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Dentistry Uncensored with Howard Farran
Dentistry Uncensored with Howard Farran
How to perform dentistry faster, easier, higher in quality and lower in cost. Subscribe to the podcast: https://podcasts.apple.com/us/podcast/dentistry-uncensored-with-howard-farran/id916907356
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1320 Daniel Abraham on the Future of AI in Dentistry : Dentistry Uncensored with Howard Farran

1320 Daniel Abraham on the Future of AI in Dentistry : Dentistry Uncensored with Howard Farran

12/26/2019 6:00:00 AM   |   Comments: 0   |   Views: 140
As the founder and president of ORCA Dental AI, Daniel shares over 20 years of experience in founding and leading technological companies. Daniel leads the vision and strategy of the company towards a future in which AI is dominant. Prior to founding ORCA Dental AI, Daniel founded CephX, ReKoverr and BitShakers. Daniel holds a B.Sc. in Computer Science from the Academic College of Tel-Aviv Yaffo in Israel, and an MBA from IDC Herzliya.

VIDEO - DUwHF #1320 - Daniel Abraham


AUDIO - DUwHF #1320 - Daniel Abraham


I am in Tel Aviv, Israel with Daniel Abraham. Thanks for meeting me today. How are you doing, Daniel? Very well, and it's a pleasure to be here, and thanks for taking the time to hear me out. Well, my column this month was on artificial intelligence, and you're with Orca Dental AI. That's the one. So tell us your journey. How did you end up in dentistry with AI? Well, the journey starts actually with my father. I'm a second generation to this dental business, but not as a practitioner. My father's an orthodontist, and I'm a technologist, and then about five years ago, we started realizing there's interesting opportunities with regards to AI in general. AI started exploding, started becoming a very interesting technological term with self-driving cars and all the way to medicine, and we just realized there's something that is also going to shape dentistry at some point, and why not be the pioneers?

It just made total sense to us that the way medicine is progressing and the way dentistry is progressing, it's going to be a very interesting time for us. So I'm the whole of technology is progressing. With the use of AI, there's a bunch of different opportunities in dentistry, and we just went for it. So that's interesting. Your father was an orthodontist. Still is. So are you going to get genetic testing before you have children just so you stop this? But that explains why your first product was actually ortho-based, because when you started, was it your first Cephex? Yeah, Cephex was still running today. Indeed, it's a product aimed for orthodontists. It's a very basic service of cephalometric analyses for orthodontists. Cephalometric products have been out there since the early days of the computer.

It's nothing new, but what is new, what we did add to it was the AI angle. So basically, what happens is that practitioners will send us their X-ray, and we automatically do an analysis for them with no human intervention using AI and using deep learning and using algorithms. Immediately, practitioners get a result. And that in itself was a revolutionary kind of moment for us to realize that there's a lot of opportunities here, not only in orthodontics but all across dentistry, and it was the lowest hanging fruit. We knew in-house regarding the requirements of this analysis, so we just said, let's give it a try with AI and see where it takes us. Yeah? us

and results are amazing and when did this come out it the commercial product came out after a lot of testing and a lot of improvements it came out almost three years ago first of the three years yeah January 2017 and how's how's that product been doing fantastic I mean it's just the the ability to give immediate results is such a big game changer just because practitioners need the information now they don't have time to wait or to you know to figure out which process internally or externally they need to they need to use in order to acquire their results they just send it off and immediately they have a result and that's it makes all the difference and again for us it's like it was sale that wind in our sails so to speak to understand That there's, there's just a huge opportunity here in all forms of dentistry so, this Cephex yeah, that was your first product, yeah.

Been out three years is it taken off at different rates around the world absolutely? First of all, the fact that we put something kind of new and I would say, the fact that there's, in a field which has been around for a while so for metric analyses and computerized cephalometric analyses is nothing new but putting innovation into an existing field made us suddenly interesting not only to practitioners but also to partners and channels and distributors and now we're integrated into some of them. Providers of dental imaging systems, I plan Mecca, and so on already have us kind of baked into their systems just because again everybody's looking for the unique edge, everybody's looking for the the ability to display innovation and provide better services through innovation, and that's what we're all about, we're all about improving dentistry through innovation, and the type of innovation we bring to the table is AI.

