Simon Chard offered his vision for the immediate future of dental treatment at Align Technology’s UKI Forum 2023.
Technology is set to play a pivotal role in improving patient experiences, outcomes, and practice productivity, according to Simon Chard – president of the British Academy of Cosmetic Dentists, who runs a seven-surgery, multi-disciplinary practice in Staines.
Speaking at Align Technology’s UKI Forum 2023, which took place in September, he offered his insights into what the dental industry can expect in the near future – something he calls Dentistry 3.0 – the new era of holistic care and prevention centred on innovation.
In his talk, which was interspersed with detailed case studies, Simon told Forum delegates that artificial intelligence will sit at the heart of technological innovations to drive digital dentistry into a new era. He outlined the parallels between the rapid growth of computer power and that of dentistry using Moore's Law - the rule that states computer power has doubled every two years for the past 40 or 50 years.
He explained, “Since 2012, it’s actually been doubling every three or four months. That’s the AI revolution. So, if I bring this into dentistry, you can see that the past 150 years – ‘Dentistry 1.0’ has been braces, amalgam, toothbrushes; things we take for granted today. In the 1980s, technology started to get involved, and that’s when the first iteration of CAD/CAM came in. And I’m sure all of you in this room are using intraoral scanners, CBCT scanners and aligners – all those things that have played such a big part in our careers: That’s ‘Dentistry 2.0’.
“Now, the key break point in the development of dentistry is going to be artificial intelligence (AI). It is going to change everything, and I don’t want you to fear that. I want you to really embrace and enjoy it. AI really is the core of ‘Dentistry 3.0’. It is a real thing and is going to completely revolutionise our industry. Either change with it or fall behind.”
He explained that artificial intelligence-driven diagnosis via digital scanners, such as the iTero intraoral scanner and advanced CAD/CAM systems, were already integrating AI into advanced dental practices, improving patient journeys and the predictability of outcomes. “And obviously improving the productivity of my business as well…and I think we can have all those things by using the latest advances in technology,” he said. “AI is already integrated into all of the different technology systems that we’re using already…but maybe you’re not implementing it or leveraging it as much as you could be.”
Simon said he did not believe that AI would replace dentists but rather enhance the treatments and services they offer, citing the upcoming launch of X-Ray Insight, AI-assisted radiographic diagnosis software from Align Technology. “And Invisalign Smile Architect, which I use myself, is clearly AI-driven. For me, it’s about enabling the conversation with my patients about what happens if we don’t do ortho treatment before restoring the teeth. It’s really, really powerful.”
Simon also told the Forum that digital tools could also be invaluable in practice management, “It can accumulate a mass of data and give you an output to help you analyse your patient base: How many of them have perio, how many have caries, how many have implants? All these sorts of questions, the answers to which can be really helpful in the way you plan the future of your practice.”
He also asserted that 3D printing was also now an essential element of digital dentistry at his practice. “I’ve been dabbling with 3D printing for a number of years. I didn’t really get on with it at first; I found it messy and inconsistent, and there wasn’t really a clear workflow that I understood. However, recently I’ve purchased a Sprintray 3D printer and am using it in combination with the iTero scanner, with exocad software and found you can really do a lot of work chairside and communicate significantly better with your lab.”
Simon’s views on digital dentistry fit into what he calls the ABCDE of dentistry – the five core pillars of the industry today and in the coming decade. The four other pillars are:
Airway
Understanding the oral health markers for sleep and breathing issues, such as snoring and sleep apnoea, is essential to good dentistry, said Simon. Sleep apnoea affects an estimated one billion people globally, contributing to other health factors, such as cardiovascular disease, heart attacks, strokes, depression and even road traffic accidents as a result of tiredness. “If you look at the States, airway dentistry is big business…the level of knowledge about the airway and the interrelationship between the mouth and the airway system is fascinating…If you imagine one in seven or eight of your patients walking through your door is struggling with sleep apnoea, that’s a scary statistic. We’ve got a really unique opportunity to screen these patients and get them the treatment they desperately need.”
Biological dentistry
This expresses the link between periodontal disease and various systemic conditions such as diabetes, cardiovascular disease, and even erectile dysfunction. Simon said, “This is looking at the mouth, not in a silo, but as part of the living, breathing human being – leveraging a modern focus on the synergistic links between oral and systemic health…The biological component of dentistry is mainly periodontal disease; almost half of the adults in the UK are still struggling with periodontal disease. This means half of our patients have perio, and we’re not doing a fantastic job at stabilising this.”
Stressing that periodontal disease is inflammation, he suggested that to reduce inflammation in the mouth and the rest of the body, more dentists should pay closer attention to vitamin D deficiency. “Why is that relevant to us as dentists?” Simon asked. “Well, vitamin D deficiency is shown to lead to increased implant failure, while healthy levels of vitamin D have also shown to reduce periodontal disease.” Simon offers his patients simple screening tests as an optional extra in addition to treatment.
He has also added oral microbiome screening to his patient dental wellness assessments. “Studies have shown that the use of oral probiotics, as an adjunctive therapy, has led to a significant reduction in periodontal pocket depth and clinical attachment loss and bleeding. There’s now a whole raft of different oral probiotics that can really help to reduce that bad bacteria and support good bacteria. You can retest and see how those patients are getting on,” he said.
Cosmetic dentistry
Ethical, exceptional cosmetic dentistry was more essential than ever, said Simon, referring to the influence of bogus and potentially harmful social media trends. “There are so many TikTok trends which consumers are following, such as filing their teeth at home with a nail file and bleaching their teeth with hydrogen peroxide. We really need to be combatting all of this misinformation…and we need to provide top-quality dentistry because a lot of these young people, as we all know, are flying off to Turkey and having their teeth prepped for irreversible dentistry…With the rapid advancement of technology, materials and techniques, we’ve got more of a responsibility than ever to be as biologically responsible and respectful as possible.”
Environment
Simon is a keen advocate of the dental industry’s ethical responsibility to the planet and asked Forum attendees to consider introducing more sustainable elements to their own businesses. “If you’ve got green space, plant it, get the bees in there, get it working to eradicate some of your carbon output, and bring your team on board.”
Ending his talk, Simon summed up his ABCDE of dentistry, asking fellow dentists not to consider and treat the mouth in isolation, part as part of the whole body. Always consider the airway and check it for signs of sleep apnea, and ask patients suffering from periodontal disease if they take vitamin D supplements. He also stressed the importance of considering the most biologically respectful option for cosmetic dentistry and leveraging technology to achieve the best patient outcomes and to help the entire practice team and business profitability. Finally, he asked his fellow dentists to look at how they can make their practices more sustainable.