How a Dentist Transformed Her Career with an AI-Driven, Remote-Staffed Practice

The best thing that I have done is to start before you're ready. I don't mean do a procedure that you're not prepared for or that you're not trained for, but you need to start now and get comfortable with all of the things, whether it's materials, techniques, technology, just get comfortable with it and start now. Welcome to Austin, Texas, and welcome to the Phil Klein Dental Podcast. Thank you for joining us. Today's episode is all about breaking the mold, rethinking what a dental practice can be, and how technology can take patient care and efficiency to the next level. Our guest, Dr. Carla Cohn, is a trailblazing dentist who has completely redefined her career by embracing cutting-edge technologies and shifting her practice to a surgery center. She's proving that the future of dentistry isn't just about adapting, it's about leading the way. With a fully remote staff powered by AI-driven software, her practice is a seamless tech-enabled machine. AI captures patient calls, texts, and website engagements, integrating every touchpoint into a cloud-based system that keeps everything and everyone connected. The efficiency she's created would have been unimaginable just a few years ago, but today it's her new normal. Her message? Don't let anything hold you back. The time to embrace new materials, techniques, and technology is now, because if you wait for it to become mainstream, you'll be left in the dust. Dr. Cohn is a general dentist with nearly 35 years of experience who has dedicated her career to pediatric dentistry. Before we bring in our guest, I do want to say that if you're enjoying these episodes and want to support the show, please follow us on Apple Podcasts or Spotify. You'll be the first to know about our new releases and our entire production team will really appreciate it. Dr. Cohn, welcome to the show. I thank you for having me. It's a pleasure to be here. Yeah, we're very happy to have you. And you've done some really great CE activities with us in the past, both webinars and podcasts. And they all have timely and practical information. You're in the trenches, you're doing the thing, and you're actually conveying. what actually is clinically appropriate in a lot of things related to treating kids, which is really nice to hear. We don't have a lot of KOLs that talk about only pediatric dentistry, and you happen to be a GP that specializes in pediatric dentistry. We call it a subspecialty of GP. There you go. I like that. Yeah, it's very cool. Thank you. Too bad you're not doing that in our country. You're out in Canada. Well, maybe we will be one of the states sometime soon. I've heard that. That's another interesting conversation. That's also not something on this podcast, but yeah. When I start getting into political podcasting, you'll be my first guest, Dr. Cohn, about taking over Canada. Fantastic. So we're talking about technology. productivity. So we're going to be talking about like things you use in your practice that has helped you make things more efficient regarding patient management, team collaboration, for instance. So tell us how integrating cloud-based software into your routine at your practice has helped you immensely in these areas. We'll be right back with our guest, but first, I want to tell you about VOCO's newest composite, Grandioso 4U. Top clinicians are calling it the most tooth-like universal composite ever made. Unlike traditional composites that force you to choose between either an anterior aesthetic composite, a stronger layering posterior composite, or a fast but aesthetic compromising bulk fill, Grandioso 4U does it all, simplifying your workflow. while delivering superior results in a single material. It cures 4mm in just 10 seconds, looks stunning with 5 cluster shades covering all 16 Vita shades, and handles like a dream with 50% less resin. It's a 91% filled nano hybrid, giving you tooth-like strength, ultra-low shrinkage, exceptional wear resistance, and an amalgam-like high radio opacity. So as they say, seeing is believing. So grab your free sample of Grandioso for you today at voco.dental. So that cloud-based software has been a game changer. About four years ago, I branched off and I started my own practice. And at that point, I needed to get a software, which I, I mean, I've used software throughout my entire career, but I never used software in my own right, in my own practice. So this was a brand new thing. And I did a little bit of research and I found one of the cloud-based softwares, which the one that I use is Curve. And to your point a few sentences ago, yeah, this is real stuff. I'm doing the stuff. These are all things that I use in my practice and in real life, as they say. So the software I'm using is Curve. It's changed the entire way that we do dentistry in my practice. I have all of my staff, except for when we're together working on a patient, my assistants and I, we all work virtually from the point of the consultation, the contact with the