new referral. They have a new patient coming in and they understand the need for treatment for that patient. We felt we needed to start bringing actual care delivery into the model.”

The TeleDentists is another digital teledentistry platform that provides teledentistry services to patients 24 hours a day. Patients can go online and get a virtual consult from a board-licensed dentist at any time, reducing the need for an emergency room visit. When follow-up visits are needed, appointments can be booked for the next day.

Teledentistry isn’t just a convenient tool to reach underserved populations; for many who go to the dentist regularly, it’s becoming an expectation. With the medical industry increasing digital offerings, patients are beginning to expect and want the same level of remote care from their dentists.

“The health care consumer is way more tech savvy and way more expectant of having visits virtually, when possible,” Herman says.

Technology can also help identify potential health issues before they start. Through early detection, potentially severe problems can be avoided before they become critical. Remote monitoring applications make early detection and preventive care more accessible to hard-to-reach populations.

One such remote monitoring service is Oral Genome, whose saliva testing uses machine learning and computer vision to identify often-undetected oral health conditions. The patient takes the saliva test and scans it with their phone to get a wellness report that details their results and any high-risk factors. Patients can then consult with their dentist about any concerning areas.

“Oral Genome’s point-of-care dental saliva test allows for remote screening and early detection of oral health issues,” Dr Saw says. “Patients in dental deserts can use this screening tool to assess their oral health status and receive personalized prevention plans without the need to physically visit a dental office.”

Saw says technologies like Oral Genome, in conjunction with Harmony Health Foundation, offer promising opportunities for increased access to care in areas known as dental deserts.

“Harmony Health Foundation’s collaborative approach can integrate telehealth solutions, enabling virtual consultations between patients in dental deserts and dental professionals from other locations,” she says. “This real-time communication empowers patients to discuss their oral health concerns, receive advice, and access specialized care without the barriers of distance.”

And advances in technology are the foundation that is making this possible.

“The integration of AI, computer vision, and machine learning greatly facilitates early diagnosis and risk assessment of oral health conditions,” Dr Saw says. “By analyzing patient data and identifying patterns, these intelligent tools support dental professionals in making more accurate and timely diagnoses, especially in areas where access to specialized care is limited.”

Technology is also supporting boots-on-the-ground efforts to bring care delivery to the patient. In March 2023, Congress passed the MOBILE Health Care Act, which expands the ability of community health centers to establish mobile clinics in underserved areas. Since 2019, there has been 40% growth in health center mobile units that bring care and treatment to patients outside the traditional office.

“Oral disease is the most prevalent disease in the world and is almost 100% preventable,” Dr Kunstadter says. “With teledentistry, a dentist and a hygienist can educate auxiliary staff at schools, medical offices, and community health centers to provide the hands-on care to apply fluoride varnish, silver diamine fluoride, and more. Teledentistry is the tool to improve oral health and health equity for millions.”

Through teledentistry the midlevel provider can bring a dentist into the appointment virtually, and they can work as a dental team for more complex dental treatments. This is happening, for example, in remote areas of Alaska, where there are few dentists. In these settings, travel logistics and distances can be arduous. With technology, the dentist can be in more locations virtually while hygienists and dental therapists (depending on state-by-state regulations) can travel to the patients to provide care.

“A virtual dentist can be anywhere there is internet,” Dr Kunstadter says. “Access to the right specialist from a community health center can be key to improving oral health for that community.”

Providing care to remote areas is important but the benefits of mobile health clinics are far-reaching and can help other populations as well. Schoolchildren, geriatric or homebound patients or those with special needs, patients who are incarcerated, and underserved urban communities are all target populations for mobile dentistry.

To reach some of these populations, The TeleDentists is working with the National Minority Health Association (NMHA) to increase access to care. The NMHA’s goal is to help close the disparity gap in minor health and health care. The organization’s Operation Healthy You program identifies areas of health care disparities and works with health care providers—such as The TeleDentists—to address those needs.

“We are working together to improve health equity by increasing access to teledentistry and offering a training course for application of silver diamine fluoride when recommended by a virtual dentist,” Dr Kunstadter says. “This is a game changer for children as it could prevent small cavities from being emergency room visits in a few years and reduce the burden of poor oral health.”

