The Tech-Savvy Hygienist: Navigating AI and Innovation

Same-store growth is the most pressing issue right now for the impact of high-level AI for dental practices. So we want to maximize every dental practice, whether you're part of a group practice or an independent practice, you want to maximize the efficiency, the effectiveness, the profit that you can get from the square foot that you have, from the team that you have. Welcome to the Phil Klein Dental Podcast. In just about everything we do with our phones, TVs, and computers, AI, artificial intelligence, has a hand in it. And the power of AI is quickly expanding into our dental practices. We started using AI for things like automated phone systems, scheduling and billing and inventory. But now, as the technology becomes more advanced with more sophisticated machine learning algorithms, AI is taking a much bigger role, such as reading x-rays and interpreting test results. This is allowing AI to play an important role in a patient's diagnosis and treatment plan. As AI continues to advance, it's essential for dental professionals to stay informed and proactive. By embracing AI today, you can position your practice for a more efficient, effective, and patient-centered future. To tell us more about AI and how it can do many things for dentists and hygienists is our guest Melissa Turner, a 20-year veteran dental hygienist. Melissa is a sought-after consultant and speaker. She partners with companies of all sizes on brand strategy and product growth, leveraging her unique insights from experience in the boardroom and as a clinician. Melissa will be joining us in a second, but first, as a dental healthcare professional, you might already know that 3M Healthcare is now solventum, and one of its next-generation products is 3M ClinPro Clear Fluoride Treatment, available in a new rosin-free water-based formula, with soluble fluoride ions immediately available to deposit on the tooth. ClinPro Clear Fluoride treatment needs only 15 minutes of contact time. Plus, with less waiting time to eat or drink after application, it's even easier for your patients to say yes. Its uniquely designed LPOP delivery system ensures a smooth and professional application process. In clinical studies, hygienists found it fast and easy to apply. and patients rated their experience an impressive 98 out of 100. So if you're looking for effective fluoride uptake in a rosin-free, water-based formula, try 3M ClinPro Clear Fluoride Treatment from Solventum. To learn more, visit solventum.com. Melissa, it's a pleasure to have you on our show. Hi, Phil. It's great to be here. Thanks for having me. Yeah. And I know how busy you are and you're doing a lot of speaking and everything else. We're all very busy. So we do appreciate you contributing your insights to our podcast program. We do not take it for granted. So thank you again. And let's begin with a very general question to start off this podcast. How do you see AI, artificial intelligence, shaping the future of dentistry? Oh, my goodness. Well, Phil, I've been in dentistry 20 years. I think a better question might be, how has it already shaped what we're doing, right? I think one of the things that we've realized is COVID changed everything, but it wasn't just COVID. During that time, there were so many changes coming down in dentistry, and technology was one of them. This whole AI experiment, really. came down at that point too. And so, you know, I just gave a lecture the other day on AI and the premise of it is when we, when we as dental professionals think about dental AI right now, the main thing we think about is, oh, this x-ray AI that we can use in our practices in the ops to diagnose to screen to see the pathologies on our computer screen it just pops it up for us right but my whole point in this lecture was to say sure that's one way that we've been using ai But really, we've been using AI in the practice management systems and the insurance and virtually everything else we're doing already. And so the whole point of that lecture was to take the fear away from, OK, AI is not new in dentistry. We've already been using it. It's changed everything already. Yeah. I mean, AI has actually been around for 60, 70 years. Obviously, not in the form that we know it today, but it's been around a long time. It's been programmable code. that's been written to make models, to make predictions on things. And AI still does not have a conscience. The machine learning is not sentient yet. There's books been written about it. And I've read a couple of them that are actually very good. And it talks about a robot being a waiter. And the robot takes the order from the patron and comes back with the food. And the person who gets the food starts eating the food and starts choking on the food. So the point of all this and the point of what the author was writing in the book was that the robot was great at taking an order, clearing the table. But as soon as there was some issue that was out of the realm of what a robot could handle, it didn't know what to do. It didn't know how to save this patient or call for help because the patient is choking. So the only thing it knew to do was to either clear the table or ask the person if they want dessert or more food while the person's choking. there's a limitation to that level of AI when it comes to restaurant serving. And in dentistry, AI has been used, obviously, for scheduling and billing and so forth. But now we're moving more into diagnostics. So where are we in dentistry with artificial intelligence actually helping us in the area of diagnostic dentistry and treatment planning? Yeah, I think we're on a good path. Me coming to this as a hygienist, I understand that in most states, I cannot officially diagnose caries, right? And sometimes not even gingivitis