Digital, Dentistry’s New Normal

Digital, Dentistry's New Normal. Image credit: © Damian Sobcyzk - stock.adobe.com

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 Bitewing films have been replaced by digital radiography.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.”

The Student Mind-Set

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.”

The Temptation of Technology

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.”

Staying Ahead of the Curve

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.”

While DSOs may be leading the way in digital technology, small practices shouldn’t be deterred by daunting upfront costs or technology adoption anxiety; Dr Jablow says the return on investment is definitely worth it.

“Digital technology and the digital workflow are here, but don’t be afraid of it,” Dr Jablow says. “Don’t be afraid of the cost to acquire it because it’s going to pay itself back easily. The ROI is there; you just have to spend the time and the effort to train in it so that you can get the maximum value out of it.”

Looking Forward

Digital is undeniably dental’s new normal, and there’s only more growth on the horizon. The industry is at a tipping point, Baker says, where technology and dentistry are coming together, giving dentists the opportunity to leverage it for more efficient and effective workflows. Dental students accustomed to digital technology such as intraoral scanners, AI, or 3D imaging are now looking farther afield for what comes next and how it can be applied in dentistry, However, this application is dependent on the industry’s willingness to adopt it.

Melot thinks there already are tried-and-true methods that dentistry just needs to embrace.

“I’d be interested to know what innovations or technology the medical field has that could be used for dental treatments,” she says. “Practicing with new technology is the best way to become proficient. Less tech-savvy clinicians could consider new technology from a growth mindset perspective, which would allow them to learn a new skill set while being kind to themselves as they struggle learning something that is unfamiliar to them.”

As practitioners learn new skills and new ways to utilize technology in their practices, advancements will continue to develop. AI and machine learning will integrate into different aspects of dentistry and provide more support in identifying pathologies and even chairside education, while automation processes will speed up workflows. The innovations will continue to unfold at a rapid clip and staying up-to-date will be paramount to success.

Jablow recommends that dentists use the resources available to them and seek out information on technologies from the internet, key opinion leaders, and continuing education seminars.

“When I graduated, you could only get this information from a bunch of magazines that came out every month,” he says. “Now the information is available in almost real time. Google searches, Facebook groups, or even asking your friends and neighbors who are dentists can get you the information you need. Plus, key opinion leaders are now easily accessible online. So take advantage of where you can and get the information that you think you need to be able to move your practice in the direction that you want it to in terms of technology.”

As far as the direction a dentist takes technology, it’s up to each individual practice to decide what works best for them, their workflows, their treatment plans, and their patients.

“I tell my students to use technology judiciously,” Dr Champion says. “Make sure that you understand how technology can enhance your practice and how it can make you more efficient. But don’t rely on digital technology solely; you still have to understand foundations of patient care. Be selective in your digital capabilities and invest in continuing education so you can understand what’s on the forefront of dentistry, and then incorporate into your own practice what makes the most sense for you and the care that you do.”

However the technology is incorporated, it’s an exciting time to be a dentist.

“Manual tasks that once consumed time are progressively transitioning into automated processes, bringing unprecedented speed and agility,” Baker says. “The continual growth of chairside point-of-care capabilities are driving exponential advancements year after year at pace not seen before. It’s a fantastic time to be a digital pioneer in dental.”

References

1. Global digital dentistry market – industry trends and forecast to 2029. Data Bridge Market Research. June 2022. Accessed August 23, 2023. https://www.databridgemarketresearch.com/reports/global-digital-dentistry-market

2. US Health Resources & Services Administration. HPSA Find. Accessed August 23, 2023. https://data.hrsa.gov/tools/shortage-area/hpsa-find