In addition to teledentistry capabilities, advances in mobile technology allow for greater onsite treatment that might not have been possible in the past.

“Portable dentistry equipment continues to advance to be even lighter, better, and more capable than in years past,” Kazen says. “One of the biggest breakthroughs is the use of vacuum blower technology vs traditional air compression. In the past, portable dental delivery systems all used air compression to run the vacuum and handpieces. Today, new vacuum blower technology is preferred because it is just as powerful, quieter, and significantly lighter than traditional air systems.”

Other advances, such as the ability to run portable dental systems using battery power, have made dentistry even more mobile. With advancements in electric motors and batteries, some portable dental systems can operate for hours using battery power. This is incredibly convenient in rural areas with little access to power or in cases where the power has been knocked out.

One such system is the Aseptico GO Ultra Portable dental system, designed for performing restorative dentistry and dental hygiene. Compact and lightweight, the GO Ultra Portable can qualify as carry-on luggage. It can operate anywhere in the world; if there is no electrical power, there is an option for it to operate via a 24-V external battery.

“Aseptico helps dentists reach patients by designing and building portable dentistry solutions that dental professionals can rely on,” Kazen says. “The equipment has to do the job well; it has to be extremely reliable. Dentistry is demanding from an equipment standpoint and we don’t want the doctor to have to worry about whether or not their equipment is up to the challenge.”

Embracing technology in dental practices is perhaps one of the best opportunities to provide improved patient engagement, promote better understanding and management of oral health, and deliver quicker access to care for patients.

“Embracing technology is vital for increasing access to care at scale,” Dr Saw says. “Telehealth, mobile health apps, AI diagnostics, and remote monitoring enhance patient engagement and enable remote consultations. Seamless data sharing and interoperability that support comprehensive care coordination are essential in continuous health monitoring. Leveraging these technological advancements empowers patients, improves treatment outcomes, and fosters a more inclusive and accessible health care system.”

With technological advances emerging every day, opportunities for increasing access to care continue to expand. Technology like teledentistry and mobile dentistry is opening doors to close care gaps across the country—and the implications could be monumental.

“Incorporating these emerging technologies into oral health care practices with a focus on inclusivity and affordability can pave the way for a brighter future, where oral health disparities are minimized and quality care is accessible to all individuals, regardless of their circumstances,” Dr Saw says.

There’s still work to do, but the progress toward reaching all dental patients is encouraging.

1. Cha AE, Cohen RA. Dental care utilization among adults aged 18−64: United States, 2019 and 2020. Centers for Disease Control and Prevention. April 20, 2022. doi:10.15620/cdc:115597

2. Dental care health professional shortage areas (HSPSAs). Kaiser Family Foundation. September 30, 2022. Accessed August 23, 2023. https://www.kff.org/other/state-indicator/dental-care-health-professional-shortage-areas-hpsas 

3. Rural America’s Oral Health Care Needs. National Rural Healthcare Association. Accessed August 23, 2023. https://www.ruralhealth.us/getattachment/Advocate/Policy-Documents/RuralAmericasOralHealthCareNeeds-(1).pdf

4. Cha AE, Cohen RA. Urban-rural differences in dental care use among adults aged 18−64. NCHS Data Brief, no 412. Hyattsville, MD: National Center for Health Statistics. 2021. DOI: 

https://dx.doi.org/10.15620/cdc:106856external icon

5. Corr A, Wenderoff J. Inequitable access to oral health care continues to harm children of color. The Pew Charitable Trusts. March 11, 2022. Accessed August 26, 2023. https://www.pewtrusts.org/en/research-and-analysis/articles/2022/03/11/inequitable-access-to-oral-health-care-continues-to-harm-children-of-color.

6. Medicaid adult dental benefits: An Overview. Center for Health Care Strategies, Inc. September 2019. Accessed August 26, 2023. https://www.chcs.org/media/Adult-Oral-Health-Fact-Sheet_091519.pdf.

