An Interview with Dr. Bruce Lieberthal

Inside Dental Technology (IDT): Will the refinement of digital technologies in the dental industry be more of a trend forward than new innovation?

Bruce Lieberthal, DDS (BL): Certainly, for the digital tools we currently have, I think we will see more of an evolution as opposed to revolution. We need to make these high-tech tools and equipment easier to use for the dentist and laboratory, which means making them more intuitive and less technique-sensitive, while giving them the ability to seamlessly communicate with one another.

For example, let’s take a look at intraoral digital impression technology. As good as it currently is at delivering a highly accurate impression, the technology needs to evolve into a tool the dentist feels more comfortable working with and is more intuitive to use. Dentists should be able to pick up and use these wands with minimal training to take a really excellent impression. In order for that to happen, the wands will need to get smaller, take impression scans faster, and instead of plugging into a very expensive computer board, plug into a standard USB port on a laptop.

IDT: From the laboratory perspective, the ability to receive a digital file from the operatory is highly desirable. What is being done to help speed up the adoption rate on the clinical side?

BL: This is a paradigm shift for the average dentist. Even though they know the technology is out there, there exists a great deal of confusion on the necessity of adoption, the amount of training needed, and the expenditure to replace something they perceive as working well for them. They also don’t have a clear understanding of the connection between CAD/CAM technology in the laboratory and digital impression data capture, and the benefits that data acquisition brings to the practice. Even more confusing is the rapidity with which the technology is changing and maturing.

So it is our job to help dentists make that connection through education. And who better to be ambassadors for digital technologies than the laboratories. We believe the relationship between the dentist and laboratory is very symbiotic. Dentists take much comfort in having a local laboratory that understands their preferences and services those individual preferences. So we are developing concepts that will strengthen that partnership and at the same time offer the laboratory the tools it needs to become more competitive and profitable. If the laboratory can provide clients with technologies that will give patients more accurate and cost-effective treatment and lock that dentist into exclusive use of the laboratory’s services, it’s a win-win for both.

IDT: Digital dental workflow requires a "highway" to facilitate seamless communication among all these digital tools. Where are we with its development?

BL: That "highway" already exists with our DDX web-based management software. We are heavily invested in promoting this technology because we believe that having an end-to-end communication network that all dental professionals can use will allow the industry to flourish. That’s why we have integrated the technology into virtually every lab management software product on the US market and into practice management software being used by more than 50,000 dentists in the US. We actually give away the connection components or APIs to our competitors because we want this technology to become an industry standard. It allows dentists to create a prescription, push a button, and send that digital envelope to where it needs to go in order to be processed. The software is smart enough to know what to do, when to do it, and what technology is required to do it.

It works much in the same way that ATM debit cards now work. No matter where you are in the world, you can use your debit card to access your account. At first, ATM machines were proprietary and each one would only accept its own bank-issued card. Finally, the banking industry realized that a universal network that accepted all debit cards would increase use. Banks would compete then merely on the services sent up and down that network. And so DDX is exactly that same type of platform for the digital dental workflow.

IDT: As you envision the future, what emerging technologies do you believe will impact the industry?

BL: Dentistry is changing so quickly and on so many fronts. The mouth is very much a window into the general health of the patient. Dentists in the future will become a frontline for physicians, helping to diagnose potential systemic problems based on certain markers in the patient’s soft tissue. Exciting new developments in medicine, such as telemedicine using mobile devices, robotic surgery, and implantable devices to communicate diagnostic information, will find their way to dentistry. Cloning natural dentition using tooth stem cells is another remarkable area of research that some day will allow patients to grow a new tooth, root and all, and will make implants seem archaic one day.

I envision a day when the handpiece becomes not only "smart," guiding the dentist either visually or with audio through proper tooth preparation, but is integrated with digital impression technology so that tooth preparation and impression capture are simultaneous. And devices such as the handpiece or the CAM milling unit will one day be embedded within software that communicates with a centralized computer, reporting the condition of the equipment. If the equipment needs or will soon need service, it is communicating this information to the management software and setting up a maintenance and/or service order. The possibilities for the future are endless.

About the Interview

Bruce Lieberthal, DDS, currently serves as the vice president of Emerging Technologies at Henry Schein Inc. Part of his role is leading the DDX business.