January 30, 2020
by Oral Health
Interviewers: Melissa Summerfield, Vice President, Newcom Media Inc.; Dr. Les Rykiss, Editorial Advisory Board Member, Oral Health
Melissa: Let’s start off with Primescan since it’s obviously a new exciting product for you guys. How is Primescan driving the innovation of digital dentistry?
Don: It’s really interesting. When we were out talking to dentists and talking about people who have not made the transition to digital dentistry, I couldn’t help but wonder why. It would seem self-evident that this is a better, easier way to keep track of your patients and get more data. And by the way, this is from the leading dental impression company in the world. We just feel that the technology is going to get there. They said the biggest obstacle was speed and ease of use. This was done well before I got here but I’m very proud of the group that kept holding themselves to a standard. They literally said, we want to be able to train you for less than five minutes and virtually have anyone be able to use the product. The most valuable thing in a dental office is the dentist’s time and we feel that digital impressions should become standard of care. You walk in and have a scan. That wasn’t going to happen if it was going to take time for the dentist or the hygienist or the dental tech to go have to spend minutes doing this. We really feel that the ease of use, speed and accuracy of Primescan is actually the thing that will tip it to the point, where we believe, it will become standard of care in every dental office. If you can’t tell, we invented the category and we’ve always been excited about chairside dentistry. The biggest change for us in the last year is we said, okay, we love chairside dentistry, we are going to continue innovating on the mill, the furnace, the acquisition unit, the treatment, but we really felt that we’re missing where digital dentistry is going. We felt that we had to basically create a whole range of products that allow us to compete impressively. Overtime, we do think digital impressions will be standard of care.
Melissa: So how are all of these numbers of innovations and developments in digital dentistry overall, how are they impacting the treatment workflow and in turn, the changes in workflow, how are they impacting the design and treatment centre?
Don: The biggest change in digital dentistry in my opinion is actually the amount of information that should be able to change how you think about treatment protocols. As a matter of fact, with Primescan, we’re super happy at this point that basically it’s three to four clicks and you have a treatment plan that’s based on millions of prior pieces of information that the machine has. In all deference to all of my dentists, your experience is not as great as the entire Cerec universe and you start thinking about big data and developing the treatment protocols. Where this goes, in my opinion, how do you take X-rays, how do you take digital impressions, how do you begin to combine that into kind of an electronic medical record that follows the patient around? And by the way, whether that goes into a treatment centre or whether it goes into something that you want to present to the patient, and you can say to them, if you want to get this treatment done – this is what it looks like. I actually think the next horizon that we’re going to push hard is, alright, let’s actually simulate based on our experience what that treatment will look like versus no treatment. So, you’re experience in a dental chair in five years could be very different. You’re going to come in, we’re going to look at five years of your scan and say, these teeth are moving and do you want to make an aesthetic consideration or by the way, we’re actually looking at your bite and whether it’s causing TMJ, etc. Here’s a potential treatment guideline and let me show you where that is. Now by the way, if you happen to have a treatment centre that puts you at the centre of that, let’s actually show you in an integrated fashion. So, it’s going to be the Amazon experience. Literally, what is the analog in dentistry where it’s going to be: take data, acquire it, and manipulate it to the point where you can see great treatment protocol? By the way, compare that to a standard of care in countries where they want to see that, and be actually able to illustrate the potential treatment and let’s get the patient involved in making the best decisions for them.
Melissa: It is a fascinating time and I think that the horizons you’re on are amazing. You talked a little it in the press conference today about education and how many online courses you’re doing and the facilities that you have for education. So, what do you see as some of the greatest challenges facing dental professionals today and how is Dentsply Sirona helping them to face and overcome some of these challenges?