7. The Mobile Health Care Act: Everything You Need To Know. NACHC. June 14, 2023. Accessed August 23, 2023. https://www.nachc.org/resource/the-mobile-health-care-act-everything-you-need-to-know/.

Technologies help dentists connect with hard-to-reach patients and add convenience to treatment.  

Care From Afar

When important equipment breaks, the last thing you need during your busy day is to have to help an assistant look for the product information, rifle through business cards to find who fixes that particular device, schedule the technician, and then keep track of when they’re coming and whether they actually show up, and know where to file the information about the repair for next time. It’s exhausting just thinking about it.

You and your staff should not have to be equipment or inventory experts. But keeping all your devices in working order is key to providing the best care to your patients and getting your best return on investment. I spoke with CEO and cofounder of UptimeHealth, Jinesh Patel, to find out about his strategy to simplifying and predicting dental equipment service, purchase, and compliance.

How did you get the idea for UptimeHealth?

Jinesh Patel (JP):I have a master’s degree in biomedical engineering and an MBA, so I enjoy working on device design as well as equipment management and processes. Early on, I got a job as a clinical engineering manager for the largest health system in Austin, Texas. This involved taking care of the equipment inside our huge health care system, developing a strategic maintenance plan, keeping track of vendors, monitoring cost-effectiveness, and working with the departments to inform their purchase decisions. I came to understand what compliance means for the environment of care in the medical world and how a broken device impacts the day-to-day operations.

In 2013, when our health system started acquiring urgent care outpatient locations, I was tasked with evaluating their equipment management policies and compliance. When I started interviewing them, I realized they had no solutions; some could not even show me a device list or management plan for their equipment. These are items required by regulatory bodies in the medical world.

I was surprised that in most of these cases, there was no equipment expert in the building. Yet every medical procedure requires some kind of medical instrument. That was my inspiration to create UptimeHealth. I was serendipitous enough to meet cofounder Bill Olsen, a software expert who formerly was chief technology officer of Accruent, the premier equipment and asset management platform for health care systems. He saw the same problems I was seeing. At first, we were hyper-focused on the urgent care and surgical markets,but in March 2020, during the COVID-19 crisis, we started to look at other markets that could be helped by UptimeHealth and decided to serve the niche of over 120,000 dental offices in the US.

First we help dental offices manage their equipment efficiently by creating a roster of what they actually own, a comprehensive list—category, model, serial number, location in the building, who is managing the device at that building, the date of purchase, and purchase price. We make all these data points searchable. So there is, for example, a list of all the autoclaves in the office, all the chairs, everything. Based on that roster, we indicate any upkeep or maintenance that is needed for that equipment—on a daily, weekly, monthly, quarterly, annual basis, and whether it’s compliance related.

A good example is testing sterilizers or clean-outs for chairs that need either to be maintained or comply with applicable laws. A task management engine flags the tasks that need to be done and then stores the maintenance record for each device in a digital binder. Also, we keep a record of your service technician so in case of an issue, you’re not searching for business cards or emails for your contact. With UptimeHealth, you can click a button and send a message to that technician telling them about your problem, along with all the pertinent information on that device, and an office contact for more information. We then track their service progress. You can look across the systems and see if the service call is scheduled, if parts are on order, and when it’s complete. Anyone in the office can log in to the product and see the status of a piece of equipment.

Lastly, we analyze data about your equipment—how often it’s failing and how much it costs to service and support those devices. We can produce depreciation reports and suggest when it may make sense to replace instead of repair equipment.

In addition to our original services, customers have requested other applications, like facilities management. We already have a concept of your space because we assigned the devices to their places in the building. So just like you open up a service ticket on a device, you can open up a service ticket on an area, such as an operatory where a ceiling tile has fallen or a plumbing issue.

 We are in the process of developing a sophisticated version of the equipment roster to store documents for your office, and in the future we are envisioning that eventually our product will communicate with the equipment, like a machine will send a message when it may be overheating, and that will create a task or a service ticket.

UptimeHealth helps dental practices manage equipment and analyze efficiency and maintenance to ensure everything runs smoothly.