and periodontal diseases. And so there's been this gap in a lot of hygienist lives, which means it's this gap in how we do the business of dentistry. There's been this gap as to say, okay, well, the hygienist can educate on what she sees, but she can't diagnose. computer is coming along, right? And it's serving the patient food ready to have them choke, right? Like you're saying. But now what we're seeing is that this diagnostic program actually can shine more as a patient education program. So the dentist still diagnoses, right? And these dental x-rays pop up on the screen. And we're in a world where It doesn't work anymore for the dentist to say, trust me, I'm a dentist. And it doesn't even work for me as a hygienist to say, trust me, I'm a hygienist. You know, listen to everything I say, take it home with you and do what I say. It just doesn't work. We're in an information overload age, thanks to AI, thanks to everything else we've been seeing. And so these diagnostic x-ray programs that we're seeing come to fruition right now really shine in the patient. patient education light because i can tell i can tell the patient okay here here's a picture of your tooth here's a dark spot on i can tell them that but if a computer tells them that they're gonna believe it and even me even me when i took my daughter and she broke her arm last year right like i didn't believe what the doctor was saying until i saw it on an x-ray right well yeah let me ask you this so give us an example because You know, I was an endodontist. I took an x-ray. I went back to the patient and I showed them a periapical lesion on number 30. And I explained to them that the bone is now a radiologic. which indicates infection, which goes along with me pushing down on it, percussion, they're feeling pain. So putting all these diagnostic observations together, we're going to come up with a diagnosis that this tooth is necrotic. Now, I never had anybody doubt my diagnostic interpretation of what I'm seeing on the film or my clinical findings. What is so special where we are now with AI where you think, that it's better as an educational tool. You're going to look at the same film, show it to them, and point out exactly what's going on. What is AI actually doing to help with case acceptance and for them to understand what their condition is? It's that instant gratification, right? We have literally two seconds on the social feed to... get their attention. And I truly believe it's the same thing in the clinical op. We speak for an hour on a topic to the patient, they're going to not listen. They'll listen to the first two seconds, right? So you pop up that screen, they see it, they're like, oh my gosh, something's wrong. You had it maybe a little easier in an endo and a specialist office because the patient was already there knowing something was wrong. In a general practice, I think it's very, very tough. That's why case acceptance and selling to your patient and that whole topic is so popular right now. And it's been ever since I've been a hygienist. But in a general practice, it's so difficult because patients don't walk in thinking something's wrong. Like especially if they're coming in for their six month or three month hygiene visit, they kind of know they had some cavities in the past. They kind of know like they're not flossing, but I'll probably make them bleed. Right. But they don't know anything else is wrong. That's that pain point that we have in a general practice that I'm actually jealous of you in the perio and in the endo and all these other specialty practices because patients are going, already walking in, having the mindset, okay, something's wrong. I need to be fixed. Right. But so I'm coming into your hygiene chair. What are you doing with AI that you couldn't do before? Explain to me in detail how are you using AI? You've taken radiographs. How does AI now? Tell me educationally what's going on. So it'll pop up on the computer screen, right? That's just from a patient standpoint, that's all they care about. The supplemental AI that goes with that, things like point of care salivary testing, point of care plaque testing, that uses AI in the background to supplement what they're seeing on the screen. So at an ideal hygiene appointment, I would have the patient come in, do, you know. look at their mouth get all the data get all the statistics and say hey we're going to take a little plaque sample or a little saliva sample and we're going to see we're going to do this on the app or to do it right here and see what results we get so whether it's a screening whether it's testing for the pathogenic dna whether it's showing indicators of what the patient is at risk for if i can do all that right there and show them the results and supplement that with what then we're seeing on the x-ray. That's the logistics. That's the behind the scenes of like, okay, pulling all that together, the patient's going to take more ownership now. And then we, I have to spend less time selling the patient, trying to convince them that they need to get this done, trying to convince them to come to you as the endodontist, right? It just cuts through all of that quickly. And I assume, I guess, at this point in time, with all the technology that surrounds us, your patients are pretty comfortable using AI. for screening their dental risks well they're almost phil they're almost indoctrinated into that already you know a lot of my patients have taken the 23andme tests or the ancestry um tests where they they send away and either and then they receive the results in the mail or on their app and so that uh precedent has already been set for our patients and so now it's just applying it within the dental practice so yeah some of these salivary tests some of these plaque tests can can utilize ai and a cell