So your first adopt major partner, a doctor was plan Mecca, yeah, at Helsinki Finland, yeah, and they own e4d out of Dallas Texas with Cad Cam in a year? Freddie Sayers, all are different projects, but there's just a lot of different avenues. Week, I mean, the more we get into the game, the more we see there's so much room in so many different verticals for AI. Yeah, there's quite a stack of projects where... no, it's fine. Moonlight laptop boss Bizet boundary south bay section of trump be true from her which is where Google tested their driverless cars and um, they said for a lot of reasons, you know. Year-round weather is good um, but um, it's so funny how so many people are uh, are worried about the uh drivers.

It hit one person yeah, and it was just like it was just like the whole city stopped and talked about it for a year, and I was like, well, humans. Run over and kill a hundred people a day, yeah, and that didn't even touch them. Um, but um, when an AI killed one person, you know the whole world had to stop. I don't know how AI has to be the future because I've witnessed natural intelligence and I'm not very impressed. Um, it seems like AI is um more of a visual thing, an object-oriented thing, you know. I'm not a programmer, but naturally it isn't. But there's also a lot of AI sites that are not visual, for example one of the biggest areas of AI um is bots and bots, yeah, um.

Google have their bot technology, Facebook have a big investment in bot technology, so the ability to interact with humans uh then another side of ai is analytics if we can take a large amount of information and extract crucial uh data points or metrics that will help us understand what's going on either on a business or on a business or on a business or on a business or on a business level or even on a clinical level um then you're talking about uh you know benefits to insurance companies and to dsos if we're if we're going back to dental there's a lot of different opportunities that are not necessarily only visual um and uh yeah i mean again we we aim to provide services across the board not necessarily in one specific vertical so would you in dentistry there's 10

Junghansil robotic Dermatologists who train on foot in the office with a asking you very about these these environmental challenges so you be able to uh interview around the world right now um we're still working on some new research we're working on the choosing the dental training courses so that you have more an idea and experience i think your insights would be very helpful okay thank you very much as an up-and-coming imaging procedure that is becoming ubiquitous, right? At some point, everything's going to be CBCT. There's no need for 2D if you have 3D machines and the radiation levels are going down. So all the advantages are going to be in 3D. So that's an imaging type that we look at and say, okay, where can we bring value here?

And we've already built out quite an interesting automated segmenting tool. I'll show it to you later. Or if you want, you can display it as part of the- What is it, on your laptop? Oh, you can actually access it on your mobile. But that's what I'm filming you with. I'll show you on my mobile right now. Open up yours. Okay. Didn't realize it'll be- Okay. So what we do is we take a CBCT that is sent to us. Anybody can upload a CBCT to our system. We automatically segment all the objects. So we know how to look at the bone and say, this is the maxilla, this is the mandible. Every tooth is an object. And convert that automatically into an STL.

And then once it's an STL, basically a bunch of STL objects, it's very easy to build out viewers and different systems that can manipulate that. So I don't know, I've got it on my phone. Yeah, yeah, just show it right to the camera. Okay. So here's a good example of a- Here, screw it closer. Okay. Okay. Our phones are- Yeah, so everything's on the phone, right? Today, being able to generate accessibility and being able to take the information that's embedded into these CBCT images. And this is a basic 3D viewer of a CBCT. But the difference here is these are all STL files. So I can remove-STL files, you're talking to a dentist. A dentist, like a 3D printable file. And that's called an STL file? STL file is a standard for 3D printable files.

So today, where you have labs and interaction between 3D scanners and when you have interaction between labs that will build out the reconstruction of the tooth or implants or 3D scanners, all the files that are created are STL based. So if you do a 3D scan on a patient- It's really dark. Oh, there you are. And we're reading all the messages from friends. Yeah, I hope nothing too intimate. Okay. So let me see if I can do from here. So here's a good example: Like this was a CBCT file sent. We automatically located the nerve and drew it out. And actually, the nerve is a 3D, is a STL file, 3D printable file. Each tooth here is printable. For us to- For us to create an implant is really simple.

You just drag the implant where you want it to be. And it's all done automatically on your phone. Very accessible, very good for patient communication and case acceptance. Very good to get a feel of, okay, I'm going into surgery. I want to quickly understand what's going to, you know, what I'm going to do in that procedure. And the point is with AI, you can automate, a lot of these processes and make it really accessible. Because the problem with data today is that there's a huge amount of data. People are taking CBCTs, but it's not accessible. It's available, but not accessible. And what AI does is take that data and make it accessible. Surface it to the user.