Don: I think the dentist of today is facing almost an insurmountable number of tasks to provide basic care. If you think about the demands of insurance, that reimbursement has put on, actually managing a small business, which is a challenge, and oh by the way, delivering outstanding patient care. So, it’s almost as if they have to be an insurance agent, they’ve got to be a small business woman, and they have to provide care. Against that, if the dentist is going to be 30 to 40 hours a week managing their practice and providing patient care, when are they supposed to be educated? In our mind, we said we have to do two things differently and this is one of the things I feel incredibly strongly about. In the last year, we’ve pumped a lot of money into this because I felt like, when talking about digital impressions for example, it’s not as if you can go back to dental school and go get trained on this stuff. Who’s going to do the training? I think one of the biggest impediments to actually seeing the advances of this technology and equipment is the fact that a) the dentist doesn’t have time, and b) doesn’t have somebody willing to provide it. So, we said look, we’ll make two commitments and we’re literally spending tens of millions of dollars in order to do so. First, we’re going to expand our digital online library, where we have close to 12,000 courses. I’m not going to give you an exact number but thinking about doubling that in the next four years is not too small of an objective. We actually want to be the partner to the dentist to understand not only the technology and the equipment but how does that change their workflow? We built a wonderful place down in Charlotte, Bensheim, Shenghai, and Canada will eventually get one as well, where we want a hands-on place. If somebody wants to invest three days with us, let’s talk about workflow and we encourage you to actually bring your entire dental office. It’s not just about just knowing how to use the technology, it’s knowing what it means. You have to be thoughtful about scheduling, follow-ups, and everything else. It was really interesting. We had the head of Boston University at our institute in Charlotte, and the first thing he said was, “Oh my gosh. Your facilities are better than ours.” They’re gorgeous. By the way, the university is building a great new facility so that won’t be the case for very long. But he said, there has to be a way that we together with the universities partner in a different way. His concern is that technology is moving faster than dentists. So, we want to make sure that they’re able to be trained.
Dr. Rykiss: That’s exactly what’s happening in the world today as well. There are dental offices that are going to jump head over heels into digital technology if they haven’t so already. And there are the other offices, who will do very minimal digital in the next five years and still be taking wet impressions. How do we give the client the best experience possible? That’s what it’s going to come down to.
Don: That’s actually one of the really big strategic decisions Dentsply Sirona has to make. We came down on the side of empowering dentists. We always feel that we need to work through the dentist. One of the conversations that we want to have with the dental community is how do we help you, as opposed to, you’re just a toll between us. Activating patients for our own benefit is not where we need to be. We believe activating patients so that you’re dealing with an informed patient, and oh, by the way, we’re informing you that we’re informing the patient is a better handshake. And that’s a commitment we’re going to make.
Melissa: It’s true. How many conversations have we had about dental schools and their curriculums?
Dr. Rykiss: That’ the other side of it. The dental schools aren’t doing their share in getting dental students up to speed to what they’re going to see out there. And that makes it a challenge for Dentsply and all of the major companies out there because like you said, they’re the ones doing the real education.
Don: It’s going to be a interesting discussion because what role does the DSO’s play? What we’re seeing more and more, if someone goes through dental school and comes out with a fair amount of debt and doesn’t have a family business or something to go into, they tend to start with a DSO where they’ll put in and actually learn the trade. So, ironically, the dental school is just the entry point and then there’s going to have to be almost an apprenticeship as you go through.
Dr. Rykiss: We learn from dental journals, we learn from suppliers, we learn from other avenues of course, but it’s not dental school. They give you that basic knowledge and teach you how you could be doing but not really the way you’re going to be doing it.
Don: You’re absolutely right. One of the opportunities that I think the industry has is how do we work with the schools in a different way that we do today?
Melissa: In general, our dental schools are not equipping students of today to be the dentists of tomorrow and that’s a scary thing.
Don: Look, one of the reasons you’re going to hear us again and again talk about clinical education is I believe we have a responsibility. Basically, the whole category, which says an educated dentist is going to deliver better patient care. We believe that we should have a responsibility because we think we’re going to be the most innovative company or space in the next ten years. Hypothetically, if we come up with some new super-duper material that’s working on a 3D printer instead of a milling machine, somebody has to educate how to do that. In my mind, that’s the role we’re going to play.
Melissa: Can you tell us a little bit more about the developments on the material side?