patient, the consultation, everything with the referring offices, because I'm now 100% referral based in my practice. And so. My administrator works at her home. My assistants, when they're not doing assisting, they're administrating. They're at their home, and I'm at mine. And to be able to have that cloud-based software has been incredible to allow us to have that flexibility. And when we're in the operating room, you know, I... in an operating room where I'm renting the operating room space basically is, and that's usually how it goes when somebody is working in an operating room, unless you have your own surgical suite. And so I see the patient, we upload the radiograph, we input the treatment, anything that's going on behind the scenes with my administrator, we know immediately in real time, and it has made such a smooth. workflow for our practice that it has made us all like incredibly productive so when you say not being in the same room yeah when you say operating room you're saying that you're treating these kids under anesthesia yes so all of my entire practice now is all anesthesia dentistry so all sleep dentistry so every kid that i'm seeing at this point is going into the operating room for the last you know the 30 years previous i did everything. I was in an office, traditional setting, seeing kids in the office, and then started off smaller. Once every month or so, 30 years ago, I would go into the operating room. And now I'm in the operating room all of the time, but it became much more over time. But even then, if I could have had that ability, I mean, we would take charts from the office, we would print the charts, we would take them with us to the operating room and then have to go back and scan everything in and to upload the radiographs. Yeah, that's unbelievable. So is this in a hospital setting, this operating room? My operating room is a surgical center. So it's a private surgical center that you rent the space. I rent the space. I'm also a shareholder there, but I do rent space. Others can rent space there as well. So as needed, or is it like an annual thing or a monthly fee? No, it's like a unit time fee. Oh, it's that right. It's a unit time fee. It's a unit time fee. So it's like renting a tennis court indoors. You pay by the minute once you go over. Yeah, pretty much. Well, it's good that you're a partner in that. So you're a general dentist and you rely on GP sending you pedo patients. I do. Yeah, that's the whole evolution. of my life in dentistry and how that all happened. That's another episode. So let me ask you this. So did you make that move to do 100% in the operatory sleep dentistry, right? You're now in a surgical center 100% of the time. So you don't even do that much in your own dental practice anymore in that setting. I don't have a dental practice. I don't have bricks and mortar. I am the practice. Right. So you strictly show up at the surgery center, the patient's there. Now you have to do some sort of consultation with the parents, right? Or the guardian beforehand. Where do you do that? We do it virtually. So we have the referral coming in from the referring dentist with that. If radiographs are possible, they come from that referring dentist, as well as the reason for referral, as you would for any referral in any discipline. And then we have our intake forms that we send to the parent. We gather all of the information that we need from that parent, and then we meet with that parent virtually. prior to going into the operating room. And I see the child at the surgery center prior to going in that day. How much time do you spend talking to the referring dentist about the case? It depends. It totally depends on the case. You know, some of the, my routine, my regular referring offices, which most of them are, they know what I need to get this kid treated. So they send it to me. So not a lot. I guess is the answer. So you use the Surger Center a lot. Do you have it stocked up with all the stuff you need or do you have to bring it each time? I leave my stuff there. But that's also because I'm an owner. And I've joked at times that the reason that I bought into the surgery center is so that I can actually leave my stuff there instead of dragging it. Because at this point, and with what I do as a KOL, I literally cupboards and drawers and drawers and drawers full of stuff that I use, equipment, materials, you name it, it's there. It's a lot. It's amazing how your career just... keeps evolving. You keep, you now have a training program. We're going to be talking about that on a different podcast, but still it's quite amazing how you've become, you know, a company by yourself. You've certainly identified and isolated what you really enjoy doing in dentistry and pursued it. You've pursued it successfully and you're through the surgery center thing, treating these patients that otherwise would be kind of kicked around. Like, where am I going to get my care from? This is just amazing. So you use this software Curve and all this stuff is done remotely by your