So if it's in the form of pathology issues that are in the, you know, are embedded somewhere in the patient's oral health cysts, things where the nerve is, or anomalies, anything of that nature can be easily surfaced to the practitioner with AI. And if it's on the other hand, saving the practitioner clicks and making streamlining digital processes, which are more and more time-consuming, it's another side of AI where we can benefit from automating a lot of procedures. So, so on, let's go back to your Ceph product. So does the orthodontist, he takes a Ceph and then he has to upload it to your website. And what, how does that work? Does he upload it to your, your website is orca-data-ai? So the, um, the SAS, um, offering, we have this, uh, software as a service, really.

It's just a web platform is actually at Cephx.com. Okay. Cephx.com. Right. So, that's CEPHX.com. Um, you go in, you register. And yeah, you can start sending off Cephs and you can start sending off, uh, um, DICOM, 3D DICOM images. So you just upload your images. It automatically generates, um, this 3D viewer that you can go into and start, uh, seeing the patient's pathology from different views. And again, remember there's no human interaction. There's nothing that's happened that's gone through a person to get those results. You wait a couple of minutes, you get your results, and now you can start, uh, basically getting more information. So that's the insight, um, where previously in order to do that, you needed a DICOM viewer and looking into slices and it's more complex and more time-consuming and you need to be in front of your computer, and, and you have to have gone through the learning curve of the software; um, the software packages where with Cephx, all you do is you've got a 3D intuitive viewer.

Anybody can just spin around a 3D object and suddenly you're looking at different views of impacted, uh, impacted teeth. And nerve replacement, and we have an airway report and a lot of different pieces of information that, um, surface to you without any effort. You didn't have to even learn software in order to be able to use it. You should write an article on that for OrthoTown. Uh, that goes to the 10,800 orthodontists in the United States. Okay. But that, that, I'm sure they would love to read an article on that. Yeah, we have more and more orthodontists using us just because CBCT is becoming so, uh, prevalent in orthodontics. Suddenly that, I mean, for a lot of cases, especially impacted canines, this is a specific, uh, use case.

It's very difficult to, um, to see just through a pan and a Ceph and a lot of the time, orthodontists, what they'll do is they'll, they'll just extract a pan and a Ceph. So they're taking a 2D snapshot of a 3D image just because the 3D software is so complex. And instead of doing that, why not just upload it, get a quick snapshot and proper 3D view of what's going on? And you've got a lot of more information that you otherwise it's difficult to see even in a pan or Ceph. So were you able to talk your father into using this? Yeah, he's crazed about using it all the time, but he might be a little subjective, so I don't know.

So, um, if someone, um, it looks like the future of this, the next we'll go to oral radiology, the, the people reading the CBCTs, um, I have a CBCT and in my office, sometimes three of us dentists, all old. Looking at the CBCT, looking at each other, like we don't even know what that is sometimes. I mean, it kind of looks like a Hubble space telescope. Um, do you see oral radiology, this, uh, AI going next to oral radiology, actually reading the CBCT for you? Well, ORCA is basically an acronym for oral care, right? That's how we came up with ORCA. Um, so yes, we are any imaging that has to do with the oral condition.

Um, we are interested in giving, um, again, reports, information, data analytics, um, and basically anything that can help to create a better treatment plan, a more informed treatment plan, um, and ultimately better treatment. So, yes, to your question, we definitely want to provide services to professionals reading and deciphering oral imagery, including oral radiology. I think it's funny when you live long enough, you get to see the same radar again. When I got to school in 87, Panos, you know, that was coming out. And the biggest thing in oral radiology was when this company came out and they figured they put an R on one side and an L on the other. And that was absolutely the biggest oral radiology innovation. I still think it trumps anything we've ever done.

Because when you showed it to the patient, the first thing they'd say is, 'Oh, that's my right side.' That's my. The R and the L was the only thing that everybody, um, watched. But it's funny when, when the Pano came out, you know what the naysayers said about it? They said, 'Well, it's going to show you areas and there might be disease and you didn't see it and you didn't diagnose it.' And it's going to come back and bite you because you missed pathology. And then 30 years later, the CBC rolls out. What is the same argument? Oh, all this diet. It's like, dude, that's exactly what they said. Three decades ago. Um, and it didn't make a difference. So it's funny how, um, it always comes back the same.