Simplifying Equipment Service, Purchase, and Compliance

Technophobes beware: Digital dentistry is here and it isn’t going anywhere. Analog impressions used to be standard, but intraoral scanning has pushed them to the wayside. Bitewing films have been replaced by digital radiography. Electronic health records have pushed practices paperless. And while many of these developments may have seemed intimidating at one time, they’re the new normal.

While many dentists might equate the embracing of new technology with younger practitioners, digital technology is catching on even among traditionalists. The numbers prove it: The global digital dentistry market, which was $915.6 million in 2021, is expected to undergo a compound annual growth rate of 8.7% by 2029.¹

“A digital environment has really gained importance for dentists in their workplaces nowadays,” says David Baker, chief information and digital officer at Pacific Dental Services. “Over the past few years, there has been less resistance and a greater openness to what technology and digital solutions can offer dentists. Dentists are increasingly realizing the benefits that digital solutions bring, both in terms of enhancing patient care and streamlining practice operations, for a more seamless health care experience.”

From streamlined workflows to improved patient care, technology can improve dental practice operations and patient experiences and support dental operations through the entire life cycle of a patient, including patient acquisition and marketing, scheduling, digital correspondence, treatment, and billing.

“Multichannel communication and marketing automation has helped patients get timely care,” says Kameron So, senior product manager for Planet DDS. “Artificial intelligence [AI]-assisted pathology detection and decision support also enhance clinical outcomes. Technology can crucially help dental offices focus their attention on patient care.”

In addition to streamlining the patient life cycle, digital platforms increase convenience in clinical care. Digital technology eliminates waiting periods, reduces the need for repeat scans or visits, and increases patient comfort.

“Clinical technology has made a great impact,” Baker says. “Conventional restorative dentistry involved sending specimens and impressions off to remote labs and waiting for days, but now, we can create crowns right there, chairside, while the patient is in the office. This digital shift has turned dentistry around, offering not only cost savings, but also a better experience for the patient and speed of service by the clinician.”

And patients are coming to expect it. Dental patients have experienced the digital workflow with their medical doctors and expect no less from their dentists. Increasingly, patients look for conveniences like paperless appointment booking and registration and being able to pay their bills digitally or manage their own medical records.

“One of the recent technology trends we’re seeing from the consumer side is the increasing expectation for a digital experience,” So says. “It’s really a differentiator for dentists to stay current on new technologies to continue meeting patient expectations.”

But it’s not just patients who are searching for a digital experience; young dentists entering the field are as well. The generation that has grown up online—with email ousting paper, cell phones that act as computers, and digital x-rays in medical offices—expects technology in the workplace, too. Digital workflows no longer are seen as innovative but have become integral pieces of a successful dental practice. The march toward a completely digital dental experience continues, with many championing its evolution.

“At this point, I wouldn’t want to go back to a nondigital workflow,” says Marty Jablow, DMD. “Everything in my office is digital from the front desk all the way up to x-rays, radiographs, cone beam, digitizing patients when they walk in the door with an intraoral scanner, etc. We’ve been paperless for 15-plus years. It’s just the normal migration forward.”

Preparing Emerging Dentists for Digital Dentistry

This push toward digital begins, as all dentists do, in dental school. The integration of digital technology into educational programs is birthing a new generation of dentists who understand and embrace digital technology. And new programs are leading the charge.

In Joplin, Missouri, the impetus for a new dental program came not from a digital focus, but from a need for care. Jasper and Newton counties (Joplin straddles both) and most of the surrounding counties have been qualified as dental health professional shortage areas by the US Health Resources and Services Administration. In Jasper County alone, 10.8 full-time dentists are needed to meet the minimum ideal practitioner-to-population target ratio.2

“Within 150-mile radius of Joplin, all of the counties were deemed dental health professional shortage areas,” says Kathryn Champion, DMD, director of clinical operations at Kansas City University’s new College of Dental Medicine (KCU-CDM). “We actually have a shortage of over 750 dentists just within this corner of the 4-state area.”

These staggering statistics reflected an obvious need for more accessible dental care in the region. Linda Niessen, DMD, founding dean of KCU-CDM, contacted Dr Champion to talk about founding a new dental school.