staff. When you go into the OR, how many staff members do you bring into that? I'll have two staff members with me most days, sometimes one. Plus anesthesia, nursing, and everything else that needs to make anesthesia run properly. So are you using a dental anesthesiologist? No, they're physician anesthesiologists. Okay. Physician anesthesiologists. Yeah. That's probably the wrong term, but not dentists. Right. But they're full MD anesthesiologists. They are. Yeah. Yeah. And those fees and that stuff is all handled separately. That's also something that has to be organized beforehand, obviously. That all has to be organized beforehand. And in Canada, it's probably different than it is in the States. So I don't know if we even want to go there. I don't know what your Canadian viewership is, but yeah, it gets, I don't want to say complicated, but it's... there's some work to do to get involved. So you could never do this without using the technology that's out there. But you've gone beyond doing a Zoom call with these parents and with the other doctor, with the referring doctor and so forth. You've gone into voice over internet protocol using voice technology. So tell us about the enhanced communication software that you use. So that became a thing that became really useful also because we're all working remotely and I don't have bricks and mortar. So each one of my staff. uses either their computer or their cell phone. And so in order for them not to call from their cell phone, they use an app. So I use Mango Voice as my voice over internet plan and their platform. And they've all got the ability to, you go into Curve, into the software. I can see the patient name. I see the patient phone number. I click on the patient name, phone number, and automatically it dials out. to that patient. So between that and I use the texting through Curve, we have this ability to communicate with our patients very easily and very seamlessly. And both of them, both Mango and Curve, they play together. And I have on my phone, I have my two apps. When I'm doing my post-op calls, I hit Curve. I hit the patient's phone on my cell. It goes directly to Mango. then I speak to the patient, do my post-op, whatever I need to do, and then I will dictate the notes into the Curve app. It goes from voice to text, and I save it, and it's all in real time so that I can have that inputted, anybody that answers the phone, because my staff also work, because it's me and two associates. But we don't they don't work full hours. So we don't have like a full time regular job. So one picks up where the next one takes off and they can all see where the voicemail is. They can see it on the on their computer. Who's called the voicemail? It's it's very. So everything you're doing through Curve and Mango Voice, that's recorded, right? So you could listen to those again. 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So whether you're taking your first step into digital dentistry or you're looking to add additional equipment, check out Shining 3D Dental's complete digital dental portfolio. To learn more, visit shining3ddental.com. Yes, you can record these calls. You can record the calls and then you've got a record of it, which becomes huge when it comes to liability or, you know, you said this. I'm like, okay, so when you do your records after the procedure is over, or even before, you can say, you know, you can talk into the software and start the record keeping your notes. does that get transferred to your main software that runs all of your clinical records? Is that, do you use something in the cloud? When I'm dictating into Curve, it goes right up into Curve and it's cloud-based. Now they both are rolling out different now AI that is going to be able to do, you know, voice to text and to take those recorded calls and to turn them into text. That's brand new within that last number of weeks. Right, but if someone... has a system software for the whole office like Dentrix or the Patterson has one. Cheyenne has Dentrix, Patterson has one. on eaglesoft or whatever does this work with that collaborate with that or is this a separate in itself an office management tool that does all the records i i'm not sure i can answer that question i don't know so you don't have you don't have any other software that i don't have any other software okay so this is no there's no need okay so then this does everything that's your answer there's your answer you do know the answer there's the answer right okay okay so how did you look into these software packages Was it because you just knew you needed this and you said, okay, let me find a software that does this? Or did someone contact you and say, hey, Dr. Cohn, check out this? How'd you learn about it? i actively searched it as an active online search of all of the cloud-based softwares i knew i wanted a cloud-based software and and that was that was what i i went after um the mango voice app came later so i didn't i didn't have you know i started this practice and i i have had no experience with any