So I noticed a, I, um, the, the, I noticed that insurance companies, um, are using it and they've already, um, found dentists resubmitting the same x-ray. Oh yeah. For like 80 root canals in a row. That was in California. Someone's going to go to jail for that. I noticed that some crown and bridge laboratories are now reading the impression to see, if this was a good impression, um, and now you're doing, um, the ortho, um, where, where else do you think, um, AI is going to end up in the future? So again, like one of the basic examples is, uh, implant planning, or are you talking out of the scope of dentistry? No, just no, just in more and more dentistry. Okay.

So again, so implant planning, implant planning is, is our basic next kind of product that we're rolling out right now. Is it are you rolling it out now? Or is it still on beta? It's right now. Okay. So where, where could they go to see this right now? Um, so again, you just go to CephX, upload a CVCT and you will get uh the ability to see our viewers. Spell out CephX. C-E-P-H-X. So he goes to C-E-P-H dot X. No no no not dot X. C-E-P-H-X dot com. Sorry. C-E-P-H-X. You missed the H. C-E-P-H-X. Right dot com. Dot com. Right. Right now you can load up your um CVCT. Yep. And then treatment plan it with an implant. And then you can start treatment planning with the implant.

You can start playing around seeing all kinds of implications and pathologies that are otherwise difficult to sometimes. Is it agnostic to the implant system or do you enter this? Entirely agnostic to the CVCT system. Even any, you know, partial CVCTs, full-view CVCTs. Quadrant scans, anything it knows how to accept and will analyze that specific image accordingly. And it's also regarding the implant system. Again, it's more to give you a feel of how to quickly decipher which implant I want to use or, you know, what space or how much bone do I have or what's my distance to the nerve and so on. So it's, it's more of a, doesn't even look at an implant system. It looks just like at a measurement. I've got a, you know, uh, uh, 10 millimeter.

I don't know, 15 millimeter implant on a three, uh, 3.2 diameter implant. How would that look, uh, in the current pathology without having to go through the, uh, proper, you know, deep implant planning systems, which are maybe, uh, super accurate, but they're very time consuming, long learning curve. And hard to show the patient because it's not, you know, available on your mobile with three clicks. And that's what we're trying to do. We believe that. And that's what we're trying to do. We believe that making the information available is the next leap at providing better, uh, care and better treatment plans. So, to reduce the number of appointment appointments, I mean, kind of more like same day, like I mentioned, if you went to the orthodontist and he took a pano and an X-ray and said, 'I'm not going to tell you the answer until next week.' That wouldn't be nearly as exciting as taking a pano and an X-ray and getting a diagnosis.

Absolutely. Absolutely. Again, the uh, the way we see the advantage of AI. It's. It's a game changer in two different vectors and we want to provide services in both those vectors. One vector is the pathologies, right? How can I surface issues that otherwise would be difficult for you as a practitioner to notice, right? Because you're not a radiologist and you don't always want to send all your cases to, you know, an external service, but you do want to know if there is something there that you haven't noticed. You're even questioning how liable you are now that you have all the information. So that's one part. How do we surface crucial information, cysts, uh, cancerous or, uh, or growths of some sort, um, all kinds of pathologies, defects, and so on.

We want to surface that to you. Otherwise it might be very difficult for you to find. Um, so that's a one, one vector. The other vector is how do we streamline and make your digital process faster and easier and more available? And that translates into faster treatment. So we, we don't necessarily know how it's going to change the flow of dentistry, but we do know that we're going to be saving time and increasing accuracy and increasing findings of crucial information. And if we can provide those, you know, those, uh, benefits to the practitioner, as far as we're concerned, you know, we've, we've done our job. So, you said earlier that AI is kind of three areas, visual, bots, and analytics. Uh, yeah. The, the, the areas that are relevant to dentistry.