phone right there in the app and give results most of those are just screening results right now um and then a lot of them you send away and then you'll have to have the patient come back but then it uses ai in the background to sort through all the genetic factors you know all the risk factors that the patient has. And there's even some of these testing that you can do for oral cancer now too. We'll be getting right back to Melissa in a second. But first, if you're on the lookout for a versatile material that serves as both a protective liner for composites and is ideal for direct and indirect pulp capping, let me introduce you to Theraquel LC from Bisco. Its unique hydrophilic resin-modified calcium silicate formulation provides a strong, stable liner that reduces post-op sensitivity. It's radiopaque and incredibly easy to apply. Once light-cured, Theracal-LC is ready for use with any bonding technique. What's even better, Theracal-LC is non-soluble, meaning it won't wash out over time. Plus, it promotes calcium release, which supports secondary Denton bridge formation. And that's perfect for those tricky pulp exposures. When you're working deep in a tooth prep, you want reliable protection for the dental pulpal complex. You want TheraCal LC, a top choice among independent evaluators and thousands of dental clinicians. For more information on Bisco's full line of pulp protection products, head on over to Bisco.com. How prevalent is it in the GP arena right now where... The GP is using and hygienists are using AI to help determine treatment plans. And there's also litigious risk there, right? Because that's kind of holding up some of this patient care AI strategies. There's still legal issues that are in the way here. How is that all panning out in the GP office right now? Right now, we are still very much in the early adopter phase when you're looking at that bell curve, right? It's the masses have not utilized it. You know, what we're seeing now are these companies that are using AI have just received their FDA clearances. They've just received funding. They're still coming out of the startup phases. So when we're thinking about the legal aspects, when we're thinking about how do we actually implement these things into our practice, it's still very new for us. But if we look at health care, if we look at Our medical colleagues outside of dentistry, they've set the stage. That's why I like dentistry, Phil, because we're a little bit behind the times, right? But it's not like we have to rewrite what's been done. We just have to see what the oncologists are doing and the obstetricians and kind of learn from them, copy and learn, learn from their mistakes and see what works and see what doesn't work. There's no question about it. In the healthcare field, dentistry follows medicine for sure. Sometimes it takes longer for us to adopt. the strategies that are being used. But there's no question about it. AI offers incredible advantages when it comes to like pathology. And looking, just imagine there's a shortage of pathologists. AI could look at a histologic slide and be very close to 100% in determining what that slide is showing. probably closer than most humans, right, that are pathologists, I would think. I don't know. I hope there's no pathologists that are listening to this podcast. Just imagine millions and millions of slides being ingested by the machine learning. It's going to kick out information that is probably pretty accurate. Same thing with reading radiographs. And I think certain types of radiographs, a lot of GPs aren't really comfortable with, especially 3D, you know, CBCT and other things where there's a lot of pathology in the jaw. that they're not real comfortable with. At least they could get an alert and say, hey, something looks suspicious here. Let's send it out to an oral surgeon for further review. So let me ask you this. How can AI address profitability for dental practices? And I assume that has to be integrated into the practice management software. I think the biggest thing, like I said before, is sales. But it'll help the patient understand right away if something is wrong, or it'll help the patient understand that they need to take ownership of their mouth. One other little known profitability aspect is also... the ai usages that we're seeing in dentistry it's helping the patient take more ownership it's helping the patient demystify what's going on in their mouth but it's not also about the patient it's it's it's about medical you know we're just talking about medical providers as well if they could take a cbct and if their ai platform could pop up things that are wrong they can refer them now to the dentist whereas before they wouldn't have at all, right? Same thing in other aspects. If the primary physician can take a salivary test and say, oh, this person is at risk for periodontal disease, we got to get them over to the dentist. Like that profitability has been talked about a lot in the past with oral systemic link, medical dental health. Like it's been talked about a lot, but there haven't been any action items. And now I see a clear, clear profit vertical here with referrals from medical facilities. Yeah, bi-directionally. Both ways. Yeah. Right. So, I mean, if the medical profession is receiving referrals from dentists because of discoveries made through AI and the reverse is happening, like you said, medical professionals are sending to the dentist. Now you have that mouth-body connection gap being filled, that bridge being filled by this flow of information back and forth. And that's really, really important. I think that's a great point that you're making, Melissa. So let's talk about And by the way, before we get on to the next question, how far off are we in your opinion? You've been doing this a long time. You're