of this And so I, you know, used our local network for our cell phone provider and it was cumbersome and it was there, it was a lot of things and, and expensive. So if someone calls you, if someone calls you on a Thursday morning at seven in the morning and saying, my five-year-old has a really bad toothache, there's someone there to answer the phone all the time or is it taken through a recording that call? You can have somebody there to answer the phone all the time. We choose to have off hours where they'll get a recording. And then there's always an ability for that patient to text us. And so somebody will monitor, one of our staff will monitor throughout almost all of the days, and then also an ability to contact us through email. So the patients have no... lack of ability to get hold of us. And I assume using the technology, you can assign a dentist to cover for you in the case, in the event you're on vacation, and then that dentist would be taking over the same technology capabilities that the whole system offers and integrates in with your whole practice. Yeah, you can do all of these things. Quite amazing. It is. It just basically anything that you might run into is built into that software. AI-powered diagnostics, that's becoming a big thing now because these cloud-based systems see... thousands and thousands of x-rays and implant cases. And now a lot of this stuff is being built into CBCT machines where these AI software's packages are actually able to adjust your implant cases just remarkably accurately and predictably by all the machine learning that's going on right now. So tell us how AI is helping you with like second opinions, for example, in your practice. So about a year ago or so, I brought Pearl into my practice, which is the second opinion. And for pediatric dentistry, what I'm interested in is I'm interested in caries detection. And so second opinion for that. So I've been using it for that. And I'll get my radiograph. And it also plays seamlessly with curve. So the radiograph. It goes into my system and to curve. And then it's just a click of a button to see the second opinion from Pearl. And then it's going to show me where the carries is from incipiency to progressed carries. There's a lot of second opinion that I don't use in what I'm doing. It'll show you things like open margins and bone height and calculus. That's not my interest, but to a general dentist that's out there. And when I speak about this and I teach these things, most of my. People that I'm speaking to are general dentists, so it does have application beyond what I use it for. So for caries, it's huge. You can really show the patient, the parent, what's going on on the radiograph. Having them look at a bunch of shades of gray on a radiograph is not very informative to them. When you start to highlight things with the artificial intelligence and showing where it is and having it read it for you is really impactful for the parent. And then the other part of the second opinion that I use. is the tooth parts where it'll color differently. The root canal system, the dentin and the enamel all have different colors to them so that that's a teaching opportunity for the parent. You can export these images to a PDF and you can send them to the patient. You can print them, just the ability. And I think that we really have no idea just how... far this is going to go. You know, we don't know what you don't know. And I am curious and excited to see what will happen in the future to help this. This will help enhance how we take care of patients. Yeah. And what I'm hearing from other KOLs is the case acceptance rate is just skyrocketing because of this. I mean, the return on investment on the case acceptance is just huge. It is. Let me just ask you this question. How dependent do you think you are? You call it a second opinion using AI. But are you at the point now where you may take a quick look, but you're going to wait to see what the AI generates first and then take a look? Or are you taking a look and seeing if it corroborates your diagnosis? I'm still taking a look and then seeing if it corroborates the diagnosis. I think that we'll get to that point. And I think for pediatrics, for primary dentition, it's still got learning to do. There's so much going on on a primary tooth radiograph in terms of root resorption and radiolucencies that show up at furcation. And how does it differentiate that between the... the crypt of a tooth that's erupting. There's a lot that is still happening with the AI learning. And I think that once that happens, it's going to become this remarkable, indispensable tool. And it learns, right? I mean, that's what AI is. It's pretty remarkable. It learns as we go along. Yeah. Do you see a lot of dentists doing this? Are you an exception? to the rule as far as a GP taking advantage of the technologies that are out there, especially the AI-powered diagnostics? I don't know if I'm an exception to the rule. I think that it's becoming more prevalent. I don't know that it, I wouldn't say it's