Yeah. So let's go to bots. Do you have plans with bots? No. Currently, currently bots is not an area we're going to deal with, but we do want to. But explain bots again. Well, bots is more, it's referring to a question you had generally about AI. Where does AI bring benefit, uh, other than the visual, uh, scope? So there are other areas. Bots was just an example. But what is a bot though? A bot is a system which helps, um, a platform, so to speak. It helps, um, you create an interaction with a customer, uh, with no human intervention. So if you're a, they have a website. Right. Okay. So if I'm a company and I want to be able to help a potential customer, but I don't have enough funds now to build out a sales or support team, I could theoretically build a bot that knows to some extent to help out or to answer questions that may arise from customers, um, to a certain extent.

But that seems, that seems very important. Because almost every dentist has a website. At some point. Absolutely. And when you, um, talk to the marketing people, um, they'll do a, say they do a big campaign in direct mail. They drive a whole bunch of people to your website. Right. There's only a 3% conversion from I go to your website to I call your office. And so I've noticed a lot of people, you know, if only 3% of people land on your site convert, you get a lot of room for growth. Absolutely. And I'm sure a lot of them have questions. So you're starting to see, um, people. Starting to do services with, um, the little, I, I call it a chat window. Chat bot. The chat bot.

Facebook has a greater platform for it, uh, to be able to take the information or the questions. Did you know Facebook, the owner of that, uh, Mark Zuckerberg, did you know his dad's a dentist? No, I didn't realize that. Yeah. Ed Zuckerberg is a dentist. Huh. And, um, so I always tease Ed because Ed and I both have four kids and his kids started Facebook and, uh, I always tease, uh, um, but anyway. Yeah. Um, interesting deal. But yeah, I, I think the, I think the website bots on the dentist website, if you could, if you could take the conversion from 3% to just four. Absolutely. That's a huge. I would imagine that if there's a lot of potential customers and they have unanswered questions and you could build out a system which answers at least some of these questions and then takes them further down the journey, okay, here's the problem.

Here's a possible solution. Why don't you come in and visit the practitioner? Makes a lot of sense that that would. And then you said the other area was analytics. Right. And the, um, the biggest, um, rub on physicians, dentists, and lawyers is they're, they're really good at their art, but they don't know their numbers. They don't. And, um, the weird thing in dentistry is that the software that runs your dental office isn't connected to your accounting software. Click. So do you see, um, AI moving there in the future of analytics of your business? Absolutely. And I would say to begin with, it would, you know, the kind of lowest hanging fruit in that respect would be the DSOs and insurance companies, right?

Because these are big organizations who are trying to control or gauge the quality of their practitioners and their providers. And from what we've seen, there's a big issue with that. It's very difficult because dentistry by nature is so fragmented and so unstandardized in a lot of ways. It's, it's hard to. Kind of. Be able to give a benchmark where the practitioners are, um, good for you as a DSO or damaging for you as a DSO. And there's a big challenge that they're having to deal with in order to, um, um, you know, answer that question. An AI-perfect kind of system to be able to decipher large pieces of information that you could feed in regarding a practitioner. And then the system or the computer would say, well, here are some, you know, here are our five.

These are our five. This is the computer's findings regarding practitioners and so on. And, uh, that also extends into the actual patients. If you could gauge the likelihood of, of patients, um, uh, you know, going through successful treatment or, um, being a good, uh, clinical prospect for, for successful treatment. Um, AI would definitely be able to help in that respect, but that's definitely further down the line for us. So, so tell us what was the, the first out of the box was the ortho at, um, Cephex.com. Yeah. That was, how many, how many products do you have out now? How many? Oh, we have about, uh, I would say 10 different services. That, that you get right now on Cephex.com? Yeah. You just send a case and you get, uh.

Tell, tell them the 10. Go, go through them. Okay. So you have cephalometric analysis. You have, uh, um. The airway analysis. You have, uh, the segmentation tool, um, which is pretty much what I showed you earlier. Uh, you have the video tool. Uh, you have a panoramic, uh, creator. So it automatically takes a CVCT, creates a, the panoramic with the, uh, nerve marking. You have the Ceph, uh, from CVCT. Uh, you have the, um, STL. Uh, generation. So basically you can download a zip file with all the STL files that are generated and import them into different systems if you want to. Um, losing my count. Um, we, did I mention the implant planner? Uh, I'm not sure if that's out yet. Uh, uh, in production, we might still be.