“We really wanted to bring a dental school here because data have shown that when you recruit students from local populations, they are more likely to stay in those areas,” Dr Champion explains. “We wanted to bring a dental school here where there’s a great need for oral health care and then, hopefully, encourage those students to then continue practicing in these rural underserved areas.”

Dr Champion was a newer dentist herself. She graduated from the Nova Southeastern University College of Dental Medicine in 2018, and had been in private practice for 3 years when Dr Niessen reached out to her.

“Academics really wasn’t anything I had previously thought about, but the opportunity to start a school from the ground up sounded almost too good to be true,” Dr Champion says. “I saw it as an opportunity to address the shortcomings that I had in my dental education and bring new things into this program.”

Dr Champion stresses that she got a great dental education but saw gaps in the curriculum that could be improved upon. She says much of this was due to little integration of real-world scenarios into the didactic portion of the education. Because dentists spend 4 years in school and are then licensed to go out and treat patients, Dr Champion felt that preparing students for that through clinical applications in real-world scenarios they might run into was important. This included understanding the latest technologies and how treatment was executed in a dental practice.

“Digital dentistry is really growing so much and expanding every day,” she says. “While not every office you might go into when you graduate will have the complete suite of digital dentistry, it’s important for our students to know what’s coming. We want to be on the cutting edge of technology so that they can go out into practice and feel comfortable using these new digital technologies to help their patients.”

And they are introducing students to many aspects of digital dentistry. Intraoral scanning, digital impressions, and exocad are all utilized in the curriculum to expose students to an all-digital prosthesis workflow. Students start in the simulation lab but eventually get to practice intraoral scanning on real patients. But even when real patients enter the picture, there’s technology that can help.

“We have simulation technology that will allow us to scan our patient’s mouth and practice treating that patient beforehand with a virtual reality headset and tools that give haptic feedback so we can be prepared for the actual procedure,” says Stephanie Melot, RDH, a first-year dental student at KCU-CDM.

Dr Champion agrees that the haptic simulator is a great tool for patient safety and patient care, as students get to practice digitally but realistically before actually working in a patient’s mouth.

“The haptic simulator mimics what it feels like to prep into a tooth so you get the feel of what real enamel feels like or what it feels like from the transition from enamel to dentin,” Dr Champion says. “You can simulate how it feels to give oral injections and how it feels when you hit bone or anatomical landmarks. It’s a really great teaching tool.”

The program uses another digital tool to evaluate preparations. E4D Compare software helps teach students how far they’ve deviated from an ideal impression.

“If you’re prepping a crown, you have certain parameters and measurements that you want to get to for certain types of materials,” Dr Champion says. “So what the student can do is prep their Typodont tooth and then they can scan it and overlay the ideal prep on that and see how far they’ve deviated. It’s a really good tool for educational purposes so they can see how they can improve in that respect.”

Dr Champion and the KCU-CDM team felt it was critical to expose students to all aspects of digital technology, not just in educational tools. The program integrates digital x-rays and sensors, CBCT, and 3D imaging, all under 1 digital suite.

“There’s 1 program that controls all of those components,” Dr Champion explains. “It makes it a really streamlined process for the students to learn all of those touch points of digital technology and how they can utilize them at different points in patient care.”

Students also have the opportunity to work with 3D printers and onsite digital milling. Dr Champion feels that all of these digital technologies combine to not only streamline a dentist’s workflow, but also entice patients because of their convenience.

“When you graduate and you’re now treating patients, patients are looking for these digital enhancements in an office,” she explains. “And so I think students are therefore looking for schools that will give them a comprehensive education on digital technology as well.”

As digital technology improves and increases, students are looking for opportunities to embrace the latest innovations, both in dental school and beyond. Dr Champion says students are looking for dental programs that are incorporating what’s on the forefront of dentistry and looking forward not to just what’s happening now, but what’s to come as well.

“Digital technology is more of an expectation now and part of that is because digital technology comes a lot easier to the next generation of graduating dentists to begin with,” Dr Champion says. “Digital dentistry can’t take away the importance of analog skills, but the digital adaptation of a lot of those things is becoming the expectation for incoming students.”

