Session 2 – Understanding Digital Dentistry

Digital dentistry is being heralded by many as likely to be the future of dentistry. It is something that has become increasingly commonplace in the last decade, in particular since 2010. Digital dentistry includes a range of different dental technologies, so it’s not as simple as asking for a clear “what is digital dentistry” definition – it is something that you would need to explore in depth – covering digital radiography, cone beam technology, and dental CAD/CAM.

Dentistry today is much more in-depth and much more technical than it was even just a few decades ago. This can only be a good thing for our patients because it means that we can identify issues more quickly, and we can give informed opinions and analyses without having to subject patients to more x-rays than necessary. We can take more accurate models of our patient’s teeth, and produce better implants. We can fit implants that will last longer, and we can detect infections, offer better advice, and even provide better pain relief. But, are we truly as digital as we would like?

There are many dentists who feel that this is not the case – here non-medical fields, and even some medical ones such as medicine and biomedical engineering, have come a long way, dentistry is lagging behind. We’re stuck in what could be called a chasm, where we’re still behind the early adopters, and it is taking time for people to truly accept the potential of digital dentistry.

What Could Digital Dentistry be Doing?

At its broadest definition, digital dentistry includes everything that is being done with computer controlled components – so that’s the modeling of implants, and even things that are perhaps now considered mundane, such as delivering nitrous oxide through computer-controlled devices.

There are so many areas where we are indeed providing digital dentistry, such as:

  • CAD.CAM imaging
  • Design and fabrication of implants
  • Digital radiography
  • Photography
  • Patient record management
  • CAries diagnosis
  • TMJ analysis
  • Shade matching

Digital technologies have made many areas of dentistry simpler, more efficient, safer, and generally better and less stressful both for the dentist and the patient.

Adoption has been slow, however, and this is not unusual for the world of dentistry. It took almost two years for belt-driven handpieces to be replaced by air rotor handpieces in the average dental surgery, and it took almost five years for PFM crowns to become commonplace. Implants were not accepted for almost two decades. All of those things are now widely used, and accepted as being worthwhile, but what is it that makes some technologies that are ‘disruptive’ be accepted rapidly, while others sit unwanted, with the stance being that they’re too expensive, too risky, or just not necessary?

One issue is that in terms of growth and investment, dentistry isn’t that glamorous. Revenue potential for anything except for cosmetic dentistry is hardly appealing, and the offers for improvements in terms of efficiency just aren’t that seductive. Digital dentistry is a field that offers small, incremental improvements – look at diode lasers – they have been around for more than ten years, but until they came down in price thanks to more competition, they were not popular. Now, they offer low-cost surgery devices, because they are so common.

Things like intraoral imaging have been available for a long time, but the price is still quite high, and this has been holding off the adoption of the technology. For an item or practice to make it into use by the average dentist, it needs to be efficient, both in terms of cost and time use, and it needs to be better than the existing methods. It also needs to be predictable and reliable. Digital practices won’t get there unless they are used – it takes testing for devices to become reliable, and it takes the demand for supply to increase enough that costs come down. When all of these factors are met, a technology will make it into the mainstream – but given the up-front cost, the training demands, and the service demands of technology, it’s easy to understand why older dentists are reluctant to change a workflow that already works quite well for them.