How, um, with the world's internet capacity, how, um, hard is it to upload a CVCT? Does it vary between countries or cities? Yeah, it really depends on your internet connection. I mean, we're working tirelessly to make the process as easy and smooth as, as possible. But I mean, at the end of the day, it's just, you drag and drop the file, and it's like, you know, putting a file into Dropbox. Yeah. So, which countries is this, um, are you taking off in, uh, the most? So, uh, our largest customer base, uh, base, uh, is in the US, Canada, uh, UK of course. Australia, basically English-speaking countries. Um, but we've got customers from literally every imaginable. I mean, I don't think there's a country where we don't have a customer.

Most of the dental companies that I've talked to break up the whole world market into thirds: US, Canada, third; Europe, third; and the rest of the world, a third. Right. Um, but you were saying US, Canada, that should be a third. But then you were saying instead of Europe, you said Australia, UK. So why, why do you think more Australia, UK? Yeah, we just... Just like Europe. Um, well, firstly, for some reason it picked up well in those countries. So even, you know, we, we put very little effort into marketing. Most of our, uh, effort goes to R&D. Um, and, and we want to provide our services initially on the SAS platform, like everything online, everything internet-based, everything, um, available, not, not through channels, but rather through just online access.

So for some reason it picked up well in those countries. I would imagine just because of the English-speaking nature. Uh, but yeah, if you look at it on a, on a business level, um, probably a good way to look at it is US, Canada, Europe, and then ROW. So how long have you, so are you a programmer? Are you an AI developer? I'm, I'm, uh, my background is, uh, with technology and, uh, formed several technology companies, not only in the dental space, but in, uh, in different advertising, online advertising spaces. So I'm very well, um, my kind of natural, uh, core competencies is online. Um, and then together with my father's clinical knowledge, we put together, you know, this idea of how do we take the technology out?

We take the clinical, put it together and give a valuable service to practitioners. So all the dentists are online advertising. They're all trying to promote their practice. What did you learn from online advertising and AI? Wow. Uh, I've never mixed between, never got to deal with both of them at the same time. Uh, I know there are companies that deal with that aspect, but they're more on how to improve the platforms rather than assist the, uh, the users, right? The users want to get the most bang for their buck basically. And the platforms want to provide that to be the best and most attractive platform. So, to help the platforms provide that, they now use AI. To decipher where and what situations, um, which would be the best potential customer and so on.

Um, to provide best conversions for practitioners. So, um, Elon Musk has told everybody that, um, this is a really bad idea. How many more years before the robots take us over, kill us and say, some people say that the only purpose of a biological human being was to connect us to AI. And as soon as you're done with your iPhone has a posing thumbs that can walk. And if you think about it, it's, it's kind of true because, um, right now, um, outside of, uh, 30 miles up in the air, it's all droids. There's no, right now we have droids on Mars and we have voyagers left the solar system. Do you think that's kind of a, do you think Elon Musk is right that?

I think there's definitely, you know, we're at the brink of a revolution with regards to how, um, Computerized systems can help humanity. Um, I have no doubt about that. And I think it's going to be prevalent on all, you know, all sides of an, all different aspects of life. Um, I think they're also like, you know, there tends to be an exaggeration. People like to say interesting and kind of flamboyant statements that, uh, uh, you know, get people, get people's attention. But, uh, there's also, you know, a lot of barriers here and a lot of, uh, I, I think we're, we're. We're still far away from, uh, Skynet taking over and the Terminator coming and, uh. So what is your biggest challenge, um, in taking your company to the U.S.?

Um, the biggest challenge, um, I would say it's less about the fact that it's U.S. It's more about, uh, just the fact that we, um, are very focused on technology. Like we like the edge. We like to be light years ahead of, uh, anybody else. And, and, uh, it takes some time to educate a market. Even natural and, and immediate, uh, products, um, it takes time to explain the value and, and get the practitioners to have an aha moment. Um, so that's the biggest challenge. How do we get the practitioners to understand how beneficial this really is to their process? Um, and, you know, that's, you know, we're working on it. And I'm sure we're going to get there because what we're aiming for is that the advantage be so great that it would take very little effort to explain why it helps.