very familiar with a lot of different practices. And you mentioned that we're in the early adoption stage. How far off are we in years from being really fully equipped to take advantages of AI in the dental practice? Well, so my definition of being fully equipped would be to say, we don't even have to talk about AI anymore because it's just part of what we do. So for that to happen, I would say there needs to be a lot of consolidation among the AI companies, both in the x-rays, salivary diagnostics, practice management software, teledentistry software, all of that has to be consolidated. And then there has to be kind of a changing of the guard. Practice ownership needs to change to the next generation. And that generation will always look for new ways to implement what they already use in their everyday lives, right? My best guess is five, seven, nine years before we don't have to talk about AI anymore because it's a part of what we're doing, fully integrated. Could you imagine the change in the way we practice dentistry when this is all fully integrated? I mean, it's just, it's going to be, I mean, and we thought we made unbelievable advances in dentistry in the last 15 years just by the digital workflow. We did. Yeah, and we did. We did, no doubt about it. But what's happening with AI and the advancements that are yet to come, are just going to be stunning. And they're going to be so powerful, they're going to reshape the way we practice dentistry. Kind of like the way digital workflow is reshaping it now, but probably in a much more powerful way. Integrating all forms of medicine, as you pointed out in this podcast, healthcare into one convergent technology where we can really understand the patient from top to bottom and not treat these patients in silos as we often do, unfortunately. So let's pivot for a second, Melissa, to staffing. And that has been quite an issue for many dental practices. A lot of that started with COVID. Dental hygienists and dental assistants were on the front line. They were being subjected to aerosol. Obviously, there was such a scare with aerosol. Dental offices were buying machines to filter the air, and the PPE was so burdensome. Unfortunately, Dental assistants and dental hygienists decided to throw in the towel and say, you know, this is not the profession I was looking to get into. I didn't sign up for this. So they left. That caused an immediate shortage of staff. And there's also the fact that 25%, this is what I hear, of hygienists that start hygiene school don't finish. One out of four. So when you put this all together, there's certainly an obvious and concerning staff shortage. among dental practices so tell us how you think ai and technology can help the dental practice manage this challenge i think you know the easy answer is to say sure there's staffing platforms out there that use ai but that's that's not what i'm referring to here if we take a step back and look at high level the impact of high level ai on our teams what we're seeing is um same store growth is the most pressing issue right now for dental practices so we want to maximize every dental practice whether you're part of a group practice or an independent practice you want to maximize the efficiency the effectiveness the profit that you can get from the square foot that you have from the team that you have. So when we look at AI and staffing, my message that I preach everywhere I go is to say, hey, if you can make your team work them to the top of their license, to the best of their ability, even if you only have two hygienists and you really should have four right now, if you can maximize what they're doing with technology and AI included in that, then you will take your practice further than you ever thought. It's not always about hiring another hygienist it's not always about hiring another assistant or front office person things like teledentistry telehealth i know you know it's it's been a confusing topic in the past i've used it i've lived it i know the potential for it and ai is in the background of teledentistry right it's going to help us connect with the physicians if we can all connect together and communicate it's going to help you know we're seeing dentists not in some states not even dropping into the hygiene visit because they don't need to, because they can still charge out for an exam and do an exam. They do it through asynchronous teledentistry at the end of the day. That creates a more optimum, more efficient hygiene schedule. You can get more patients in. You're maximizing the hygienist. That's a tangent for another day, Phil, but that's exactly what I'm seeing. There's so many ways we can optimize what we're doing with the team that we currently have. And so AI is going to impact that once we discover what all of those ways are. AI will even, you know, further impact that. Yeah. And there's a lot of technology that also could bring efficiency to the practice, whether there's AI built into it or not, you know, answering the phone, even though it's nice to have someone personally answer the phone. I mean, how many companies do you call these days where you don't get some menu that you have to go through? And it's frustrating, but that's just the way it is now. I mean, in the beginning when that first happened, I hated it. Now I'm just... used to it that you get this menu of five different things they ask you before you can get a live person. And you're lucky if you get a person that's actually in the United States that you could understand. But that's just the way the world is. But there are technologies that bring efficiency. And yeah, the staffing crisis is something to really take seriously in dentistry. I hope it's resolved. And I know we're going to be doing a separate podcast, Melissa, on staffing, which is something we're