What 2023 Taught Me for 2024

As the new year settles into its normal tempo, it is a good time to reflect on the experiences of the past year. We spoke to 3 of our editorial board clinicians about what they learned this past year and how that will affect their dental practice in 2024.

More AI Professionally and Personally

John Flucke, DDS, chief dental editor and technology editor at Dental Products Report, predicted last January that 2023 would be the year of artificial intelligence (AI) in dentistry, and it was. Going into 2024, he thinks its applications will continue to develop and grow, and not just in dentistry. AI is everywhere.

“It reminds me of science fiction where the killer plant puts all these roots underground, and no one realizes it, and all of a sudden, one day, these things sprout up everywhere,” Dr Flucke says. “Artificial intelligence is so embedded in many things we do now that it can accelerate change quickly. We saw huge growth regarding AI in 2023, and I look for that to continue to grow exponentially in the next few years.”

For example, Pearl AI assists dentists by analyzing radiographs and applying algorithms that look for caries, infections, and periodontal disease. Dr Flucke says as these systems get more data, Pearl AI will identify more areas for clinicians to examine. Comparing the technology to a second set of eyes, he emphasizes that AI doesn’t make decisions; it provides more data points.

“It doesn’t decide what to do any more than an x-ray tells you what to do,” Dr Flucke says.

AI also impacts the clear aligner market. Dr Flucke began working with Candid, which has functionalities enhanced by AI. Candid has a tool that attaches to a mobile phone, which the patient uses along with the app to take a video of their mouth. Once uploaded, AI monitoring can determine when the patient should change aligners. Also, it can detect when something is not working as it should and notify the patient and practice that they should meet to make adjustments. 

“You get all…this info every time they scan, and the patient doesn’t have to take off work and come in for a 20-minute appointment where I look and go, ‘yep, everything looks great! See you in another 4 weeks when you take another day off work,’” Dr Flucke says.

He also likes the polymer chemistry of CandidPro’s material, which provides continual slight pressure movements. Therefore, the teeth do not get as sore as they do with other plastics.

“Now the trays stabilize the pressure so your body can get used to it,” Dr Flucke says.

In-office mills design software that will also soon have enhancements provided by AI, he says. Maybe as early as 2024, an AI system can design the indirect restorations needed from the intraoral scan taken in the office. 

“Then you can download the file and mill it, and it will take 5 minutes to create all that for you,” Dr Flucke says. “That’s a game changer, too. Artificial intelligence is slowly permeating everything.”

Delving Deeper Into Digital Dentistry and Marketing, and Working on Balance

Speaker and educator Jeffrey Lineberry, DDS, AAACD, FAGD, FICOI,has a private practice in North Carolina that has delved deeper into the digital side of dentistry this past year. He recommends that clinicians follow suit, particularly those on the fence about taking on a digital workflow. Digital dentistry is not a fad that is going away, he says. Plus, digital scanners are getting a lot more affordable.

“Printing is another huge part of what we do. It’s getting to the point now where I don’t remember the last time we poured up a model in our office. That’s interesting when you don’t hear the model trimmer going anymore,” Dr Lineberry says.

In addition to models, Dr Lineberry prints surgical guides in-office, which has been more cost-effective and predictable. With files available for download to print in-house, his team appreciates not having to wait for the guides to be shipped.

The most significant change while incorporating 3D printing is creating a digital workflow that is practice specific. Dr Lineberry’s staff has taken on this responsibility, particularly regarding the practice’s printer setup. Moreover, it is essential to mention that using a 3D printer in the dental practice is not as easy as using a printer to print a Word doc.

“But once they figured that there were more steps to it, it [was] like everything else,” Dr Lineberry says, comparing the implementation phase to figuring out a new cell phone for the first time. “When you start using the phone, it’s time-consuming and makes you want to pull your hair out. But once you get used to doing it that way, you forget how you used to do it otherwise.”

In addition to investing in the digital workflow for his practice, he thinks that 2023 confirmed for him the critical nature of constantly refining the elements of practice management. He thinks the days of riding out the status quo are gone.

For example, ongoing marketing is a necessity today and it was not in the past. In some cases, advertising dental practices used to be taboo.

“There was a time here in North Carolina [when] we weren’t allowed to advertise other than making announcements [such as] we opened a practice or [were] accepting new patients,” Dr Lineberry explains. “Marketing was very much frowned upon. Now it’s very much mainstream. It’s a different thought process, especially [for] dentists like me who have been doing it for 20 years.”

Dr Lineberry has been marketing more in 2023 and letting his marketing dollars gravitate away from the traditional channels and toward digital marketing and social media. Keeping up to date on these types of changes is vital, he notes.

“You may not want to embrace the whole digital marketing thing, but it is a viable channel and an integral piece of how we market today,” he says.

Consistency is key with marketing. Getting busy and letting marketing efforts slide will lead to a schedule that waxes and wanes between very busy and not so much, Dr Lineberry says.

Plus, having an online presence is essential to a dental practice. Many patients find their dentists online, using reviews and other online feedback to narrow their choices. Dr Lineberry thinks the time of giving a referral and expecting the patient to go to that referred clinician is also past.

“Patients are much more involved with making some of these decisions, and some of those are made online,” Dr Lineberry says. “Marketing, the internet, and an online presence are very much a driving force in making selections in health care nowadays.”

He also thinks that dentists should focus on self-care in 2024. Self-care should be an ongoing priority for clinicians.