Right? If you could have automated everything, you wouldn't really have to explain why it's good for you. But not everything is automated. So you have to explain why these increments of automation already help you as a practitioner. Well, your marketing should just be, uh, think of your last thought. That's natural intelligence. Uh-huh. You know, you can only get better than that. But I think what's most exciting about your area is that, you know, cleanings, fillings, exams, x-rays, that's a very mature century-old market. I mean, it goes back to Pierre Fouchard, you know, 200 years ago. And it's, it's grows one and a half, two and a half, 3%. But the only double-digit growth in dentistry around the world is implants and ortho, clear liners and implants. And you're in both of those areas in spades.

Right. So to have a company with two feet and one's in implants and one's in clear liners, um, have, are you doing anything with the, um, the Invisaligns of the world? Oh, absolutely. There's a lot of, um, firstly, there's a lot of automation, uh, we're working on in those areas. Um, and there's a lot of kind of built-in problems with, uh, uh, meshing, uh, intraoral scans and CBCT images. Intraoral scan only gives you so much information. It impacts on the predictability, um, of the, of the treatment. So we're helping build systems that, um, give you more information and help you better, uh, create a treatment plan for your patients. So Align Technology, which owns Invisalign and iTero. Right. I noticed they wanted their own oral scanner system. Right.

And weren't excited about being open to other systems or lawsuits with 3Shape and et cetera. But is that, was that part of that challenge? Was Align Technology trying to have their own scanner to control it, to, um, make it work better? We, we kind of stay out of that game. It's not really, you know, we want to be agnostic to everything. So it doesn't matter which system you're using, which scanner you're using. We want to provide services to you as a practitioner and not you as a specific platform user. So you like to stay agnostic. Yeah, absolutely. Um, but do you, um, but is this still a challenge? Taking an oral scan and a CBCT and putting that into one? Oh, absolutely. Absolutely. It's, it's a challenge.

That's where I was going out thinking maybe Align was trying to help solve that problem. But, um, again, it's, it's a technological challenge taking two different image sets that really have nothing to do with each other. Um, and tying them together in a very easy and immediate manner. The minute you have the user, you know, you require the user to click here and click there. And learn where to click and which bells and whistles you're supposed to use. You've already reduced the amount of users that are going to interact with that drastically. And the minute you make it automatic and, you know, entirely, uh, with no human interaction and just, here it is. Just send us the images and it's, it's available immediately.

Then we believe that's the next leap of, okay, by standard, you take an image, you take a CBCT, you take an intraoral scan. You've got the whole picture. Is, um, do you think CBCT is moving in orthodontics? Is it moving towards a standard of care? I mean, you talked earlier about someone having a pano and maybe bite wings. Um, do you think in orthodontics, especially for this big clear aligner market, which is exploding because everybody wants right. Whiter, brighter, straighter, sexier smiles. Do you think CBCTs is, uh, going to be the standard of care that everyone would believe? Will 3D and 2D will fade away? I'm, I'm certain of it. Um, regardless of AI, I'm certain of it just because I see, um, the, um, I see the evolution happening, um, with regards to just the basic kind of pieces of information that CBCT provides.

There's a lot of cases where you simply cannot see, uh, what's going on with pano. And then you kind of have to guess. Um. And you need CBCT in order to, uh, to get those pieces of information. And then the next layer is AI. And I think AI will actually help, uh, CBCT become ubiquitous in, in orthodontics. Nice. Um, so, um, my gosh, like I say, I, I really, it, orthodontist is your lowest hanging fruit, right? Yeah. Orthodontics. You should write an article for OrthoTown and um or or even I don't know publish it on uh Dental Towns platform. But um this month my column was on AI. And basically to summarize the column, I said AI is on third.

And what it was was um analogy to baseball that when I um my first base hit, I was so innovated that I copied um my next door neighbor and became a dentist. Uh Ken you know I went to work with my dad who worked at a restaurant and made hamburgers and hot dogs. And then my next neighbor Kenny Anderson was a dentist. So my best idea was Kenny had a better job than my dad. So my, my first base hit was to first base dentist. And then that was in 87. And at the end of the first decade, I saw this internet thing take off, and so many people do not believe in it back then. And I, and I did it for selfish reasons that, um, I wanted to talk to other dentists.