Melot is enrolled in KCU-CDM’s inaugural class. She began working as a dental hygienist in 2011 but always wanted to pursue a career as a dentist.

“I was drawn to dentistry when I was in dental hygiene school and I realized that the skill set I was learning there would not match the need that I saw in my community,” Melot explains. “The need for quality dental treatment in the underserved community where I lived would only partly be met by what I could do as a dental hygienist, and I wanted to be able to fully meet those needs.”

This brought Melot to KCU-CDM, where she is learning the latest technology, and being immersed in the digital workflow has fanned her enthusiasm for other emerging technologies.

“The dental technology that excites me is the research of stem cells for dental tissue regeneration and the use of intraoral scanners used in conjunction with CEREC [Chairside Economical Restoration of Esthetic Ceramic] technology and 3D printing,” she says. “These technologies optimize what dentists are capable of in the office.”

To truly accomplish this optimization, Melot says a digital work environment is a must. “I’ve worked in an office that was more analog, and the patient care was diminished by a lack of resources,” she says. When it comes time to graduate and enter the workforce, Melot will look for a more technology-minded practice.

“I will look for a practice that serves the underserved in the community, but beyond that, I want the practice to be open to new technology that will create a better patient experience,” she says. “Some of the newer technology like 3D scanners, CBCT, intraoral scanners, and high-quality software management are quickly becoming the standard of care in the dental office. Therefore, those are important features to look for.”

With so many young dentists accustomed to working with digital tools—and interested in continuing to do so—existing practices need to stay abreast of new technology if they want to attract associates or sell their practice. Practices that aren’t embracing digital workflows may not be as appealing to younger dentists who want a modern experience that they feel will better help them succeed.

“If you’re coming out of school and you’ve had exposure to this digital technology, it’s hard to adjust to not having the capabilities and the accessibility that you had in school,” Dr Champion says. “The dentists who aren’t incorporating new technology into their practices are maybe seen as a little more antiquated and maybe not as successful. Students want to come out into a practice that has the best success potential for them and that is incorporating digital dentistry within the practice.”

Dr Jablow agrees and says he sees the same trends in practice sales.

“If you’re running on the analog side of the bell curve in terms of technology acquisitions and implementation in your office, you’re going to have a little bit more difficulty if you want to sell your office,” he says. “People would like more up-to-date things, especially younger dentists who are coming in and thinking, how much money do we have to pump into this venture to bring it up to the standards of the 2020s?”

The draw of technology has dovetailed with the rise of dental service organizations (DSOs) and group practices. Cost can be a significant barrier for smaller practices, but larger organizations have more money to invest in cutting-edge technology. This makes technology-forward groups and DSOs appealing to young dentists because they will be able to practice more advanced (and often subsequently more profitable) dentistry right from the beginning of their careers.

“[With a DSO], there won’t be a need to spend time developing, researching, and implementing these technologies over extended periods,” Baker says. “Instead, they’re readily available as soon as you begin. This enhances the quality of care and your potential for success.”

With staffing and staff retention issues continuing to be a critical concern in the dental industry, providing digital tools that automate tasks, streamline workflows, and allow staff to work more efficiently can be an effective strategy in attracting (and keeping) staff.

“If technology can allow staff to work more efficiently and automate tasks that aren’t as valuable for creating outcomes for the practice or patient, it certainly would make that practice or DSO more attractive to staff,” So says. “Implementing technology that allows staff and associates to focus on higher-value tasks can increase job satisfaction and staff retention. Being technology-oriented can also help attract younger dentists and staff who tend to be earlier adopters of new innovations.”

As technology advances and continues to shift to the norm, dentists need to ensure they understand the latest trends and embrace the technologies that can at least keep them even with the rest of the pack. Baker believes dentists should actively look for digital tools to stay competitive and provide high-quality care. Digital environments, he says, empower practices to manage patient data efficiently, elevate diagnostic capabilities through advanced imaging, and offer better patient care.