“No matter how busy you get in your practice, you should always take time to take care of yourself,…mentally and physically…. [Carve] out time specifically for yourself and your family, working on your work-life balance,” Dr Lineberry advises.

The benefits of this effort are improved performance in the practice and an abundance of positive energy. The pitfalls of ignoring self-care are the opposite.

“If you come in like, ‘Oh my gosh, why am I here today? Somebody please shoot me,’ that’s not going to be very healthy for your practice or your patients,” Dr Lineberry says.

Working Smarter as Well as Harder to Manage Shrinking Margins

Jason H. Goodchild, DMD, vice president of clinical affairs at Premier Dental Products Company, says because new technology and materials come out all the time, clinicians should always learn new techniques for whatever pathway they choose for their practice. He describes this type of lesson as table stakes. Learning these new techniques is essential, whether through live events, webinars, podcasts, or journal articles.

In addition to new techniques for the services dentists already provide in their practice, Dr Goodchild thinks an eye toward the efficient and effective expansion of services is also critical. Part of this consideration is recognizing how to acquire new skills and the technology accompanying the service while managing the shrinking margins in dentistry to increase revenue.

“We can’t just do more and expect to make a better profit. That’s the fallacy many dentists fall into, which is, ‘I’m going to work more hours or pick up a Saturday here and there, and I will make more money,’” Dr Goodchild says. “But unless you do the other things to increase the profit margin, you’re just killing yourself for no particular reason.”

The revenue associated with more activity should produce a profit after the costs of the increased activity. Dr Goodchild explains that if you spend more to acquire that revenue, with things such as workforce costs, you can end up spinning your wheels from the perspective of bottom-line success. Dentists should have a keen eye for efficiency with their time and an understanding of what they spend to get to more production to protect their profitability.

“Unless you do the things underneath the top line to protect and increase [the] margin, it won’t work,” he says. “That’s why one of the things I’m involved with is how to do things more efficiently.”

Dr Goodchild has a unique clinician perspective because he also works on the manufacturing side. Both viewpoints value doing things better, safer, and faster. However, on the clinician side, there is also the element of doing it more cheaply without compromising care.

“What they want to do is minimize,” Dr Goodchild explains from the practice-owner perspective. “They want to look for great deals on equipment, supplies, and consumables.”

One way to find deals that increase the margin without sacrificing quality of care is to look for areas where a private label can perform as well as a brand name. Dr Goodchild discourages clinicians from buying a brand name at a higher price when it does not provide specific value in the present environment.

“[For] paper products, gloves, cotton rolls, distilled water, and other highly commoditized products, I’m always looking for the best deals. When it comes to products like burs, composite, bonding agents, cements, and [prophylaxis] paste, I still look for the deals, but also still feel like branded products will handle and perform the way I want,” he says. “Everything is getting so expensive, and dental products are no exception. There’s at least 1 price increase every year, probably more—and you can’t say the same for your reimbursement from insurance.”

Another area that Dr Goodchild thinks he learned a lot from in 2023 was managing the cost of the acquisition of talent. It’s not a secret that acquiring and keeping the right team was a challenge this past year, and it is only getting more complicated, he says. With all the competition, dental assistants and hygienists are commanding more per hour and getting it. In some cases, hygienists are doubling their hourly rates. Dr Goodchild says this area significantly challenges a dentist’s bottom line.

Digital workflow components press the margins, too, he says. When one compares the price of their digital technology to that of their more affordable analog counterparts, such as film and processors or alginate, it compounds the growing costs associated with running a dental practice. Plus, it is harder to control production when the workflow depends on the internet, which can fail, or a server or image management programs that can glitch. Dr Goodchild says these are all practice killers.

“They grind us to a halt, and we still need to keep going with the schedule,” he explains, adding that he worries the growing pressure with overhead expenses could influence the treatment planning of young dentists. “Are they prescribing things on the borderline because they need the revenue? I hope that they resist that urge.”

Per Dr Goodchild, a solution-based approach to procedures is a powerful way to move forward into the new year. For example, clinicians do not require 5 different bonding agents and composites, nor do they need an assortment of approaches to procedures. One system for Class II composite filings or crown placements can streamline things.

“This approach becomes important when there are multiple doctors in a practice because every doctor wants a different thing and does things their way. But suppose there are systems in place and solution-based approaches for better outcomes. In that case, that’s a powerful way of looking at it because then you don’t have tons of different materials in the practice [or] lots of extra stock that you don’t need,” Dr Goodchild explains.

He also favors the just-in-time approach to managing inventory. Rather than carrying thousands of dollars’ worth of inventory in the practice’s storage closet, have only the items used consistently and reorder often. If the inventory budget is 6% of the gross revenue, why not reduce that by 1% in 2024?

“If I cut that 1%, then [those dollars flow] right back into my pocket as the owner,” Dr Goodchild explains.

In general, Dr Goodchild would encourage clinicians to look at the bigger picture regarding the margins in the business. However, it is also critical to remember to plan for taxes. In the first year of his practice, he worked hard and didn’t spend any money on capital improvements or equipment. His practice revenue was significant, but his tax bill killed his profit. However, this hard lesson drove home the idea that you can work harder, but working smarter is also crucial. He thinks clinicians should remember this going into the new year.

“In the days of everything getting so expensive so fast, it’s even more in focus,” Dr Goodchild says. “It has to be."