Don: In my mind, we undersold Surefil One. It is just awesome. Look, amalgams are great but amalgams are metal. And then you look at some of the glass ionomers and they don’t have the strength to actually sit there and do it. We think we’ve solved that. We think we’ve got something that is incredibly pliable. What our experience is telling us with our Surefil dentists who have been there is the amount of time they’re doing on follow-up is minimal because they’ve now learned. The key statistic there is we believe you can basically get from start to finish in 6.5 minutes, which we think is 50 per cent of what a standard treatment is going to be. We’re doing it in four steps instead of 13 steps. We’ve been working on that product for close to a decade. We’ll talk in two years here and you’ll ask how Surefil worked out for us, and I’ll tell you that it was the sleeper product that we introduced this year.
Melissa: On the implant side, as we know that implantology continues to be a key growth area, what is Dentsply Sirona doing in terms of products that are helping dentists deliver greater patient satisfaction and also productivity in their practice?
Don: We launched two things today. When we were out talking to DSO’s and others about GP’s interested in doing single-tooth replacement, they’re saying it’s a little overwhelming. So, what we did was introduced Azento, which is essentially a checklist. You need this, this and this. I’ve actually watched dentists be trained on this product. We are not trying to get people who are not qualified to do single tooth replacement. We want to give them the tools once they’ve decided to be trained, that reinforce the training. The interesting issue is that it has 100 per cent of what you need there and it’s step-by-step. We think it’s reinforcing the best clinical practice. In my mind, where implants are going to be in five years, I think there is an aging population that is going to want the aesthetics associated with implants. Whether it’s going to be a little bit more of a standardized procedure, or where it’s going to be full dentures or not, I think we are just starting to see what I think will be a very aggressive expansion as the baby boomers get to this age and are not going to want to make aesthetic sacrifices. It’s going to be one of those price-value conversations. In terms of your assessment on the show, I think scanning is going to be a really big deal here. I think people are finally seeing the systems, led by Prime Scan, are going to deliver on the products. I think 3D printing is going to be, “we launched 3D printing but it was missing something.” You brought up material, I think material is going to have to move a little bit faster to see 3D printing become mainstream as part of a practice. That being said, I think there will be a lot of 3D printers sold and I think people are going to use it. If you look at implants and clear aligners as kind of the harbingers of aesthetic management over time, and the growth that we’ve seen in those two categories, I agree with the assessment. The question is, “how do you deliver the broadest range of implants to the broadest range of doctors?” Clinically educate them so they’re doing a good job but then being understanding of a patient who is going to have several different price value points that they’re going to want to have.
Melissa: I think you’re absolutely right about the baby boomers. We’re not our parents. Our parents fully expected to have their teeth beside them in a jar.
Don: The interesting conversation there is right now, is that there’s not an educated patient to the effect of if you said dentures, they’d say no. But then what are the options? I think the industry, whether it’s the companies or the dentists, have to do a better job at educating patients with the idea of functionality first. I know in the US, and I don’t mean to generalize, but we’re going to see 25 million 80-year-olds by 2025. No one knows what to do with 25 million 80-year-olds and they’re not going to thrive if they don’t have teeth. So, if you start with functionality and then move to aesthetics aggressively, then what are the aesthetic options? And then there’s going to be economics. I think society is going to have to figure out what are we going to reimburse and what are we not? I don’t think they’re going to reimburse at the same level that most people would like, so that means you’re going to have to work with the dentist to figure out how do you actually give that therapeutic and functional benefit at a price they can afford?
Dr. Rykiss: You’re going to have the ability to take someone in for the first time and the ability to scan their jaw, tell them they need dentures, go back to their original scans from ten years ago and show them what they looked like. Then can ask them if they want to look like this again and get them there.
Don: I think 3D printing of dentures will actually wind up being the first 3D product that might start on the lab side versus the chairside. I think that’ll be the first broad application. I get the pleasure of travelling around the world and the economy around the world has actually been pretty good the last couple of years. When you get out to Asia, the Middle East, Latin America, you see the tremendously rapid growth. I think the amount of technology that’s coming in is going to change. I think digital is going to change in a big, big way. I think we’ll look back and sit there and say, it was almost barbaric as to where we’ll be. We’re all excited about it now.