Management Telemedicine

How business leaders (and dentists) can plan for the next normal

From McKinsey:

The figures for telemedicine and virtual health are just as striking. Teladoc Health, the largest US stand-alone telemedicine service, reported a 50 percent increase in service in the week ending March 20, and is adding thousands of doctors to its network. The Federal Communications Commission is spending $200 million to improve connectivity between patients and virtual-healthcare providers, and the US Department of Health and Human Services has increased reimbursements for telemedicine and enabled cross-state provision of virtual care.

Source: How business leaders can plan for the next normal | McKinsey

More evidence that telemedicine (and teledentistry) will be a huge part of the future of health care. There are many reasons for this and the Covic pandemic has accelerated the change and eliminated many of the barriers to change.

Dentistry will continue to be a hands on profession however there are many tasks we could perform remotely. Following is an article I wrote a couple of years ago written as “News of the Future” that presents how we could be using teledentistry a few years from now. All the technology presented in the article is already available.

May 21, 2022: Arnold Zimmer , a San Jose dentist, prepped a tooth on a patient in Fargo North Dakota. By means of tele-dentistry techniques Dr. Zimmer used 3D images of the patient, including bones, teeth and soft tissue integrated into a virtual patient simulation transmitted to his office in California over the Internet. He transmitted his telepresence image back to the clinic in Fargo to talk with the patient and inevitably to ask him to open his mouth.

With Augmented Reality Glasses to guide him Dr. Zimmer slipped his hands into a pair of cyber gloves in San Jose to guide the digital laser handpiece connected to a surgical robot at the other end in Fargo. He used real time 3D images of the tooth prep including patient vitals off to the side and a shadow image of the pulp below the surface to help guide the prep.

The image of the prepped tooth was than transmitted to an artificial intelligence driven online system to design the restoration. The design process took 12 minutes. A master technician in Bern Switzerland then reviewed the design and checked it off in one minute. The design was whisked back to a 3D printer in Fargo to create the restoration.

Dentists and lab techs in Fargo could not be reached for comment.

3D images, virtual patient integration, telepresence robots, 3D goggles, surgical robots, augmented reality, digital impressions and 3D printers all exist right now. 

Future Tech Security

Aetna, Anthem, IBM Announce Healthcare Blockchain Collaborative

From Health IT Analytics:

Blockchain technology could reduce administrative errors and ensure the efficient exchange of health information, which would lead to improved patient outcomes and lower care costs. Although there have been multiple initiatives to digitize health information, significant advancements are still necessary, and these organizations will seek to move the industry forward.“This alliance will enable healthcare-related data and business transactions to occur in way that addresses market demands for transparency and security, while making it easier for the patient, payer and provider to handle payments,” said Chris Ward, head of product, PNC Treasury Management.“Using this technology, we can remove friction, duplication, and administrative costs that continue to plague the industry.”The collaborative will use blockchain to improve a range of issues, including promoting efficient claims and payment processing, enabling seamless health information exchanges, and maintaining current and accurate provider directories.

Source: Aetna, Anthem, IBM Announce Healthcare Blockchain Collaborative

I have long been of the opinion that the digitization  of dentistry and medicine will improve the human condition in amazing ways we can hardly imagine. However the primary issue holding it back is security. Perhaps Blockchain will be the answer?

3D Printing

3D printing advantages for dentistry

Both the material and the so-termed FAB family of printers have the aim of increasing efficiency and reducing the number of procedures necessary to produce dental prostheses. The printers can generate five-element precision bridges in less than 20 minutes.

Source: 3D printing advantages for dentistry

3D is coming fast.

Artificial Intelligence Diagnostics Future Tech

Stunning AI Breakthrough – One Step Closer to the Singularity

From Gizmodo:

Incredibly, it took AlphaGo Zero (AGZ) just three days to train itself from scratch and acquire literally thousands of years of human Go knowledge simply by playing itself. The only input it had was what it does to the positions of the black and white pieces on the board. In addition to devising completely new strategies, the new system is also considerably leaner and meaner than the original AlphaGo.

Source: Stunning AI Breakthrough Takes Us One Step Closer to the Singularity

Amazing! The linked article is not at all dental and it is a bit geeky. Never the less it is important to medical dental professionals.

AIs have already demonstrated they are better than doctors at diagnosis and treatment planning. The development of faster and more powerful neuro nets will simply accelerate the switch from human doctor to cyber docs. This switch will result in faster better and much less expensive medical treatments. Less expensive is immensely important. Most all the issues we are facing with the “Health Care Crisis” are the result of high costs.

Doctors and dentists will resists this change. However just as horses drawn carriages were doomed by the development of the automobile the traditional practice of medicine is doomed by the development of Artificial Intelligence.