common by any means. When I talk about it, when I teach it, the majority of the people in the audience are not yet using this. And it's coming, but not yet. And you're using this. AI diagnostics with, and you mentioned you can color the pulp, you can color the decay. You do that over Zoom with the patients, parents. I can, yes. Yeah, so you're actually doing it. You're doing a show and tell. I can share my screen and I can show them their child and exactly what's going on. And do they book these Zoom appointments with you remote, like through technology or do they do it through your remote staff? Both. They do it both. They can go to my website. That's a whole different thing. That's Kids Sleep Dentistry Winnipeg. They go to my website and they can book an appointment or a dentist can submit a referral through the website, upload all of their radiographs, download all of their forms that they need because there's all kinds of things that have to happen with preoperative history and physicals and so on. Or they can call or they can text. So let's talk about the future dentistry as we wrap this one up. With all these advancements in technology, which you certainly are taking advantage of, Dr. Cohn, in really remarkable ways, what do you see the biggest opportunities for growth? and efficiency going forward? And what advice would you give our listeners to implement these tools? You know, that's a big question. The best thing that I have done, I think throughout my career, is to start before you're ready. And by no means do I, I don't mean do a procedure that you're not prepared for or that you're not trained for, but you need to start now. and get comfortable with all of the things, whether it's materials, techniques, technology, just get comfortable with it and start now. Because if you're waiting until this becomes mainstream, you're left way behind. It's given you a whole new outlook on your career, right? It has. And one of the things that's not uncommon for dentists is to fall into a rut. It's a routine. Then they have this feeling of stagnation and they feel like, okay, for the rest of my life until I retire, I'm going to kind of be doing the same thing. But you've opened up a whole new window of efficiencies, opportunities, workflow. You're changing everything in your life by using this technology and relying on remote individuals. They don't have to come into your office. You don't have a brick and mortar. You know, the encumbrances with brick and mortar that all of us, you know, typically would have as a dentist. I mean, there are, you know, professions where you don't need to go to work and do stuff, but dentistry is not one of them. But you've made that kind of happen in a hybrid approach. Have you not? I have. I have. And, you know, 10 years ago, you would have told me, you're crazy. You can't do this. Right? Even five years ago, I probably would have said that. But, you know, here we are. So maybe a little bit of crazy is a little bit good, too. Well, they told me in 1999, I started Viva Learning. And just think about that. It's 26 years old, this company that we're doing this podcast on. And we do 70,000 webinar completions per month on the on-demand and 5,000 to 6,000 live seats per week on Viva Learning. Yeah. And everybody told me, no one's going to take online CE. They're just not going to do it. You have to go to sit in an audience. And in 1999, they were correct because we had dial-up. And I told my family, I said, listen, we're going to be eating rice and crackers for a couple of years while we get through this difficult time. But eventually, when bandwidth opens up, we'll be able to have a good, solid operation here, which, of course, we have close to 500,000 subscribers now. So you're right. You do it before you have to. You do it before you have to. Yeah. That's amazing. Yeah. So we'll wrap up this podcast. Just tell our audience in a minute, if you can, Dr. Cohn, about your training program. Tell us about what you're doing with Litsmileacademy.com. Yeah. So Litsmileacademy is my continuing education platform, and it is meant to empower people. I always wanted to... be able to give continuing education that gave you real information that you can really use. Cut through all of the crap. This is not to show anybody the beautiful photos of dentistry, but to teach you how to do the stuff that you need to know and to help to make your practice a better place for everybody. So come and attend one of my courses. Yeah, excellent. And you have so much to offer because not only the technology, not only treating children, but all the... clinical tips and tricks that you incorporate into your program is just so invaluable. It's the kind of stuff that they can actually, as soon as they get back to their office, they can implement it. You know, it's practical stuff. That's the idea. Yeah. That's it. And that's what a lot of dentists are looking for when they go to these courses and hygienists and staff. Thanks very much, Dr. Cohn. We'll see you on another episode. Thank you. Thank you.