looking forward to. Before I ask you about the myth about AI, because there is some myth that floats around in the dental world about AI, which I'd like you to debunk. But before we get into that, how does a dental practice decide at this point what... AI systems to actually purchase and integrate? How do you make that decision? I think it's impossible right now because no matter if you're talking about X-Ray AI or software that you use for data analytics from the business side of dentistry, no matter what you use, it's all fragmented right now. And so it goes back to that consolidation. You have no idea unless you have hours and hours and hours as the business owner, as the clinician to spend researching all of this. reading the Yelp reviews and talking to people who've used these systems, you're really in the dark. So this is exactly the time where you need to attend lectures. You need to go to dental events and figure out what's going on. You need to work with consultants, technology consultants, AI consultants to help implement because you're going to otherwise spend so much time. trying to do it on your own. And we don't have time, right, as clinicians or as business owners, we do not have time to figure out what is best for us. And then if it's not best to, you know, replace it. So that's actually a whole new profession that's evolving now, an AI consultant for healthcare. Is that your next venture? It's in the works. Yes. It's in the works. Okay. Yeah. I'm just asking. Teledentistry and different technologies. So it goes right along. Yeah. I mean, it's overwhelming because, you know, when you're you got to look at the person getting out of dental school, they have so much they've learned about dentistry, but they have also had lack of training in many areas, including business management, leasing and versus buying a building or whatever, working in a DSO versus being a solo practitioner or an associate. Now we're talking about. digital workflow equipment, and then AI, it's really important for an office or a person who's thinking about starting a practice to speak to a specialist who really knows as much as possible on making those right decisions, those purchasing decisions. And it is changing very, very quickly. So as we wrap up this podcast, Melissa, what is the biggest myth about AI? The biggest myth is that we don't need it. I'm good how I am. I'm good as a dentist. I'm good as a clinician. I'm good as a practice owner. I don't need it. And I think the biggest myth is debunked when you realize how much you're already using it without even knowing. So how are they using it without knowing? It's in the background of everything we do. I read an article the other day about the most popular ways to use AI. And it was things like, okay, when in your everyday life, it was things like when you're scrolling Netflix, that when you're scrolling your social feed, the customization, the personalization that's happening, when you're using your face ID on your phone, when you're purchasing things on Amazon, you know, all of these things. That was the most popular ways to use AI. And I said, well, I do every one of these every day in my life. So I'm already using it. I'm reliant on it, right? But the kicker was all of those things were the most popular ways to use AI in 2019. So five years ago, you know, and I just read the article and that was the kicker, right? So now like we're in this new era of like understanding how to implement new ways of AI and more personalization and things like that. self-driving cars you know these things are like still new to us but give us a couple months a couple years and it's just gonna happen there's no question but the examples you're using or you're mentioning you're the consumer but from the standpoint of a dental professional the dental professional needs to understand how to use ai because the patient is going to be the main center of of what the application is so um it has to help a dentist practice efficiently and detect pathologies earlier, of course, when it comes to oral cancer and other lesions like that and treatment planning. But it's all going to come together, like you said, when this fragmentation is met by some technology company or several technology companies where they figure out through some API, there's a new hub that processes all these different fragmented AI systems that could converge it into something that's easily interpretable by somebody like a dentist. Until that happens, it's better to wait on the sideline, you're saying, and see how it all pans out. Or find the simple ways. Maybe find the ways that you're already using it in your personal life and apply it to your practice life too. Things like online payments. Easy. It's easy now to use that in your dental practice. And are you yet? Right? Right. No, that's a good point. Just the easy, small ways that... you use as a patient in the medical facility or you use every day online shopping. Those are the simple ways, the 2019 popular AI ways, like those should now be used in the dental practice, hands down. And when you give a lecture and you're a very sought after lecturer on this topic, do you fill a room with young people, young dentists, or are you getting dentists that are in their 50s, 60s, late 40s? I mean, or is it just 20s to 39? No, it's actually the older ages because the younger ones have already been implementing it. Oh, really? So it's the ones that have been in practice a while that are saying, what am I missing out on? Exactly. It's still a mystery to them and they need to have practical applications. First step. This is the first step right here. Very good. All right, Melissa. Very, very good conversation. Thank you very much for joining us. And we certainly look forward to having you on future podcasts. Thank you. Thank you, Phil.