Dental Speaker Management Paperless

Person Place or Thing?

Is the Front Desk a Person, a Place or a Thing?

Once we transfer the data from paper to electronic paperless records, we no longer need a single physical place, like the front desk, to gather the information. An administrator can gather the data where ever there is a computer. That could be at the front, in the back or even in a different building! The computer becomes the Data Center of the practice. The practice is Front Deskless.

The term Front Desklessness is quite provocative but not very descriptive. The concept could be more accurately called: An Alternative Approach to Dental Office Management and Work Flow Using Integrated Paperless Records. That may be a more descriptive title but it sure doesn’t grab you like Front Desklessnes.

Since Front Desklessness is catchy but not well defined all kinds of misconceptions have come oozing out of the woodwork. The term does not mean that no one does the duties of the front desk. There is still a person. It doesn’t even necessarily mean the office doesn’t have a front desk. There is still a place. There is no one way to practice Front Desklessness. Front Desklessness is simply a way of managing the workflow of a dental office made possible by computers and technology. It is still a thing, just a different thing.

How to go Paperless:

Artificial Intelligence Diagnostics Future Tech

Google’s artificial intelligence can diagnose cancer faster than human doctors

From Mirror Online:

Making the decision on whether or not a patient has cancer usually involves trained professionals meticulously scanning tissue samples over weeks and months.But an artificial intelligence (AI) program owned by Alphabet, Google’s parent company, may be able to do it much, much faster.

Source: Google’s artificial intelligence can diagnose cancer faster than human doctors – Mirror Online

Another step to the Tricorder.

We readily acknowledge that hi res cameras and computers can see things on satellite images that are not readily seen by the human eye. It is not much of a leap from basic photography to diagnostic images. In fact looking for hidden patterns or repetitions is one of the things that computers are really good at.

For now the system is designed to detect cancer. Human pathologists are still needed to look for other anomalies or occult pathology. And as usual the money and interest is focused on medical uses. Nevertheless dental applications are sure to follow.

Future Tech Theraputics

Scientists have found a drug that regenerates teeth, and it could reduce the need for fillings

From ScienceAlert:

Researchers have identified a drug that can regenerate teeth from the inside out, possibly reducing the need for artificial fillings.

The drug was previously used in Alzheimer’s clinical trials, and it now appears to improve the tooth’s natural ability to heal itself. It works by activating stem cells inside the tooth’s pulp centre, prompting the damaged area to regenerate the hard dentin material that makes up the majority of a tooth.

Source: Scientists have found a drug that regenerates teeth, and it could reduce the need for fillings – ScienceAlert

This is amazing!!

Future Tech Management

Peter Drucker, the dean of American management theorists, wrote

drucker“Every few hundred years throughout Western history, a sharp transformation has occurred. In a matter of decades, society all together rearranges itself – its worldview, its basic values, its social and political structure, its arts, and its key institutions. Fifty years later a new world exists. And the people born into that world cannot even imagine the world in which their own grandparents were born. Our age is in such a period of transformation. If history is a guide the transformation will be complete in 2010 to 2020.”

CAD CAM Dental Speaker Diagnostics Future Tech Theraputics

The Future of Dentistry is ‘Amazing’ | The Digital Image Stream

From Carestream:

We could make bold outlandish predictions that are exciting but unlikely to come true next year. Any dentist looking to plan ahead would be disappointed. The best alternative is to point out trends and predict how those trends will impact dentistry in the coming years.

Source: The Future of Dentistry is ‘Amazing’ | The Digital Image Stream

Diagnostics Future Tech

S-Ray in the News

Future Tech

Biomimetic dental prosthesis

HT ADA News:

…a group of researchers led by André Studart, Professor of Complex Materials, has developed a new procedure that mimics the natural model almost perfectly. The scientists were able to produce a tough, multi-layered material based on the construction principle of teeth or seashells,

Source: Biomimetic dental prosthesis | EurekAlert! Science News

This is still in the basic research stage however it could provide us with a synthetic material with a structure very similar to enamel for dental restorations.

Diagnostics Future Tech Theraputics

Smart Mouth Guard Could Detect Teeth Grinding

Researchers at the University of Florida have developed a smart mouth guard equipped with sensors that allow it to detect if you’re grinding your teeth, tell your dentist and even help you stop doing it.

…the next version of the guard, currently under development, may be able to tell when an athlete is becoming dehydrated or overheated and even whether he or she may have gotten a concussion.

Source: Smart Mouth Guard Could Detect Teeth Grinding, Dehydration, Concussions | News – Home

I LOVE this. What a wonderful example of using technology to improve diagnosis then connecting it to a smart phone, not some huge single purpose proprietary computer. This hits two of my big buttons. That is using open interoperable technology as opposed to closed systems and improving care while reducing costs with technology and innovation rather than centralized command and control.