And so we started Dental Town in 1998. And I've been, uh, that was second base for me. And that was 20 years ago. Yeah. But I told every, um, everybody. Wow. Yeah. Early. Yeah, that was early. I was five years before Facebook. They, I, I, um, came out in 1990, started, I got the idea in 1998. I hired my first programmer and got a launch in 1999, and Zuckerberg came out in 2004. And then I said, as second base, I said, you know, you know, who's on third AI. And now it's what I think is interesting is like, um, two or three years ago, I never heard anybody talking about AI on Dental Town. Right. So it's the, the new big thing in your, like say insurance companies are talking about it.

And I look at the insurance companies and I just think to me, um, they have the biggest data set. Yeah. When, when you hear Dennis arguing for hours on hours and, and usually involving alcohol, uh, what lasts longer an amalgam or a composite and they, and they don't even know the answer. And I'm sitting there thinking insurance companies are sitting on hundreds of millions of claims. And could tell you exactly what lasts longer. And then the other thing that, um, annoys me is, um, new products come out. Right. But Dennis just enters the chart. I did a composite. Well, obviously he did a composite. You know, you don't buy any mountain, but there's a lot of brands that composite. Could you imagine?

I can see a future where, um, a new product comes out and within a year AI says, you know what? This has already been tried a hundred thousand times. And it already failed. 10% in the first year. And then everybody's like, wow. So that needs to go back to the drawing board. And I, um, I was really excited when I saw that these dental insurance companies were using AI on a radiograph, which to me is laughable that when I do a root canal, when I build the insurance, the only thing they want is an X-ray just proof that I'm not a lying sociopath. Right. And I really did the X-ray. And of course they caught one that was actually a lying sociopath.

But I always thought, um, what I want to know when I sent in my X-ray is, uh, how does it look compared to everyone else's or what is my success rate? So I've been billing insurance claims to Delta of Dental of Arizona, my own state, for 32 years. And they've never once sent me back a report that said, 'How are your fillings?' last half as long as the average or. Yeah. So I, I hope the future is that the notes are okay. You did a filling, but was it what was the brand name of the filling? What was the bonding agent? It goes back to the analytics aspect of how do we take and they're challenged by, I mean, it's not like they're not trying.

They, they want it for themselves, but it's just too much information to be able to extract like crucial bits of, of data that help you, you know, come to your conclusion. So, um, so definitely there's going to be an improvement. And AI is going to contribute in that area. Last question. We all have, uh, we all have kids. I have four kids, five grandkids. Um, if AI is going to be the next internet, you know, it's going to change the world in a big way. So does that usually mean go to school and learn how to program in Python? Is that the, what was that movie where he said, uh, what was that movie where he kept giving everybody the secret? It was like cement or what was that movie?

We're fiber cement. Anyway, uh, is, is Python the future? Well, I wouldn't say it's not a specific language. It's a discipline. And, uh, the, um, the academic world is definitely gravitating towards providing more and more courses in that discipline of AI. Um, it doesn't really matter if it's specific, but Python is just like an easy, uh, very available language, but there are many others. Is Python like the HTTP one? Well, it was for the, when the internet came out, everybody was going to learn HTTP. No, no, no, no, no. It's not in that way. It's just has a lot of very available libraries that you can use to do shortcuts, um, to get to the results that you want to do.

Um, but it's not, uh, HTTP was more like, uh, how do we make it available for anybody who doesn't even know programming? You still have to know how to program. You still have to be kind of dedicated to the discipline and academics are pushing towards that more and more just because there's a growing need. Yeah. Now it's challenging to find, uh, um, programmers and developers in these types of languages. 10 years time, it's just going to be, you know, everybody's going to know that's going to be the basics. And let me, let me give you the, uh, historical analysis on that. I, I started, uh, Creighton University College in 1980 and my, um, career counselor guy, he's, I went to tell him I want to be a dentist.

He told me I had to sign up for either Fortran or Cobalt. I said, why do I want to take Fortran or Cobalt? He goes, he says, son, when you're my age, if you can't program Fortran or Cobalt, you'll be illiterate. And it scared me, but I wanted to take all my pre-dental recs. So I, I, I, I decided I was going to be a dentist and go, uh, uh, literate. Um, last but not least, I, I hope you, uh, comment on after my call in this month, uh, AI's on third and, um, um, and tell them what you're doing. And, um, it was just, uh, an honor to, uh, podcast you. Thank you so much. Thank you so much for meeting me today. Thank you very much.
Category: Imaging, CBCT, and Radiography
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