“What’s more, these digital solutions resonate with tech-savvy patients, making the adoption of such technologies not just an attractive option but a necessary step to meet the ever-changing health care standards a patient should expect,” Baker says. “I believe that it is important for dentists to understand the shifting market landscape, as there’s an impressive amount of progress taking place. But in my view, as a DSO, it’s our responsibility to stay ahead of the latest technology trends and ensure that they reach a ‘proven’ state where benefits are well-established.”

When it comes to those well-established technology trends, there are several that all practices should embrace—but some that may not be necessary for everyone. Sifting through the glitz and marketing flair of emerging technologies can be critical to ensuring dentists are getting the best return on their investments.

“The first thing when adding any digital technology is to assess what it is going to do for your practice,” Dr Jablow says. “How’s it going to be helpful? Is there a return on my investment? That’s just an intellectual discussion to have with yourself.”

Intraoral scanning and digital impressions have become a staple in many practices and intraoral scanners are a tool that most young dentists will expect to find in a practice’s workflow. Champion thinks this technology is probably one of the biggest digital innovations that dentists need to have, while Baker also cites the importance of other clinical technology.

“Equally important are precision-enhancing technologies that elevate patient care, including advanced imaging solutions and comprehensive patient health records that highlight a truly integrated longitudinal medical and dental history,” he says. “Also, the evolution of 3D printing and chairside labs has transformed our approach to restorative dentistry, offering patients the convenience of same-day procedures.”

Outside the operatory, digital workflow technology is another imperative adoption. Tools that streamline time-consuming or cumbersome administrative tasks (such as automated scheduling and billing) can increase practice efficiency dramatically, lowering workloads and allowing more time for patient care. Combined with clinical technology, a digital administrative workflow can optimize care.

“In essence, the combination of proven technologies across administrative and clinical domains ensures that dental practices can provide the highest level of care while remaining efficient and patient focused.”

Taking things to the cloud is another technological solution that can keep things running smoothly. With everyone accustomed to Google Docs and programs accessible from multiple devices, going cloud-based makes sense for many practices.

“A cloud-based practice management solution would be the most important because it truly is the central operating system and source of truth where you keep all patient data, and it covers the entire life cycle of the patient experience,” So says. “Our cloud-native applications are designed to take advantage of cloud computing principles and services to be highly scalable, resilient, and flexible in support of practice growth.”

So shares that Planet DDS offers numerous options for practices looking to leave a centralized system. Planet DDS couples its cloud-based practice management solution Denticon (along with Denticon Practice Analytics, Denticon Pay, and Denticon Practice Engagement) with cloud-based imaging (Apteryx XVWeb), and Cloud 9, an orthodontic practice management solution. Integrating several of these applications will provide practices with 1 easy, streamlined digital workflow, So says.

Baker also believes a digital workflow is key to success. Pacific Dental Services is committed to leveraging proven technology, which is reflected in the range of tools it offers its clinicians. This includes CEREC computer-aided design/computer-aided manufacturing for same-day dental restorations, AI-powered software, state-of-the-art practice management systems, and salivary diagnostics—keeping clinicians on the cutting edge.

“Our clinicians have access to the latest advancements that enhance accuracy and efficiency in patient care,” Baker says. “These technologies not only streamline daily tasks but also enable precise diagnostics and treatment planning, ultimately contributing to improved patient outcomes. In essence, Pacific Dental Services is dedicated to providing clinicians with a technological and digital edge that empowers them to consistently deliver the highest standard of care.”

Digital dentistry is the future of dentistry, making it vital that clinicians familiarize and grow comfortable with all the digital dental technologies at their disposal

Dental Products Report October 2023

Report Provides Insights to Help Give Patients Clarity on the Cost of Dental Care

SmileFast Makeovers Are in Position to Bring UK Success to America

The 3 Critical Components of Effective Cybersecurity

Care From Afar

Simplifying Equipment Service, Purchase, and Compliance

Digital, Dentistry’s New Normal

How Do We Help Those Who Came Before Us?

Celebrating a Toothlike Composite With 10 Years of Performance

Ghost of Implants Past

Sponsored Content: Why Water Matters to a Dental Practice