Future Tech General

Stem-Cell Dental Implants Grow New Teeth Right In Your Mouth


Dr. Jeremy Mao, the Edward V. Zegarelli Professor of Dental Medicine at Columbia University Medical Center, has unveiled a growth factor-infused, three-dimensional scaffold with the potential to regenerate an anatomically correct tooth in just nine weeks from implantation.

Source: Stem-Cell Dental Implants Grow New Teeth Right In Your Mouth | Popular Science


Navident, Implant Guide System

This is an amazing implant targeting system that is easy to use in one visit. It was developed by a couple of brain surgeons in Canada. BTW it turns out the dental device needs more precision than the brain surgery device. 🙂 Navident has undergone extensive testing and is expected to be available in the US later this year.

Future Tech Theraputics

The machine can do better than human anesthesiologists

From Washington Post:

Anesthesia is tricky. It’s often compared to flying a plane – keeping a patient hovering in just the right plane of consciousness. It’s called depth of hypnosis. Surgeons don’t want patients writhing on the table. And patients don’t want to be aware of the operation. Of course, no one wants patients to die, a distinct possibility if too much of an anesthesia drug is delivered.

The iControl-RP aims to thread that needle by using an EEG to scan a patient’s brain waves to make sure the sedation is adequate. And it looks at heart and breathing rates and blood oxygen levels to make sure the patient is not slipping too deeply into sleep. The machine’s algorithm makes all the medical decisions that a doctor usually does.

via ‘We are convinced the machine can do better than human anesthesiologists’ – The Washington Post.

Another step to robodoc. No job is safe from automation.

Future Tech Internet Management

Third Generation Online Referrals

First generation attempts to create digital referral slips simply recreate the paper form in an electronic format, usually pdf. The referring dentist needs to download and print the form then fill in the information (patient name, practice information, tooth #, diagnosis etc.) by hand. The patient takes the form to the specialist and the data is entered just as if the patient had come in and was handed a form to fill out.

Second generation online referrals can be filled in online, no paper. However the referring dentist or the patient still needs to fill in the information by hand using a keyboard and mouse. Once the information is filled in the specialist office could access it from the Internet and create a new patient record with no additional data entry.

Third generation digital referral slips will be smart and interactive. The system will upload data directly from the electronic record without the dentist or dental staff member re-typing or pasting the data. It will include the basics we have done in the past as well as a complete medical history, patient demographics and insurance information.

When the patient shows up at the specialists office there will be no clipboard and forms they will already have complete electronic record waiting for them ready to go.


Digital Marketing Future Tech Health Care Politics Internet Mobile

An Uber for Doctor Housecalls

From NYT:

Heal is a smartphone app similar to the on-demand car service Uber, but instead of a car, a doctor shows up at your door. Users download the app and then type in a few details such as address and the reason for the visit. After adding a credit card and a request for a family doctor or a pediatrician, the physician arrives in 20 to 60 minutes for a flat fee of $99.

via An Uber for Doctor Housecalls –

What a great idea. I love the use of technology to completely re-arrange the business model. This could be truly disruptive.

What I do not like is the loss of a personal relationship turning the physician into a commodity.

Perhaps the next step would be combining the intense personal service of a “concierge practice” with he efficiency of “Uber like” calls.

Future Tech Hardware Office Design

MIT Turns Thumbnail into Trackpad

Is this cool or what?

The researchers envision NailO helping people control wireless devices when their hands are full—for example, answering the phone when they’re cooking, or inspecting a circuit board’s layout on a computer while holding a soldering iron.


via MIT Turns Thumbnail into Trackpad – IEEE Spectrum.

The obvious dental use would be in the clinical area during treatment the dentist, assistant or hygienist could bring up images, zoom in on a radiograph or quick check a medical condition without interrupting treatment or breaking asepsis.

Dental Speaker

Charter Oak Connecticut


I will be presenting two sessions later this week May 7  in Connecticut. The morning session is an overview of the many digital technologies that are changing dentistry and the afternoon in on paperless records.


Independent Clinical Study Finds the Canary System to Be Superior to Bitewing Radiography

…found The Canary System® to exhibit superior performance compared to bitewing radiography for the detection of proximal caries.

via Oral Health Journal – Independent Clinical Study Finds the Canary System to Be Superior to Bitewing Radiography.

This is huge! It is easy to see how the Canary System would be useful for occlusal caries detection. However this new study indicates it is useful for interproximal caries detection as well. Not just useful but in fact superior. Interproximal caries detection without radiation.

I believe we are on the brink of an enormous revolution in diagnostic technology.