There is a fun line in the movie Shrek: Ogres are like onions because they have layers. This reminds us not to take things at face value. Consider that scary piece of technology also has layers of opportunity. When I talk to many doctors about implementing pieces of technology in their practice, there is a common theme where leveraging that capital investment falls short as a value add.
Take into consideration that the digital space offers many opportunities outside of the analog world we are used to. The layers I refer to are best explained when you think about the use of a smart phone or smart watch. If your intention with a smartphone is simply to make better phone calls, you are missing the big picture. A smart watch is also a piece of technology that is not intended to just tell time. If I wanted a timepiece, then there are probably much more elegant devices out there that do the job. The smart watch integrates apps and layers of functions that measure my heart rate, remind me to take a break to breathe, measures the number of steps I have taken, tracks my golf swing, sends me messages, links to my calls, integrates with my car, sends me reminders, and with a voice command serves as my personal assistant.
Beyond phones and watches, many of us are integrating pieces of technology in our practices. They become a means and not an end. These tools are often used as an alternative to an analog process, where the layers of benefit are often missed:
If your focus on scanning is to replace alginate or PVS impressions, then you are missing several of the benefits this technology offers. The impression is a basic benefit. We often take a digital process and integrate it to replace an analog one without implementing the added layers this equipment delivers. Most intraoral scanners offer several different add ons that build value for both practitioner and patient. The Trios scanner, for example, offers full color images in 3D, where this could replace intraoral photography. The outcome simulator Trios will be offering as well as the iOSim iTero has integrated into their device suddenly offers a layer of benefit to the patient on boarding process and treatment presentation. The digital and visual treatment presentation tool now delivers a new workflow in planning treatment, progress tracking, retention and post-tx monitoring.
I have heard that once you go 3D, you will never go back to 2D. That is clearly a benefit in a diagnostic tool. I see many doctors taking a CBCT and reconstructing 2D images to get back to our comfort zone. In that case, I can see the argument that a pan and ceph have lower doses, lower costs and similar benefits for the average patient. It’s like using that smartwatch simply to tell time. The benefits of 3D imaging expand the layers of benefits to view cases differently and open up the transverse plane, better perception of asymmetries, fewer artifacts, volumetric measurements, and a better representation of the actual patient we are treating.
Let’s tackle the obsession with aligners vs. braces, are they comparable in outcomes? As orthodontists begin to actually learn how to use this technology, and the technology improves in predictability, we start seeing the destination of both appliance systems becoming more similar and equal for some of us. If we leave it at that, then we have also missed the added layers of benefits aligner therapy systems offer to patient experience, practice efficiency, and practice growth. If you are offering aligners as an alternative to braces, then you are leaving a lot on the table and similarly using a smartwatch to tell time. Clear aligners are less about the clear part, and more about the journey. A braces practice and an aligner practice cannot operate with the same systems. The scheduling, clinical flow, CAD workflow, treatment presentation and marketing efforts are not the same. Trying to fit the round peg of aligner therapy into the square hole of brackets and wires continues to frustrate many who wonder why they can’t see beyond the high lab fee. If you are working to implement aligner therapy in your practice, don’t forget about those layers beyond the exterior.
Fixed Appliance Therapy
Let’s not forget that brackets and wires are still the most common tool used in the orthodontics today. Treatment becomes less about moving teeth, than on the layers added to the treatment experience. Orthodontists are more than just tooth movers, and we must consider how the choice of fixed appliances can save time, save office visits, change perceptions and enhance the motivation to achieve the desirable result. There are many layers of opportunity in the development of fixed appliance technology.
The integration of 3D printing still makes many rant that it is a useless digital toy that is an expensive alternative to plaster. Again, the analogy applies. If your limitation in using additive manufacturing for printing models is to replace plaster models keeps proving my point about missing the layers of benefits. Additive manufacturing will continue to disrupt the orthodontic lab industry in ways we have only started to imagine. The availability of free/cheaper software solutions, faster turn around and full control of the CAD/CAM process within the average orthodontic practice have more layers of benefits than I can put into this post. As stated above, taking this tool and making it fit into the analog process and traditional scheduling and orthodontic methodologies misses most of the benefits that add layers of value. Manufacturing in-house changes the game, period.
These are but a few of the technologies out there that I see don’t get their due acknowledgement. We keep comparing them to the traditional methodologies, where their potential to improve our specialty are not fully realized. The benefit of time is that it is a constant, and the inevitable progress will continue to move forward whether we embrace it or not. Across industries and professions, technological innovations will continue to add to the layers of benefits being offered and change the landscape.