An Interview with Bernard Robichaud

Panthera Dental Cofounder Bernard Robichaud says dental laboratories can gain an advantage by becoming proficient in sleep appliances and implant dentistry.

Inside Dental Technology: What trends are you noticing in dentistry?

Bernard Robichaud: From my point of view, two major areas are emerging. Obviously, digital dentistry is one. We are seeing some really significant developments taking shape now, especially in the implant arena. The other trend is growth in the sleep disorder industry and the important role dentistry plays. General medicine has related sleep disorders to many other physical illnesses, and the dental industry is becoming heavily involved in providing a major solution.

IDT: Why is sleep apnea an important subject?

BR: Sleep apnea is related to myriad other health problems such as high blood pressure, diabetes, psychological issues, and depression. Also, social issues arise from this disorder such as marital problems, learning difficulties, and work accidents. When you do not sleep well, the day after is really difficult. Dentists have access to solutions that are more patient-friendly than the continuous positive airway pressure (CPAP) machine, which is the first treatment offered by most physicians. According to a 2008 study at the University of Pennsylvania, approximately 46% to 83% of patients refuse to wear the CPAP device or stop wearing it after the first couple months due to its bulky and/or uncomfortable design and/or an obstruction that does not allow the device to work effectively. The solution dentists can offer is small and works very well.

IDT: Where does the dental laboratory fit in with sleep apnea?

BR: The laboratory’s role is very important. After a physician diagnoses a patient with sleep apnea and consults with the dentist about an oral appliance, the question becomes: Who is going to make the appliance? This is where the laboratory plays a really important role. A sleep apnea device is worn for the patient’s lifetime. The patient and dentist need the laboratory to propose the proper device, and to facilitate modification anytime the patient returns to the clinician for treatment. The laboratory needs to be involved at every stage to facilitate proper creation of the device and to support the dentist throughout the process. Few dentists specialize in treating sleep apnea, so they need someone reliable to answer technical questions or be there for support when they need help. So the laboratory can play a key role as the technical guru advising on what to do and where to go with treatment. That role will become even more important as technology such as intraoral scanning is incorporated into the production of sleep appliances.

IDT: What do you predict for the future of the sleep market in the dental industry?

BR: We are currently living the same story as when implant dentistry was in its early stages. Right now only a few laboratories and a few dentists are qualified to provide sleep appliances. Many are hesitant about the market. However, the numbers are simple: One out of two adults snores. Do you know what the other one out of two does? He or she sleeps next to the person snoring. Sleep is going to become a huge market.

IDT: You mention implant dentistry as a major trend impacting the dental market. What business opportunities do you see on the horizon that laboratories should consider?

BR: The growth of the implant market is not stopping. Digital is gaining more momentum because of the emergence of intraoral scanning technology. We are even starting to see some companies start to discuss CBCT scans for implant dentistry. Laboratories should be aware of these and other emerging technologies. In the future, dentists will use these innovations to facilitate new approaches to quality care and service for their patients. The laboratory will need to be prepared to receive the digital files, communicate with the implant team, and use those technologies for treatment planning and restorative solutions. Laboratories also need the proper partner to support them. A laboratory can differentiate itself from others by how it can reconstruct and build trusted partnerships with the dental team.

IDT: As technology continues to evolve, what new capabilities do you anticipate when it comes to producing custom implant solutions?

BR: Digital dentistry provides access to new materials and new possibilities. New materials such as PEEK will impact the industry in much the same fashion as zirconia has done over the last 5 years. Machines and CAD software continue to evolve. Today, we can use these technologies to produce patient-specific implant bars and custom abutments. The next step is incorporating intraoral scanning into the digital workflow. Currently, we have some projects underway at Panthera Dental that will change the way we envision digital dentistry workflow, implantology, and patient treatment.